Immunogenicity of COVID-19 Vaccines Among Immunocompromised Individuals

In a recent study, individuals on active immunosuppression did not demonstrate a positive response to RNA-based COVID-19 vaccines with respect to antibody production, thus supporting the continued need for these patients to be closely monitored and to be vigilant in protecting themselves from exposure to COVID-19.  These were among findings reported by researchers at the American Association of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting, held in Phoenix, Arizona, from February 25 to 28.

The presentation reported on what researchers described as a “quality improvement project” assessing antibody production in response to an RNA-based COVID-19 vaccine in immunocompromised individuals. The project’s goal was to determine the level of active immunity among these individuals so that better decisions could be made with respect to medical management.

A retrospective chart review was conducted between January and August 2021 involving 18 participants who were immunocompromised and had no history of infection with COVID-19. Among these participants, 7 had common variable immunodeficiency (CVID), 4 had specific antibody deficiency (SAD), and 7 were receiving immunosuppression for a number of reasons, including having undergone a solid organ transplant or having an autoimmune disease.

All 18 individuals had received either the Moderna (56% of participants) or the Pfizer BioNTech (44% of participants) coronavirus vaccine. All study participants had been assessed for postvaccination immunoglobulin (Ig)G antibodies against the spike protein (S1 at least 2 weeks after they had received their second vaccination.

Overall, 33.3% of the participants exhibited positive antibodies. Among individuals with SAD, 75% had positive antibodies detected; in contrast, positive antibodies were detected in only 42.9% of participants with CVID. Notably, none of the patients who were receiving active immunosuppression exhibited a positive antibody response.

The investigators concluded that the findings from this study support the continued need for close monitoring of immunocompromised participants who have been vaccinated against COVID-19 and aggressive precautions in this patient population.

Reference  

Ghannam S, Fernandez J. COVID antibody production following vaccination in immunocompromised subjects – a quality improvement project. Presented at: American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting; February 25–28, 2022; Phoenix, AZ. Abstract 195. 

This article originally appeared on Pulmonology Advisor