Characterization of the antispike IgG immune response to COVID-19 vaccines in people with a wide variety of immunodeficiencies.
Mackenzie ZendtFausto Bustos CarrilloSophie E KellyTaylor SaturdayMaureen DeGrangeAnita GinigemeLurline WuViviane CallierAna M Ortega-VillaMondreakest FaustEmma Chang-RableyKara BugalHeather KenneyPavel P KhilJung-Ho YounGloria OseiPravesh RegmiVictoria AndersonMarita BosticardoJanine DaubThomas DiMaggioSamantha KreuzburgFrancesca PalaJustina PfisterJennifer TreatJean UlrickMaria KarkanitsaHeather KalishDouglas B KuhnsDebra A Long PrielDanielle L FinkJohn S TsangRachel SparksGulbu UzelMeryl A WaldmanChrista S ZerbeOttavia Maria DelmonteJenna R E BergersonSanchita DasAlexandra F FreemanMichail S LionakisKaitlyn SadtlerNeeltje Van DoremalenVincent J MunsterLuigi Daniele NotarangeloSteven M HollandEmily E RicottaPublished in: Science advances (2023)
Research on coronavirus disease 2019 vaccination in immune-deficient/disordered people (IDP) has focused on cancer and organ transplantation populations. In a prospective cohort of 195 IDP and 35 healthy volunteers (HV), antispike immunoglobulin G (IgG) was detected in 88% of IDP after dose 2, increasing to 93% by 6 months after dose 3. Despite high seroconversion, median IgG levels for IDP never surpassed one-third that of HV. IgG binding to Omicron BA.1 was lowest among variants. Angiotensin-converting enzyme 2 pseudo-neutralization only modestly correlated with antispike IgG concentration. IgG levels were not significantly altered by receipt of different messenger RNA-based vaccines, immunomodulating treatments, and prior severe acute respiratory syndrome coronavirus 2 infections. While our data show that three doses of coronavirus disease 2019 vaccinations induce antispike IgG in most IDP, additional doses are needed to increase protection. Because of the notably reduced IgG response to Omicron BA.1, the efficacy of additional vaccinations, including bivalent vaccines, should be studied in this population.