Abstract
It is critical to protect immunocompromised patients against COVID-19 with effective SARS-CoV-2 vaccination as they have an increased risk of developing severe disease. This is challenging, however, since effective mRNA vaccination requires the successful cooperation of several components of the innate and adaptive immune systems, both of which can be severely affected/deficient in immunocompromised people. In this article, we first review current knowledge on the immunobiology of SARS-COV-2 mRNA vaccination in animal models and in healthy humans. Next, we summarize data from early trials of SARS-COV-2 mRNA vaccination in patients with secondary or primary immunodeficiency. These early clinical trials identified common predictors of lower response to the vaccine such as anti-CD19, anti-CD20 or anti-CD38 therapies, low (naive) CD4 + T-cell counts, genetic or therapeutic Bruton tyrosine kinase deficiency, treatment with antimetabolites, CTLA4 agonists or JAK inhibitors, and vaccination with BNT162b2 versus mRNA1273 vaccine. Finally, we review the first data on third dose mRNA vaccine administration in immunocompromised patients and discuss recent strategies of temporarily holding/pausing immunosuppressive medication during vaccination.
Keywords: BNT162b2; COVID-19; MRNA-1273; SARS-CoV-2; immunosuppressed; inborn errors of immunity; transplantation; vaccine.
【저자키워드】 COVID-19, SARS-CoV-2, Vaccine, mRNA-1273, BNT162b2, inborn errors of immunity, Immunosuppressed, transplantation, 【초록키워드】 Treatment, mRNA vaccination, Vaccine, vaccination, clinical trial, Trial, adaptive, mRNA vaccine, knowledge, Genetic, immunodeficiency, animal model, CD4, Immunocompromised patient, humans, mRNA1273, therapeutic, Patient, Immunocompromised, jak inhibitors, predictor, T-cell, Critical, Therapies, SARS-CoV-2 vaccination, anti-CD20, administration, dose, severe disease, tyrosine, deficiency, increased risk, anti-CD38, agonist, CTLA4, component, immune systems, Immunosuppressive medication, effective, Anti-CD19, PROTECT, healthy, the vaccine, 【제목키워드】 mRNA, clinical, response, insight, Assessing,