Prospective Assessment of Humoral and Cellular Immune Responses to a Third COVID-19 mRNA Vaccine Dose Among Immunocompromised Individuals

作者：Ghady Haidar, Jacob C. Hodges, Andrew Bilderback, Amy Lukanski, Kelsey Linstrum, Barbara Postol, Rachel Troyan, Mary Kay Wisniewski, Lindsay Coughenour, Amy Heaps, Jana L. Jacobs, Kailey Hughes Kramer, Cynthia Klamar-Blain, Joshua B. Kohl, Wendy Liang, Benjamin B. Morris, Bernard Macatangay, Urvi M. Parikh, Michele D Sobolewksi, Christopher Musgrove, Melissa Crandall, John K. Mahon, Katie Mulvey, Kevin Collins, Adam C. King, Alan Wells, Rachel L. Zapf, Mounzer Agha, Tami Minnier, Derek C. Angus, John W. Mellors · 发表于：The Journal of Infectious Diseases · 年份：2023 · DOI：10.1093/infdis/jiad511 · 被引用次数：10 · 研究领域：SARS-CoV-2 and COVID-19 Research、COVID-19 and healthcare impacts、COVID-19 Clinical Research Studies

BACKGROUND: Improved coronavirus disease 2019 (COVID-19) prevention is needed for immunocompromised individuals. METHODS: A prospective study was performed of health care workers (HCW) and immunocompromised participants with baseline serology following 2 mRNA vaccine doses and who were retested after dose 3 (D3); multivariable regression was used to identify predictors of serological responses. IFN-γ/TNF-α T-cell responses were assessed in a subset. RESULTS: In total, 536 participants were included: 492 immunocompromised (206 solid organ transplant [SOT], 128 autoimmune, 80 hematologic malignancy [HM], 48 solid tumor, 25 HIV), and 44 HCW. D3 significantly increased spike IgG levels among all, but SOT and HM participants had the lowest median antibody levels post-D3 (increase from 0.09 to 0.83 and 0.27 to 1.92, respectively), versus HCW and persons with HIV, autoimmune conditions, and solid tumors (increases from 4.44 to 19.79, 2.9 to 15.75, 3.82 to 16.32, and 4.1 to 25.54, respectively). Seropositivity post-D3 was lowest for SOT (49.0%) and HM (57.8%), versus others (>90%). Neutralization post-D3 was lowest among SOT and HM. Predictors of lower antibody levels included low baseline levels and shorter intervals between vaccines. T-cell responses against spike increased significantly among HCW and nonsignificantly among immunocompromised individuals. CONCLUSIONS: D3 significantly improves serological but not T-cell responses among immunocompromised individuals. SOT and HM patie...