PDF(Pubmed)
Abstract：
UNASSIGNED: Previous studies have demonstrated that the majority of patients with an inborn error of immunity (IEI) develop a spike (S)-specific IgG antibody and T-cell response after two doses of the mRNA-1273 COVID-19 vaccine, but little is known about the response to a booster vaccination. We studied the immune responses 8 weeks after booster vaccination with mRNA-based COVID-19 vaccines in 171 IEI patients. Moreover, we evaluated the clinical outcomes in these patients one year after the start of the Dutch COVID-19 vaccination campaign.
UNASSIGNED: This study was embedded in a large prospective multicenter study investigating the immunogenicity of COVID-19 mRNA-based vaccines in IEI (VACOPID study). Blood samples were taken from 244 participants 8 weeks after booster vaccination. These participants included 171 IEI patients (X-linked agammaglobulinemia (XLA;N=11), combined immunodeficiency (CID;N=4), common variable immunodeficiency (CVID;N=45), isolated or undefined antibody deficiencies (N=108) and phagocyte defects (N=3)) and 73 controls. SARS-CoV-2-specific IgG titers, neutralizing antibodies, and T-cell responses were evaluated. One year after the start of the COVID-19 vaccination program, 334 study participants (239 IEI patients and 95 controls) completed a questionnaire to supplement their clinical data focusing on SARS-CoV-2 infections.
UNASSIGNED: After booster vaccination, S-specific IgG titers increased in all COVID-19 naive IEI cohorts and controls, when compared to titers at 6 months after the priming regimen. The fold-increases did not differ between controls and IEI cohorts. SARS-CoV-2-specific T-cell responses also increased equally in all cohorts after booster vaccination compared to 6 months after the priming regimen. Most SARS-CoV-2 infections during the study period occurred in the period when the Omicron variant had become dominant. The clinical course of these infections was mild, although IEI patients experienced more frequent fever and dyspnea compared to controls and their symptoms persisted longer.
UNASSIGNED: Our study demonstrates that mRNA-based booster vaccination induces robust recall of memory B-cell and T-cell responses in most IEI patients. One-year clinical follow-up demonstrated that SARS-CoV-2 infections in IEI patients were mild. Given our results, we support booster campaigns with newer variant-specific COVID-19 booster vaccines to IEI patients with milder phenotypes.
UNASSIGNED: This study was embedded in a large prospective multicenter study investigating the immunogenicity of COVID-19 mRNA-based vaccines in IEI (VACOPID study). Blood samples were taken from 244 participants 8 weeks after booster vaccination. These participants included 171 IEI patients (X-linked agammaglobulinemia (XLA;N=11), combined immunodeficiency (CID;N=4), common variable immunodeficiency (CVID;N=45), isolated or undefined antibody deficiencies (N=108) and phagocyte defects (N=3)) and 73 controls. SARS-CoV-2-specific IgG titers, neutralizing antibodies, and T-cell responses were evaluated. One year after the start of the COVID-19 vaccination program, 334 study participants (239 IEI patients and 95 controls) completed a questionnaire to supplement their clinical data focusing on SARS-CoV-2 infections.
UNASSIGNED: After booster vaccination, S-specific IgG titers increased in all COVID-19 naive IEI cohorts and controls, when compared to titers at 6 months after the priming regimen. The fold-increases did not differ between controls and IEI cohorts. SARS-CoV-2-specific T-cell responses also increased equally in all cohorts after booster vaccination compared to 6 months after the priming regimen. Most SARS-CoV-2 infections during the study period occurred in the period when the Omicron variant had become dominant. The clinical course of these infections was mild, although IEI patients experienced more frequent fever and dyspnea compared to controls and their symptoms persisted longer.
UNASSIGNED: Our study demonstrates that mRNA-based booster vaccination induces robust recall of memory B-cell and T-cell responses in most IEI patients. One-year clinical follow-up demonstrated that SARS-CoV-2 infections in IEI patients were mild. Given our results, we support booster campaigns with newer variant-specific COVID-19 booster vaccines to IEI patients with milder phenotypes.
