Immunogenicity of COVID-19 adsorbed inactivated vaccine (CoronaVac) and additional doses of mRNA BNT162b2 vaccine in immunocompromised adults compared with immunocompetent persons

Inactivated COVID-19 vaccines data in immunocompromised individuals are scarce. This trial assessed the immunogenicity of two CoronaVac doses and additional BNT162b2 mRNA vaccine doses in immunocompromised (IC) and immunocompetent (H) individuals. Adults with solid organ transplant (SOT), hematopoie...

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Published in:	Revista do Instituto de Medicina Tropical de São Paulo Vol. 66; pp. e24 - 16
Main Authors:	Ibrahim, Karim Yaqub, Moreira, Raquel Megale, Santos, Carolina Ferreira Dos, Strabelli, Tânia Mara Varejão, Belizário, Juliana de Cássia, Pinto, Maria Isabel de Moraes, Marinho, Ana Karolina Barreto Berselli, Pereira, Juliana Marquezi, Mello, Liliane Saraiva de, Ando, Mauricio Cesar, Silva, Vitor Gabriel Lopes da, Sato, Paula Keiko, Lima, Marcos Alves de, França, João Italo Dias, Loch, Ana Paula, Miyaji, Karina Takesaki, Infante, Vanessa, Precioso, Alexander Roberto, Sartori, Ana Marli Christovam
Format:	Journal Article
Language:	English
Published:	Brazil Instituto de Medicina Tropical de Sao Paulo 2024 Instituto de Medicina Tropical de São Paulo
Subjects:	Adult Aged Antibodies, Viral - blood BNT162 Vaccine - administration & dosage BNT162 Vaccine - immunology COVID-19 - immunology COVID-19 - prevention & control COVID-19 Vaccines - administration & dosage COVID-19 Vaccines - immunology Female Humans Immunization, Secondary Immunocompetence - immunology Immunocompromised Host - immunology Immunogenicity, Vaccine Male Middle Aged TROPICAL MEDICINE Vaccines, Inactivated - administration & dosage Vaccines, Inactivated - immunology Young Adult COVID-19 vaccines BNT162 vaccine Vaccine immunogenicity Immunocompromised host Inactivated vaccine
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Summary:	Inactivated COVID-19 vaccines data in immunocompromised individuals are scarce. This trial assessed the immunogenicity of two CoronaVac doses and additional BNT162b2 mRNA vaccine doses in immunocompromised (IC) and immunocompetent (H) individuals. Adults with solid organ transplant (SOT), hematopoietic stem cell transplant, cancer, inborn immunity errors or rheumatic diseases were included in the IC group. Immunocompetent adults were used as control group for comparison. Participants received two CoronaVac doses within a 28-day interval. IC received two additional BNT162b2 doses and H received a third BNT162b2 dose (booster). Blood samples were collected at baseline, 28 days after each dose, pre-booster and at the trial end. We used three serological tests to detect antibodies to SARS-CoV-2 nucleocapsid (N), trimeric spike (S), and receptor binding domain (RBD). Outcomes included seroconversion rates (SCR), geometric mean titers (GMT) and GMT ratio (GMTR). A total of 241 IC and 100 H adults participated in the study. After two CoronaVac doses, IC had lower SCR than H: anti-N, 33.3% vs 79%; anti-S, 33.8% vs 86%, and anti-RBD, 48.5% vs 85%, respectively. IC also showed lower GMT than H: anti-N, 2.3 vs 15.1; anti-S, 58.8 vs 213.2 BAU/mL; and anti-RBD, 22.4 vs 168.0 U/mL, respectively. After the 3rd and 4th BNT162b2 doses, IC had significant anti-S and anti-RBD seroconversion, but still lower than H after the 3rd dose. After boosting, GMT increased in IC, but remained lower than in the H group. CoronaVac two-dose schedule immunogenicity was lower in IC than in H. BNT162b2 heterologous booster enhanced immune response in both groups.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	1678-9946 0036-4665 1678-9946
DOI:	10.1590/S1678-9946202466024