Humoral and T-Cell Immune Response After 3 Doses of Messenger RNA Severe Acute Respiratory Syndrome Coronavirus 2 Vaccines in Fragile Patients : The Italian VAX4FRAIL Study
© The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases Society of America..
BACKGROUND: Patients with solid or hematological tumors or neurological and immune-inflammatory disorders are potentially fragile subjects at increased risk of experiencing severe coronavirus disease 2019 and an inadequate response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination.
METHODS: We designed a prospective Italian multicenter study to assess humoral and T-cell responses to SARS-CoV-2 vaccination in patients (n = 378) with solid tumors (ST), hematological malignancies (HM), neurological disorders (ND), and immunorheumatological diseases (ID). A group of healthy controls was also included. We analyzed the immunogenicity of the primary vaccination schedule and booster dose.
RESULTS: The overall seroconversion rate in patients after 2 doses was 62.1%. Significantly lower rates were observed in HM (52.4%) and ID (51.9%) than in ST (95.6%) and ND (70.7%); a lower median antibody level was detected in HM and ID versus ST and ND (P < .0001). Similar rates of patients with a positive SARS-CoV-2 T-cell response were found in all disease groups, with a higher level observed in ND. The booster dose improved the humoral response in all disease groups, although to a lesser extent in HM patients, whereas the T-cell response increased similarly in all groups. In the multivariable logistic model, independent predictors of seroconversion were disease subgroup, treatment type, and age. Ongoing treatment known to affect the immune system was associated with the worst humoral response to vaccination (P < .0001) but had no effect on T-cell responses.
CONCLUSIONS: Immunosuppressive treatment more than disease type per se is a risk factor for a low humoral response after vaccination. The booster dose can improve both humoral and T-cell responses.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:76 |
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| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 76(2023), 3 vom: 08. Feb., Seite e426-e438 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Corradini, Paolo [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 10.02.2023 Date Revised 20.02.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/cid/ciac404 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Corradini, Paolo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Humoral and T-Cell Immune Response After 3 Doses of Messenger RNA Severe Acute Respiratory Syndrome Coronavirus 2 Vaccines in Fragile Patients |b The Italian VAX4FRAIL Study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 10.02.2023 | ||
| 500 | |a Date Revised 20.02.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. | ||
| 520 | |a BACKGROUND: Patients with solid or hematological tumors or neurological and immune-inflammatory disorders are potentially fragile subjects at increased risk of experiencing severe coronavirus disease 2019 and an inadequate response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination | ||
| 520 | |a METHODS: We designed a prospective Italian multicenter study to assess humoral and T-cell responses to SARS-CoV-2 vaccination in patients (n = 378) with solid tumors (ST), hematological malignancies (HM), neurological disorders (ND), and immunorheumatological diseases (ID). A group of healthy controls was also included. We analyzed the immunogenicity of the primary vaccination schedule and booster dose | ||
| 520 | |a RESULTS: The overall seroconversion rate in patients after 2 doses was 62.1%. Significantly lower rates were observed in HM (52.4%) and ID (51.9%) than in ST (95.6%) and ND (70.7%); a lower median antibody level was detected in HM and ID versus ST and ND (P < .0001). Similar rates of patients with a positive SARS-CoV-2 T-cell response were found in all disease groups, with a higher level observed in ND. The booster dose improved the humoral response in all disease groups, although to a lesser extent in HM patients, whereas the T-cell response increased similarly in all groups. In the multivariable logistic model, independent predictors of seroconversion were disease subgroup, treatment type, and age. Ongoing treatment known to affect the immune system was associated with the worst humoral response to vaccination (P < .0001) but had no effect on T-cell responses | ||
| 520 | |a CONCLUSIONS: Immunosuppressive treatment more than disease type per se is a risk factor for a low humoral response after vaccination. The booster dose can improve both humoral and T-cell responses | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Fragile patients | |
| 650 | 4 | |a SARS-CoV-2 mRNA vaccine | |
| 650 | 4 | |a T-cell immunity | |
| 650 | 4 | |a humoral immunity | |
| 650 | 7 | |a COVID-19 Vaccines |2 NLM | |
| 650 | 7 | |a mRNA Vaccines |2 NLM | |
| 650 | 7 | |a RNA, Messenger |2 NLM | |
| 650 | 7 | |a Antibodies, Viral |2 NLM | |
| 700 | 1 | |a Agrati, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Apolone, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Mantovani, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Giannarelli, Diana |e verfasserin |4 aut | |
| 700 | 1 | |a Marasco, Vincenzo |e verfasserin |4 aut | |
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| 700 | 1 | |a Mantegazza, Renato |e verfasserin |4 aut | |
| 700 | 1 | |a Tagliavini, Fabrizio |e verfasserin |4 aut | |
| 700 | 1 | |a Lupo-Stanghellini, Maria Teresa |e verfasserin |4 aut | |
| 700 | 1 | |a Ciceri, Fabio |e verfasserin |4 aut | |
| 700 | 1 | |a Damian, Silvia |e verfasserin |4 aut | |
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