摘要：
■先前的研究表明，大多数患有先天性免疫错误（IEI）的患者在两次剂量的mRNA-1273COVID-19疫苗后会产生尖峰（S）特异性IgG抗体和T细胞反应，但是对加强疫苗接种的反应知之甚少。我们研究了171名IEI患者在使用基于mRNA的COVID-19疫苗加强疫苗接种8周后的免疫反应。此外，我们在荷兰COVID-19疫苗接种活动开始一年后评估了这些患者的临床结局.
这项研究被纳入了一项大型前瞻性多中心研究，该研究调查了IEI中基于COVID-19mRNA的疫苗的免疫原性（VACOPID研究）。在加强免疫接种8周后，从244名参与者身上采集血液样本。这些参与者包括171名IEI患者(X连锁无丙种球蛋白血症(XLA;N=11)，联合免疫缺陷（CID；N=4），常见可变免疫缺陷(CVID；N=45)，孤立或未定义的抗体缺陷（N=108）和吞噬细胞缺陷（N=3））和73个对照。SARS-CoV-2特异性IgG滴度,中和抗体，和T细胞反应进行评估。COVID-19疫苗接种计划开始一年后，334名研究参与者（239名IEI患者和95名对照）完成了一份问卷，以补充他们的临床数据，重点是SARS-CoV-2感染。
■加强疫苗接种后，在所有COVID-19初始IEI队列和对照组中，S特异性IgG滴度增加，与启动方案后6个月的滴度相比。对照组和IEI队列之间的倍数增加没有差异。与启动方案后6个月相比，加强疫苗接种后的所有队列中SARS-CoV-2特异性T细胞反应也同样增加。在研究期间，大多数SARS-CoV-2感染都发生在Omicron变体占主导地位的时期。这些感染的临床过程是轻微的，尽管与对照组相比，IEI患者出现更频繁的发热和呼吸困难，并且他们的症状持续时间更长。
■我们的研究表明，在大多数IEI患者中，基于mRNA的加强疫苗接种可诱导记忆B细胞和T细胞反应的强烈回忆。一年的临床随访表明，IEI患者的SARS-CoV-2感染较轻。鉴于我们的结果,我们支持针对表型较温和的IEI患者的新型变体特异性COVID-19加强疫苗的加强运动.
这项研究被纳入了一项大型前瞻性多中心研究，该研究调查了IEI中基于COVID-19mRNA的疫苗的免疫原性（VACOPID研究）。在加强免疫接种8周后，从244名参与者身上采集血液样本。这些参与者包括171名IEI患者(X连锁无丙种球蛋白血症(XLA;N=11)，联合免疫缺陷（CID；N=4），常见可变免疫缺陷(CVID；N=45)，孤立或未定义的抗体缺陷（N=108）和吞噬细胞缺陷（N=3））和73个对照。SARS-CoV-2特异性IgG滴度,中和抗体，和T细胞反应进行评估。COVID-19疫苗接种计划开始一年后，334名研究参与者（239名IEI患者和95名对照）完成了一份问卷，以补充他们的临床数据，重点是SARS-CoV-2感染。
■加强疫苗接种后，在所有COVID-19初始IEI队列和对照组中，S特异性IgG滴度增加，与启动方案后6个月的滴度相比。对照组和IEI队列之间的倍数增加没有差异。与启动方案后6个月相比，加强疫苗接种后的所有队列中SARS-CoV-2特异性T细胞反应也同样增加。在研究期间，大多数SARS-CoV-2感染都发生在Omicron变体占主导地位的时期。这些感染的临床过程是轻微的，尽管与对照组相比，IEI患者出现更频繁的发热和呼吸困难，并且他们的症状持续时间更长。
■我们的研究表明，在大多数IEI患者中，基于mRNA的加强疫苗接种可诱导记忆B细胞和T细胞反应的强烈回忆。一年的临床随访表明，IEI患者的SARS-CoV-2感染较轻。鉴于我们的结果,我们支持针对表型较温和的IEI患者的新型变体特异性COVID-19加强疫苗的加强运动.
