Key result
A third dose of BNT162b2 or CoronaVac safely increased S-RBD IgG responses in patients with inborn errors of immunity, overcoming inadequate responses observed after 2 doses.
Why the study?
Does a 3-dose primary series of BNT162b2 or CoronaVac improve immunogenicity in patients with inborn errors of immunity?
Does a 3-dose primary series of BNT162b2 or CoronaVac improve immunogenicity in patients with inborn errors of immunity?
A 3-dose primary series of COVID-19 vaccines is required for optimal immunogenicity in patients with inborn errors of immunity.
May support third dose for better immunogenicity in inborn errors of immunity; hypothesis-generating pending RCTs on clinical outcomes.
Our study (NCT04800133) aimed to determine the safety and immunogenicity in patients with IEIs receiving a 3-dose primary series of mRNA vaccine BNT162b2 (age 12+) or inactivated whole-virion vaccine CoronaVac (age 3+) in Hong Kong, including Omicron BA.1 neutralization, in a nonrandomized manner. Intradermal vaccination was also studied. Thirty-nine patients were vaccinated, including 16 with homologous intramuscular 0.3ml BNT162b2 and 17 with homologous intramuscular 0.5ml CoronaVac. Two patients received 3 doses of intradermal 0.5ml CoronaVac, and 4 patients received 2 doses of intramuscular BNT162b2 and the third dose with intradermal BNT162b2. No safety concerns were identified. Inadequate S-RBD IgG and surrogate virus neutralization responses were found after 2 doses in patients with humoral immunodeficiencies and especially so against BA.1. Dose 3 of either vaccine increased S-RBD IgG response. T cell responses against SARS-CoV-2 antigens were detected in vaccinated IEI patients by intracellular cytokine staining on flow cytometry. Intradermal third dose vaccine led to high antibody response in 4 patients. The primary vaccination series of BNT162b2 and CoronaVac in adults and children with IEIs should include 3 doses for optimal immunogenicity.
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Leung et al. (2022) studied Inborn errors of immunity (n=39). BNT162b2 or CoronaVac was evaluated on Safety and immunogenicity (including Omicron BA.1 neutralization). A third dose of BNT162b2 or CoronaVac safely increased S-RBD IgG responses in patients with inborn errors of immunity, overcoming inadequate responses observed after 2 doses.
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