Boosting Vaccine Response in Autoimmune Rheumatic Disease Patients With Inadequate Seroconversion : An Analysis of the Immunogenicity of Vector-Based and Inactivated Vaccines

Copyright © 2024, Vijayan et al..

BACKGROUND: An additional dose of COVID-19 vaccine is being offered to vaccinated people, especially those immunocompromised. The most widely available vaccines in India are the adenoviral vector-based AZD1222 (ChAdOx1 nCoV-19) and the heat-inactivated (BBV152). This study investigated the efficacy of both vaccines in patients with autoimmune rheumatic diseases (AIRD).

OBJECTIVES:  To compare final anti-SARS-CoV-2 antibody titers, neutralization of pseudovirions by these antibodies, and T cell responses between patients of AIRD who had received the third dose of AZD1222 and BBV152 vaccines.

METHODS: Patients with stable AIRD who had completed two doses of COVID-19 vaccination but had a suboptimal response (anti-receptor binding domain (RBD) antibody<212) were randomized (1:1) to receive either AZD1222 or BBV152 as a booster dose. Patients with previous hybrid immunity or those who developed COVID-19 during the trial were excluded. Antibody titers, neutralization of Wuhan and Omicron pseudovirions, and interferon release by T cells (enzyme-linked immunosorbent spot (ELISpot)) in response to the Spike antigen were measured four weeks after this booster dose.

RESULTS: 146 were screened, 91 were randomized, and 67 were analyzed per protocol. The third dose improved antibody titers (p<0.001), neutralization of the Wuhan strain (p<0.001), and T cell interferon release (p<0.001) but not neutralization of the Omicron strain (p=0.24). Antibody titers were higher (p<0.005) after ADZ1222 boost (2,414 IU (interquartile range (IQR): 330-10,315)) than BBV1222 (347.7 IU (0.4-973)). Neutralization of the Wuhan stain was better (AZD1222: 76.6%(23.0-95.45) versus BBV152 (32.7% (0-78.9), p=0.03 by ANCOVA). Neutralization of Omicron (0 (0-28.4) vs 0 (0-4.8)) and T cell interferon release (57.0 IU (23.5-95) vs 50.5 IU (13.2-139)) were similar.

CONCLUSION: The third dose improved all parameters of immunogenicity in AIRD patients with previous inadequate responses except Omicron neutralization. The vector-based vaccine exhibits notable efficacy, particularly in antibody titers and neutralizing the Wuhan strain.

TRIAL REGISTRATION: CTRI/2021/12/038928.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:16

Enthalten in:

Cureus - 16(2024), 3 vom: 28. März, Seite e55764

Sprache:

Englisch

Beteiligte Personen:

Vijayan, Anuroopa [VerfasserIn]
Sukumaran, Aswathy [VerfasserIn]
Jones, Sara [VerfasserIn]
Paul, Aby [VerfasserIn]
Ahmed, Sakir [VerfasserIn]
Mehta, Pankti [VerfasserIn]
Mohanan, Manju [VerfasserIn]
Kumar, Santhosh [VerfasserIn]
Easwaran, Sreekumar [VerfasserIn]
Shenoy, Padmanabha [VerfasserIn]

Links:

Volltext

Themen:

Booster vaccine
Covid 19 vaccine
Heterologous vaccine
Immunocompromised patient
Immunogenicity
Journal Article

Anmerkungen:

Date Revised 09.04.2024

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.7759/cureus.55764

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370761863