BNT162b2; COVID-19; MRNA-1273; SARS-CoV-2; immunosuppressed; inborn errors of immunity; transplantation; vaccine; Immunology; Immunology and Allergy
Abstract :
[en] 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.
Disciplines :
Immunology & infectious disease
Author, co-author :
BARON, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'hématologie clinique
Ariën, Kevin K; Virology Unit, Institute of Tropical Medicine Antwerp, Antwerp, Belgium ; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
Kemlin, Delphine; Department of Nephrology, Dialysis and Renal Transplantation, Hôpital Erasme, Université libre de Bruxelles, Brussels, Belgium
Gerbaux, Margaux; Institute for Medical Immunology and ULB Center for Research in Immunology (U-CRI), Université libre de Bruxelles (ULB), Gosselies, Belgium ; Department of Microbiology, Immunology and Transplantation, Laboratory of Adaptive Immunology, KU Leuven, Leuven, Belgium
BEGUIN, Yves ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'hématologie clinique
Marchant, Arnaud; Institute for Medical Immunology and ULB Center for Research in Immunology (U-CRI), Université libre de Bruxelles (ULB), Gosselies, Belgium
Humblet-Baron, Stéphanie; Department of Microbiology, Immunology and Transplantation, Laboratory of Adaptive Immunology, KU Leuven, Leuven, Belgium
Language :
English
Title :
Insights From Early Clinical Trials Assessing Response to mRNA SARS-CoV-2 Vaccination in Immunocompromised Patients.
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