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Cellular and humoral immune response to SARS-CoV-2 vaccination and booster dose in immunosuppressed patients: An observational cohort study.
Yang, Lu M; Costales, Cristina; Ramanathan, Muthukumar; Bulterys, Philip L; Murugesan, Kanagavel; Schroers-Martin, Joseph; Alizadeh, Ash A; Boyd, Scott D; Brown, Janice M; Nadeau, Kari C; Nadimpalli, Sruti S; Wang, Aileen X; Busque, Stephan; Pinsky, Benjamin A; Banaei, Niaz.
  • Yang LM; Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Costales C; Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Ramanathan M; Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Bulterys PL; Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Murugesan K; Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Schroers-Martin J; Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Alizadeh AA; Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Boyd SD; Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 United States of America; Sean N. Parker Center for Allergy & Asthma Research, Stanford, CA 94305 United States of America.
  • Brown JM; Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Nadeau KC; Sean N. Parker Center for Allergy & Asthma Research, Stanford, CA 94305 United States of America; Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Nadimpalli SS; Department of Pediatrics, Division of Pediatric Infectious Diseases, Stanford University School of Medicine, Stanford CA 94305 United States of America.
  • Wang AX; Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Busque S; Department of Surgery, Division of Abdominal Transplantation, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Pinsky BA; Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 United States of America; Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA 94305 United States of America.
  • Banaei N; Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305 United States of America; Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA 94305 United States of America; Clinical Microbiology La
J Clin Virol ; 153: 105217, 2022 08.
Article in English | MEDLINE | ID: covidwho-1885897
ABSTRACT

BACKGROUND:

Humoral and cellular immune responses to SARS-CoV-2 vaccination among immunosuppressed patients remain poorly defined, as well as variables associated with poor response.

METHODS:

We performed a retrospective observational cohort study at a large Northern California healthcare system of infection-naïve individuals fully vaccinated against SARS-CoV-2 (mRNA-1273, BNT162b2, or Ad26.COV2.S) with clinical SARS-CoV-2 interferon gamma release assay (IGRA) ordered between January through November 2021. Humoral and cellular immune responses were measured by anti-SARS-CoV-2 S1 IgG ELISA (anti-S1 IgG) and IGRA, respectively, following primary and/or booster vaccination.

RESULTS:

496 immunosuppressed patients (54% female; median age 50 years) were included. 62% (261/419) of patients had positive anti-S1 IgG and 71% (277/389) had positive IGRA after primary vaccination, with 20% of patients having a positive IGRA only. Following booster, 69% (81/118) had positive anti-S1 IgG and 73% (91/124) had positive IGRA. Factors associated with low humoral response rates after primary vaccination included anti-CD20 monoclonal antibodies (P < 0.001), sphingosine 1-phsophate (S1P) receptor modulators (P < 0.001), mycophenolate (P = 0.002), and B cell lymphoma (P = 0.004); those associated with low cellular response rates included S1P receptor modulators (P < 0.001) and mycophenolate (P < 0.001). Of patients who had poor humoral response to primary vaccination, 35% (18/52) developed a significantly higher response after the booster. Only 5% (2/42) of patients developed a significantly higher cellular response to the booster dose compared to primary vaccination.

CONCLUSIONS:

Humoral and cellular response rates to primary and booster SARS-CoV-2 vaccination differ among immunosuppressed patient groups. Clinical testing of cellular immunity is important in monitoring vaccine response in vulnerable populations.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Viral Vaccines / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Female / Humans / Male / Middle aged Language: English Journal: J Clin Virol Journal subject: Virology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Viral Vaccines / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Female / Humans / Male / Middle aged Language: English Journal: J Clin Virol Journal subject: Virology Year: 2022 Document Type: Article