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Reduced Immune Response to Inactivated Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine in a Cohort of Immunocompromised Patients in Chile

2022; Oxford University Press; Volume: 75; Issue: 1 Linguagem: Inglês

10.1093/cid/ciac167

1537-6591

María Elvira Balcells, Nicole Le Corre, Josefina Durán, María Elena Ceballos, Cecilia Vizcaya, Sebastián Mondaca, Martín Dib, Ricardo Rabagliati, Mauricio Sarmiento, Paula I. Burgos, Manuel Espinoza, Marcela Ferrés, Constanza Martínez-Valdebenito, Cinthya Ruiz-Tagle, Catalina Ortiz, Patricio Ross, Sigall Budnik, Sandra Solari, María de los Ángeles Vizcaya, Hanns Lembach, Roslye V. Berríos-Rojas, Felipe Melo-González, Mariana Ríos, Alexis M. Kalergis, Susan M. Bueno, Bruno Nervi,

Vaccine Coverage and Hesitancy

Abstract Background Inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines have been widely implemented in low- and middle-income countries. However, immunogenicity in immunocompromised patients has not been established. Herein, we aimed to evaluate immune response to CoronaVac vaccine in these patients. Methods This prospective cohort study included 193 participants with 5 different immunocompromising conditions and 67 controls, receiving 2 doses of CoronaVac 8–12 weeks before enrollment. The study was conducted between May and August 2021, at Red de Salud UC-CHRISTUS, Santiago, Chile. Neutralizing antibody (NAb) positivity, total anti–SARS-CoV-2 immunoglobulin G antibody (TAb) concentrations, and T-cell responses were determined. Results NAb positivity and median neutralizing activity were 83.1% and 51.2% for the control group versus 20.6% and 5.7% (both P < .001) in the solid organ transplant group, 41.5% and 19.2% (both P < .0001) in the autoimmune rheumatic diseases group, 43.3% (P < .001) and 21.4% (P<.01 or P = .001) in the cancer with solid tumors group, 45.5% and 28.7% (both P < .001) in the human immunodeficiency virus (HIV) infection group, 64.3% and 56.6% (both differences not significant) in the hematopoietic stem cell transplant group, respectively. TAb seropositivity was also lower for the solid organ transplant (20.6%; P < .0001), rheumatic diseases (61%; P < .001), and HIV groups (70.9%; P = .003), compared with the control group (92.3%). On the other hand, the number of interferon γ spot-forming T cells specific for SARS-CoV-2 tended to be lower in all immunocompromising conditions but did not differ significantly between groups. Conclusions Diverse immunocompromising conditions markedly reduce the humoral response to CoronaVac vaccine. These findings suggest that a boosting vaccination strategy should be considered in these vulnerable patients. Clinical Trials Registration NCT04888793.