key: cord-0031250-zeaa3iev
authors: Connolly, Caoilfhionn M.; Paik, Julie J.
title: SARS-CoV-2 vaccination in the immunocompromised host
date: 2022-05-12
journal: J Allergy Clin Immunol
DOI: 10.1016/j.jaci.2022.05.001
sha: 4fcb83ab2249bfa1a5f2a1140cfdbf1da9490766
doc_id: 31250
cord_uid: zeaa3iev

nan

immunodeficiency secondary to immunosuppressive therapies (such as solid organ transplant 23 recipients [SOTRs] , autoimmune diseases or hematological malignancy) and persons with 24 poorly controlled human immunodeficiency virus (PWH) are at increased risk of infections 25 due to impaired host defenses. Vaccination is a critical measure to reduce preventable 26 infections among this vulnerable patient population. Immunocompromised patients were 27 largely excluded from the original SARS-CoV-2 vaccine trials, and while international 28 efforts have attempted to address the resultant data deficit, many questions remain. Herein, 29

we review currently available data on the safety and efficacy of SARS-CoV-2 vaccination, as 30 well potential strategies to optimize protection in the immunocompromised host. 

general population (5) . As new variants of concern (VOC) emerge, antibody quality, as well 52 as quantity has become an important factor. 53 54 While SARS-CoV-2 vaccination induces seroconversion and robust antibody responses 55 among most immunocompetent patients, rates of seroconversion are lower in many 56 immunocompromised patients, particularly those with IEI and SOTRs (3,4,6). Notably, PWH 57 with well controlled disease appear to respond similarly to the general population (2) . 58

Lymphocyte-depleting agents such as anti-CD20 therapies (e.g. rituximab), anti-T cell 59 stimulators (e.g. belatacept) and certain anti-metabolites (e.g. mycophenolate mofetil), with 60 resultant B-cell incompetence, are the primary immunosuppressive therapies associated with 61 an attenuated antibody response following vaccination (3,6) ( Figure) . There is also 62 accumulating evidence that the intensity of immunosuppressive regimen, as well as 63 mechanism, is important in blunting the vaccine response. These 

Safety and antibody response to two-dose SARS-COV-2 messenger RNA 176 vaccination in persons with HIV

Immunogenicity and tolerability of COVID-19 messenger RNA vaccines in primary 179 immunodeficiency patients with functional B-cell defects

Response to 182 additional COVID-19 vaccine doses in people who are immunocompromised: a rapid 183 review

Correlates of 186 protection against symptomatic and asymptomatic SARS-CoV-2 infection

Immunosuppression on the Immunogenicity of mRNA Vaccines to SARS-CoV-2 : A 190

Postvaccination 192 antibody titres predict protection against COVID-19 in patients with autoimmune

Comparison of mRNA-1273

and BNT162b2 Vaccines on Breakthrough SARS-CoV

Death During the Delta-Predominant Period

Temporary hold of mycophenolate augments humoral response to SARS-CoV-2 205 vaccination in patients with rheumatic and musculoskeletal diseases: a case series