key: cord-0829852-1dn0uo9c
authors: van Leeuwen, Leanne P.M.; GeurtsvanKessel, Corine H.; Ellerbroek, Pauline M.; de Bree, Godelieve J.; Potjewijd, Judith; Rutgers, Abraham; Jolink, Hetty; van de Veerdonk, Frank; van Gorp, Eric C.M.; de Wilt, Faye; Bogers, Susanne; Gommers, Lennert; Geers, Daryl; Bruns, Anke H.W.; Leavis, Helen L.; van Haga, Jelle W.; Lemkes, Bregtje A.; van der Veen, Annelou; de Kruijf-Bazen, S.F.J.; van Paassen, Pieter; de Leeuw, Karina; van de Ven, Annick A.J.M.; Verbeek-Menken, Petra H.; van Wengen, Annelies; Arend, Sandra M.; Ruten-Budde, Anja J.; van der Ent, Marianne W.; Martin van Hagen, P.; Sanders, Rogier W.; Grobben, Marloes; van der Straten, Karlijn; Burger, Judith A.; Poniman, Meliawati; Nierkens, Stefan; van Gils, Marit J.; de Vries, Rory D.; Dalm, Virgil A.S.H.
title: Immunogenicity of the mRNA-1273 COVID-19 vaccine in adult patients with inborn errors of immunity
date: 2022-04-11
journal: J Allergy Clin Immunol
DOI: 10.1016/j.jaci.2022.04.002
sha: 8463484f466a9f9a45167dd204ee972009054aee
doc_id: 829852
cord_uid: 1dn0uo9c

Background Patients with inborn errors of immunity (IEI) are at increased risk of severe coronavirus disease-2019 (COVID-19). Effective vaccination against COVID-19 is therefore of great importance in this group, but little is known about the immunogenicity of COVID-19 vaccines in these patients. Objectives We studied humoral and cellular immune responses after mRNA-1273 COVID-19 vaccination in adult IEI patients. Methods In a prospective, controlled, multicenter study 505 IEI patients (common variable immunodeficiency (CVID), isolated or undefined antibody deficiencies, X-linked agammaglobulinemia (XLA), combined immunodeficiency (CID), phagocyte defects) and 192 controls were included. All participants received two doses of the mRNA-1273 COVID-19 vaccine. Levels of SARS-CoV-2-specific binding antibodies, neutralizing antibodies, and T-cell responses were assessed at baseline, 28 days after first and 28 days after second vaccination. Results Seroconversion rates in patients with clinically mild antibody deficiencies and phagocyte defects were similar to healthy controls, but seroconversion rates in patients with more severe IEI, like CVID and CID, were lower. Binding antibody titers correlated well to the presence of neutralizing antibodies. T-cell responses were comparable to controls in all IEI cohorts, with the exception of CVID patients. The presence of non-infectious complications and the use of immunosuppressive drugs in CVID patients were negatively correlated with the antibody response. Conclusion COVID-19 vaccination with mRNA-1273 was immunogenic in mild antibody deficiencies and phagocyte defects and in most patients with CID and CVID. Lowest response was detected in XLA and in CVID patients with non-infectious complications. The assessment of longevity of immune responses in these vulnerable patient groups will guide decision-making for additional vaccinations.

vaccination was administered at study visit 2 (interval between vaccinations was 28 days).

Study visit 3 was scheduled 28 days after visit 2. Blood samples were collected at all visits.

Severe adverse events (SAEs) were recorded during follow-up. LLoD is 0.01 IU/ml, responder (resp) cut-off is 0.15 IU/ml (black dotted line). Number of

Antibody responses to the SARS-CoV-2 vaccine in individuals with various inborn 520 errors of immunity