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Huang A, Cicin-Sain C, Pasin C, Epp S, Audigé A, Müller NJ, Nilsson J, Bankova A, Wolfensberger N, Vilinovszki O, Nair G, Hockl P, Schanz U, Kouyos RD, Hasse B, Zinkernagel AS, Trkola A, Manz MG, Abela IA, Müller AMS. Antibody Response to SARS-CoV-2 Vaccination in Patients Following Allogeneic Hematopoietic Cell Transplantation. Transplant Cell Ther 2022; 28:214.e1-214.e11. [PMID: 35092892 PMCID: PMC8802693 DOI: 10.1016/j.jtct.2022.01.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 01/06/2023]
Abstract
Vaccines against SARS-CoV-2 have been rapidly approved. Although pivotal studies were conducted in healthy volunteers, little information is available on the safety and efficacy of mRNA vaccines in immunocompromised patients, including recipients of allogeneic hematopoietic cell transplantation (allo-HCT). Here we used a novel assay to analyze patient- and transplantation-related factors and their influence on immune responses to SARS-CoV-2 vaccination over an extended period (up to 6 months) in a large and homogenous group of allo-HCT recipients at a single center in Switzerland. We examined longitudinal antibody responses to SARS-CoV-2 vaccination with BNT162b2 (BioNTech/Pfizer) and mRNA-1273 (Moderna) in 110 allo-HCT recipients and 86 healthy controls. Seroprofiling recording IgG, IgA, and IgM reactivity against SARS-CoV-2 antigens (receptor-binding domain, spike glycoprotein subunits S1 and S2, and nucleocapsid protein) was performed before vaccination, before the second dose, and at 1, 3, and 6 months after the second dose. Patients were stratified to 3 groups: 3 to 6 months post-allo-HCT, 6 to 12 months post-allo-HCT, and >12 months post-allo-HCT. Patients in the 3 to 6 months and 6 to 12 months post-allo-HCT groups developed significantly lower antibody titers after vaccination compared with patients in the >12 months post-allo-HCT group and healthy controls (P < .001). Within the cohort of allo-HCT recipients, patients age >65 years (P = .030), those receiving immunosuppression for prevention or treatment of graft-versus-host disease (GVHD) (P = .033), and patients with relapsed disease (P = .014) displayed low humoral immune responses to the vaccine. In contrast, the intensity of the conditioning regimen, underlying disease (myeloid/lymphoid/other), and presence of chronic GVHD had no impact on antibody levels. Antibody titers achieved the highest levels at 1 month after the second dose of the vaccine but waned substantially in all transplantation groups and healthy controls over time. This analysis of long-term vaccine antibody response is of critical importance to allo-HCT recipients and transplant physicians to guide treatment decisions regarding revaccination and social behavior during the SARS-CoV-2 pandemic.
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Affiliation(s)
- Alice Huang
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Caroline Cicin-Sain
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Chloe Pasin
- Institute of Medical Virology, University of Zurich, Switzerland; Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland
| | - Selina Epp
- Institute of Medical Virology, University of Zurich, Switzerland
| | - Annette Audigé
- Institute of Medical Virology, University of Zurich, Switzerland
| | - Nicolas J Müller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland
| | - Jakob Nilsson
- Department of Immunology, University Hospital Zurich, Switzerland
| | - Andriyana Bankova
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Nathan Wolfensberger
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Oliver Vilinovszki
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Gayathri Nair
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Philipp Hockl
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Urs Schanz
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Roger D Kouyos
- Institute of Medical Virology, University of Zurich, Switzerland; Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland
| | - Barbara Hasse
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland
| | - Annelies S Zinkernagel
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland
| | - Alexandra Trkola
- Institute of Medical Virology, University of Zurich, Switzerland
| | - Markus G Manz
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Irene A Abela
- Institute of Medical Virology, University of Zurich, Switzerland; Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland
| | - Antonia M S Müller
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland.
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Mandigny L, Lhomme E, Pasin C, Richert L, Thiébaut R. Facteurs associés à la réponse anticorps après vaccination contre le virus Ebola : revue systématique et méta-analyse. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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