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Immunogenicity of Pfizer-BioNTech COVID-19 vaccine in patients with inborn errors of immunity - 03/09/21

Doi : 10.1016/j.jaci.2021.05.029 
David Hagin, MD, PhD a, , Tal Freund, MSc, MBA a, , Michal Navon, BMSc b, , Tami Halperin, PhD c, Dikla Adir, MD a, Rotem Marom, MSc c, Inbar Levi, BSc c, Shira Benor, MD a, Yifat Alcalay, PhD a, Natalia T. Freund, PhD b, ,
a Allergy and Clinical Immunology Unit, Department of Medicine, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 
b Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 
c Laboratory for HIV Diagnosis, the AIDS Center, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 

Corresponding author: David Hagin, MD, PhD, Allergy and Clinical Immunology Unit, Department of Medicine, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Israel 6 Weizmann St, Tel Aviv, 6423906, Israel.Allergy and Clinical Immunology UnitDepartment of Medicine, Tel Aviv Sourasky Medical Center and Sackler Faculty of MedicineTel Aviv UniversityIsrael 6 Weizmann StTel Aviv6423906Israel∗∗Natalia T. Freund, PhD, Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.Department of Clinical Microbiology and ImmunologySackler Faculty of MedicineTel Aviv UniversityTel Aviv6997801Israel

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Abstract

Background

In mid-December 2020, Israel started a nationwide mass vaccination campaign against coronavirus disease 2019 (COVID-19). In the first few weeks, medical personnel, elderly citizens, and patients with chronic diseases were prioritized. As such, patients with primary and secondary immunodeficiencies were encouraged to receive the vaccine. Although the efficacy of RNA-based COVID-19 vaccines has been demonstrated in the general population, little is known about their efficacy and safety in patients with inborn errors of immunity (IEI).

Objective

Our aim was to evaluate the humoral and cellular immune response to COVID-19 vaccine in a cohort of patients with IEI.

Methods

A total of 26 adult patients were enrolled, and plasma and peripheral blood mononuclear cells were collected from them 2 weeks following the second dose of Pfizer-BioNTech COVID-19 vaccine. Humoral response was evaluated by testing anti–SARS-CoV-2 spike (S) receptor-binding domain and antinucleocapsid antibody titers and evaluating neutralizing ability by inhibition of receptor-binding domain–angiotensin-converting enzyme 2 binding. Cellular immune response was evaluated by using ELISpot, estimating IL-2 and IFN-γ secretion in response to pooled SARS-CoV-2 S- or M-peptides.

Results

Our cohort included 18 patients with a predominantly antibody deficiency, 2 with combined immunodeficiency, 3 with immune dysregulation, and 3 with other genetically defined diagnoses. Twenty-two of them were receiving immunoglobulin replacement therapy. Of the 26 patients, 18 developed specific antibody response, and 19 showed S-peptide–specific T-cell response. None of the patients reported significant adverse events.

Conclusion

Vaccinating patients with IEI is safe, and most patients were able to develop vaccine-specific antibody response, S-protein–specific cellular response, or both.

El texto completo de este artículo está disponible en PDF.

Key words : Inborn errors of immunity, IEI, primary immunodeficiency disorders, PIDD, SARS-CoV-2, COVID-19, vaccine, Pfizer-BioNTech, CVID, XLA, NFKB1, STAT1-GOF, STAT3-LOF, HIES, inhibiting antibodies

Abbreviations used : ACE2, ALPS, anti-N, anti-S, AU, AUC, CID, COVID-19, CVID, IEI, IVIG, NF-κB1, NFKB1-HI, RBD, SARS-CoV-2, STAT, STAT1-GOF, XLA


Esquema


 Supported by the Israel Science Foundation (grants 41222/18 and 3711/20 [to N.T.F.]), the Dahlia Greidinger Cancer Fund (to N.T.F.), a Marguerite Stolz Fellowship (N.T.F.), The Campbell Foundation for AIDS Research (to N.T.F.), and the Alrov Foundation (to D.H.).
 Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.


© 2021  American Academy of Allergy, Asthma & Immunology. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 148 - N° 3

P. 739-749 - septembre 2021 Regresar al número
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