Cellular and humoral immune response to SARS-CoV-2 vaccination and booster dose in immunosuppressed patients: An observational cohort study.

Abstract

BACKGROUND:

Humoral and cellular immune responses to SARS-CoV-2 vaccination among immunosuppressed patients remain poorly defined, as well as variables associated with poor response.

METHODS:

We performed a retrospective observational cohort study at a large Northern California healthcare system of infection-naïve individuals fully vaccinated against SARS-CoV-2 (mRNA-1273, BNT162b2, or Ad26.COV2.S) with clinical SARS-CoV-2 interferon gamma release assay (IGRA) ordered between January through November 2021. Humoral and cellular immune responses were measured by anti-SARS-CoV-2 S1 IgG ELISA (anti-S1 IgG) and IGRA, respectively, following primary and/or booster vaccination.

RESULTS:

496 immunosuppressed patients (54% female; median age 50 years) were included. 62% (261/419) of patients had positive anti-S1 IgG and 71% (277/389) had positive IGRA after primary vaccination, with 20% of patients having a positive IGRA only. Following booster, 69% (81/118) had positive anti-S1 IgG and 73% (91/124) had positive IGRA. Factors associated with low humoral response rates after primary vaccination included anti-CD20 monoclonal antibodies (P < 0.001), sphingosine 1-phsophate (S1P) receptor modulators (P < 0.001), mycophenolate (P = 0.002), and B cell lymphoma (P = 0.004); those associated with low cellular response rates included S1P receptor modulators (P < 0.001) and mycophenolate (P < 0.001). Of patients who had poor humoral response to primary vaccination, 35% (18/52) developed a significantly higher response after the booster. Only 5% (2/42) of patients developed a significantly higher cellular response to the booster dose compared to primary vaccination.

CONCLUSIONS:

Humoral and cellular response rates to primary and booster SARS-CoV-2 vaccination differ among immunosuppressed patient groups. Clinical testing of cellular immunity is important in monitoring vaccine response in vulnerable populations.

• Authors: Lu M Yang, Cristina Costales, Muthukumar Ramanathan, Philip L Bulterys, Kanagavel Murugesan, Joseph Schroers-Martin, Ash A Alizadeh, Scott D Boyd, Janice M Brown, Kari C Nadeau, Sruti S Nadimpalli, Aileen X Wang, Stephan Busque, Benjamin A Pinsky, Niaz Banaei
• Journal: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology (J Clin Virol) Vol. 153 Pg. 105217 (08 2022) ISSN: 1873-5967 [Electronic] Netherlands
• PMID: 35714462 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2022. Published by Elsevier B.V.

Chemical References

• Ad26COVS1
• Antibodies, Viral
• COVID-19 Vaccines
• Immunoglobulin G
• Viral Vaccines
• BNT162 Vaccine

Topics

• Ad26COVS1
• Antibodies, Viral
• BNT162 Vaccine
• COVID-19 (prevention & control)
• COVID-19 Vaccines
• Female
• Humans
• Immunity, Humoral
• Immunoglobulin G
• Male
• Middle Aged
• Retrospective Studies
• SARS-CoV-2
• Vaccination
• Viral Vaccines