Longevity of the humoral and cellular responses after SARS-CoV-2
vaccination in immunocompromised patients
Abstract
Background Immunocompromised patients are at risk for more
severe COVID-19 infection and may have lower vaccination efficiency. In
this report, we evaluate immunogenicity one year after standard regimen
of mRNA vaccine administration in cohorts of primary or secondary
immunocompromised patients. Methods In line with National
recommendations, a third and fourth dose of the BNT162b2 (BioNTech) was
administered to five clinical groups of immunocompromised patients,
including primary immunodeficiency (PID) (n=57), people living with HIV
(PLWH) (n=27), secondary immunocompromised patients with a broad variety
of underlying rheumatologic (n=23) and homogeneous (multiple sclerosis)
neurologic (n=53) conditions and chronic kidney disease (CKD) (n=39)]
patients as well as a healthy control group (n=54). Humoral and cellular
immune responses were evaluated at pre-defined time-points up to one
year after standard vaccination. Results All PLWH and CKD
patients and almost all (98.2%) of the PID patients had measurable
antibodies 3 and 6 months after administration of the third and fourth
vaccine dose. In contrast, 53.3% and 83.3% of the neurologic and
rheumatologic patients, respectively, developed a humoral immune
response after a third and fourth vaccine dose. In contrast to the other
patient groups, all PLWH developed a cellular immune response after
administration of 4 vaccine doses. In addition, cellular immune response
was positive in 89.6%, 97.8%, 73.3% and 96.9% of the PID,
neurologic, rheumatologic and CKD patients, respectively. Unlike the
other groups, only the neurologic patient had a significantly higher
cellular immune response compared to the healthy control group.
Depending on the time point and epitopes used for cell stimulation,
significant correlations between the humoral and cellular immune
responses were observed in all patient groups, except for the neurology
patient group. Conclusion Administration of a third and fourth
vaccine dose results in retained or increased humoral and cellular
immune response in patients with acquired or inherited immune disorders.
The underlying condition, immunosuppressive treatment and/or individual
risk factors may explain delayed humoral, cellular or both immune
responses.