Abstract
Purpose: Limited data is available on the effect of COVID-19 vaccination in immunocompromised individuals. Here, we provide the results from vaccinating a single-center cohort of patients with common variable immunodeficiency (CVID).
Methods: In a prospective, open-label clinical trial, 50 patients with CVID and 90 age-matched healthy controls (HC) were analyzed for SARS-CoV-2 spike antibody (Ab) production after one or two doses of the Pfizer-BioNTech BNT162b2 mRNA vaccine. Additionally, in selected patients, SARS-CoV-2 spike-specific T-cells were assessed.
Results: A potent vaccine-induced anti-spike-specific IgG Ab response was observed in all the HC. In contrast, only 68.3% of the CVID patients seroconverted, with median titers of specific Ab being 83-fold lower than in HC. In fact, only 4/46 patients (8.6%) of patients who were seronegative at baseline reached the threshold for an optimal response (250 U/mL). Using the EUROclass definition, patients with either a reduced proportion, but not absolute counts, of switched memory B-cells or having an increased frequency of CD21 low B-cells generally generated poor vaccine responses. Overall, CVID-patients had reduced spike-specific IFN-γ positive CD4 + T cell responses 2 weeks after the second dose, compared to HC. The total CD4 and CD4 central memory cell counts correlated with humoral immunity to the vaccine.
Conclusions: CVID patients with low frequency of switched memory B-cells or an increased frequency of CD21 low B-cells according to the EUROclass definition demonstrated poor responses to Pfizer-BioNTech BNT162b2 mRNA vaccination. Cellular immune responses were significantly affected, affirming that the defect in CVID is not limited to humoral immunity.
Keywords: CD21low B-cells; COVID-19; CVID; Pfizer-BioNTech BNT162b2 mRNA vaccine; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2., CVID, CD21low B-cells, Pfizer-BioNTech BNT162b2 mRNA vaccine, 【초록키워드】 SARS-CoV-2, IgG, immune response, clinical trial, Open-label, antibody, immunodeficiency, CD4, Humoral immunity, COVID-19 vaccination, response, Patient, T-cell, threshold, patients, Pfizer-BioNTech, T cell response, seronegative, BNT162b2 mRNA vaccination, BNT162b2 mRNA, BNT162b2 mRNA vaccine, IFN-γ, SARS-CoV-2 spike, B-cell, Frequency, dose, vaccine responses, memory B-cell, immunocompromised individuals, second dose, healthy control, single-center, CD21, positive, cell count, median titer, selected, analyzed, affected, significantly, proportion, reduced, seroconverted, demonstrated, correlated, reached, the vaccine, baseline, central memory, cohort of patient, Limited, patients with CVID, SARS-CoV-2 spike-specific, were assessed, 【제목키워드】 SARS-CoV-2, Pfizer-BioNTech, BNT162b2 mRNA, CD21, variable, common, Poor, Against,