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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Response to Severe Acute Respiratory Syndrome Coronavirus 2 Initial Series and Additional Dose Vaccine in Patients With Predominant Antibody Deficiency
Journal of Allergy and Clinical Immunology: In Practice, Volume 10, No. 6, Year 2022
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Description
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with predominant antibody deficiency (PAD) is associated with high morbidity, yet data regarding the response to SARS-CoV-2 immunization in PAD patients, including additional dose vaccine, are limited. Objective: To characterize antibody response to SARS-CoV-2 vaccine in PAD patients and define correlates of vaccine response. Methods: We assessed the levels and function of anti-SARS-CoV-2 antibodies in 62 PAD patients compared with matched healthy controls at baseline, at 4 to 6 weeks after the initial series of immunization (a single dose of Ad26.COV2.S [Janssen] or two doses of BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna]), and at 4 to 6 weeks after an additional dose immunization, if received. Results: After the initial series of SARS-CoV-2 vaccination, PAD patients had lower mean anti-spike antibody levels compared with matched healthy controls (140.1 vs 547.3 U/mL; P =.02). Patients with secondary PAD (eg, B-cell depletion therapy was used) and those with severe primary PAD (eg, common variable immunodeficiency with autoinflammatory complications) had the lowest mean anti-spike antibody levels. Immune correlates of a low anti-spike antibody response included low CD4+ T helper cells, low CD19+ total B cells, and low class-switched memory (CD27+IgD/M–) B cells. In addition, a low (<100 U/mL) anti-spike antibody response was associated with prior exposure to B-cell depletion therapy, both at any time in the past (odds ratio = 5.5; confidence interval, 1.5-20.4; P =.01) and proximal to vaccination (odds ratio = 36.4; confidence interval, 1.7-791.9; P =.02). Additional dose immunization with an mRNA vaccine in a subset of 31 PAD patients increased mean anti-spike antibody levels (76.3 U/mL before to 1065 U/mL after the additional dose; P <.0001). Conclusions: Patients with secondary and severe primary PAD, characterized by low T helper cells, low B cells, and/or low class-switched memory B cells, were at risk for low antibody response to SARS-CoV-2 immunization, which improved after an additional dose vaccination in most patients. © 2022 American Academy of Allergy, Asthma & Immunology
Authors & Co-Authors
Barmettler, Sara
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard Medical School
Naranbhai, Vivek
United States, Boston
Harvard Medical School
United States, Boston
Dana-farber Cancer Institute
Dighe, Anand S.
United States, Boston
Harvard Medical School
United States, Boston
Massachusetts General Hospital
Burke, Kristin E.
United States, Boston
Massachusetts General Hospital
Blumenthal, Kimberly G.
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard Medical School
Saff, Rebecca R.
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard Medical School
Ofoman, Onosereme
United States, Boston
Massachusetts General Hospital
Berrios, Cristhian
United States, Boston
Massachusetts General Hospital
St Denis, Kerri J.
United States, Boston
Massachusetts General Hospital
Lam, Evan Christopher
United States, Boston
Massachusetts General Hospital
Gregory, David J.
United States, Boston
Massachusetts General Hospital
Iafrate, Anthony John
United States, Boston
Massachusetts General Hospital
Poznansky, Mark C.
United States, Boston
Massachusetts General Hospital
Lee, Hang
United States, Boston
Harvard Medical School
Balazs, Alejandro Benjamin
United States, Boston
Massachusetts General Hospital
Pillai, Shiv S.
United States, Boston
Harvard Medical School
United States, Boston
Massachusetts General Hospital
Farmer, Jocelyn R.
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard Medical School
Statistics
Citations: 10
Authors: 17
Affiliations: 4
Identifiers
Doi:
10.1016/j.jaip.2022.03.017
ISSN:
22132198
Research Areas
Covid
Maternal And Child Health
Study Design
Case-Control Study