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Safety and Immunogenicity of 3 Doses of BNT162b2 and CoronaVac in Children and Adults with Inborn Errors of Immunity
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  • Daniel Leung,
  • Xiaofeng Mu,
  • Jaime Rosa Duque,
  • Samuel Cheng MS,
  • Manni Wang,
  • Wenyue Zhang,
  • Yanmei Zhang,
  • Issan Tam YS,
  • Toby Lee SS,
  • Jennifer Lam HY,
  • Sau Man Chan,
  • Cheuk Hei Cheang,
  • Yuet Chung,
  • Howard Wong HW,
  • Amos Lee MT,
  • Wing Yan Li,
  • Sara Chaothai,
  • Leo Tsang CH,
  • Gilbert T Chua,
  • Kai-Ning Cheong,
  • Elaine Au,
  • Janette Kwok SY,
  • Koon Wing Chan,
  • Patrick Chong,
  • Pamela Lee,
  • Marco HK Ho,
  • Tsz Leung Lee,
  • Tu WW,
  • Malik Peiris,
  • YL Lau
Daniel Leung
The University of Hong Kong Department of Paediatrics and Adolescent Medicine

Corresponding Author:dan.leung@connect.hku.hk

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Xiaofeng Mu
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Jaime Rosa Duque
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Samuel Cheng MS
The University of Hong Kong School of Public Health
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Manni Wang
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Wenyue Zhang
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Yanmei Zhang
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Issan Tam YS
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Toby Lee SS
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Jennifer Lam HY
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Sau Man Chan
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Cheuk Hei Cheang
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Yuet Chung
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Howard Wong HW
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Amos Lee MT
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Wing Yan Li
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Sara Chaothai
The University of Hong Kong School of Public Health
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Leo Tsang CH
The University of Hong Kong School of Public Health
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Gilbert T Chua
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Kai-Ning Cheong
Hong Kong Children’s Hospital Hong Kong China
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Elaine Au
Queen Mary Hospital
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Janette Kwok SY
Queen Mary Hospital
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Koon Wing Chan
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Patrick Chong
Virtus Medical Hong Kong China
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Pamela Lee
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Marco HK Ho
Virtus Medical Hong Kong China
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Tsz Leung Lee
Hong Kong Children’s Hospital Hong Kong China
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Tu WW
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Malik Peiris
The University of Hong Kong School of Public Health
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YL Lau
The University of Hong Kong Department of Paediatrics and Adolescent Medicine
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Abstract

Background Safety and immunogenicity of 3 doses of BNT162b2 and CoronaVac in adult and pediatric patients with inborn errors of immunity (IEIs) remain unknown. Intradermal vaccination may improve immunogenicity in immunocompromised patients. Our study (NCT04800133) aimed to determine the safety and immunogenicity in patients with IEIs receiving a 3-dose primary series of mRNA vaccine BNT162b2 (age 12+) or inactivated whole-virion vaccine CoronaVac (age 3+) in Hong Kong, including Omicron BA.1 neutralization, in a nonrandomized manner. Intradermal vaccination was also studied. Methods Thirty-nine patients were vaccinated, including 16 with homologous intramuscular 0.3ml BNT162b2 and 17 with homologous intramuscular 0.5ml CoronaVac. Two patients received 3 doses of intradermal 0.5ml CoronaVac, and 4 patients received 2 doses of intramuscular BNT162b2 and the third dose with intradermal BNT162b2. Adverse reactions and adverse events were tracked for 7 and 28 days after each dose. Antibody responses assessed included binding IgG antibody to wild-type (WT) spike receptor-binding domain (S-RBD IgG) and surrogate neutralization activity to WT and BA.1 viruses. T cell responses were examined by intracellular cytokine staining following stimulation with SARS-CoV-2 peptide pool(s). Results No safety concerns were identified. Inadequate antibody responses were found after 2 doses in patients with humoral immunodeficiencies and especially so against BA.1. Dose 3 of either vaccine increased S-RBD IgG response. T cell responses against SARS-CoV-2 antigens were detected in vaccinated IEI patients. Intradermal third dose vaccine led to high antibody response in 4 patients. Conclusions The primary vaccination series of BNT162b2 and CoronaVac in adults and children with IEIs should include 3 doses for optimal immunogenicity.