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Humoral and T-cell responses to SARS-CoV-2 vaccination in patients receiving immunosuppression.
Prendecki, Maria; Clarke, Candice; Edwards, Helena; McIntyre, Stacey; Mortimer, Paige; Gleeson, Sarah; Martin, Paul; Thomson, Tina; Randell, Paul; Shah, Anand; Singanayagam, Aran; Lightstone, Liz; Cox, Alison; Kelleher, Peter; Willicombe, Michelle; McAdoo, Stephen P.
  • Prendecki M; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, UK m.prendecki@imperial.ac.uk.
  • Clarke C; Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.
  • Edwards H; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, UK.
  • McIntyre S; Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.
  • Mortimer P; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, UK.
  • Gleeson S; Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.
  • Martin P; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, UK.
  • Thomson T; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, UK.
  • Randell P; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, UK.
  • Shah A; Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.
  • Singanayagam A; Centre for Inflammatory Disease, Department of Immunology and Inflammation, Imperial College London, London, UK.
  • Lightstone L; Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.
  • Cox A; Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.
  • Kelleher P; Department of Infection and Immunity, North West London Pathology NHS Trust, London, UK.
  • Willicombe M; Respiratory Medicine, Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
  • McAdoo SP; MRC Centre of Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.
Ann Rheum Dis ; 80(10): 1322-1329, 2021 10.
Article in English | MEDLINE | ID: covidwho-1346035
ABSTRACT

OBJECTIVE:

There is an urgent need to assess the impact of immunosuppressive therapies on the immunogenicity and efficacy of SARS-CoV-2 vaccination.

METHODS:

Serological and T-cell ELISpot assays were used to assess the response to first-dose and second-dose SARS-CoV-2 vaccine (with either BNT162b2 mRNA or ChAdOx1 nCoV-19 vaccines) in 140 participants receiving immunosuppression for autoimmune rheumatic and glomerular diseases.

RESULTS:

Following first-dose vaccine, 28.6% (34/119) of infection-naïve participants seroconverted and 26.0% (13/50) had detectable T-cell responses to SARS-CoV-2. Immune responses were augmented by second-dose vaccine, increasing seroconversion and T-cell response rates to 59.3% (54/91) and 82.6% (38/46), respectively. B-cell depletion at the time of vaccination was associated with failure to seroconvert, and tacrolimus therapy was associated with diminished T-cell responses. Reassuringly, only 8.7% of infection-naïve patients had neither antibody nor T-cell responses detected following second-dose vaccine. In patients with evidence of prior SARS-CoV-2 infection (19/140), all mounted high-titre antibody responses after first-dose vaccine, regardless of immunosuppressive therapy.

CONCLUSION:

SARS-CoV-2 vaccines are immunogenic in patients receiving immunosuppression, when assessed by a combination of serology and cell-based assays, although the response is impaired compared with healthy individuals. B-cell depletion following rituximab impairs serological responses, but T-cell responses are preserved in this group. We suggest that repeat vaccine doses for serological non-responders should be investigated as means to induce more robust immunological response.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Autoimmune Diseases / Immunocompromised Host / Immunogenicity, Vaccine / COVID-19 Vaccines / COVID-19 Topics: Vaccines Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Ann Rheum Dis Year: 2021 Document Type: Article Affiliation country: Annrheumdis-2021-220626

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Autoimmune Diseases / Immunocompromised Host / Immunogenicity, Vaccine / COVID-19 Vaccines / COVID-19 Topics: Vaccines Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Ann Rheum Dis Year: 2021 Document Type: Article Affiliation country: Annrheumdis-2021-220626