Serological response after COVID-19 mRNA-1273 booster dose in immunocompromised patients, Taiwan, July to August 2021

Kuan-Yin Lin; Ming-Ju Hsieh; Sui-Yuan Chang; Si-Man Ieong; Chien-Yu Cheng; Wang-Huei Sheng; Shan-Chwen Chang

doi:10.1016/j.jfma.2022.08.017

Serological response after COVID-19 mRNA-1273 booster dose in immunocompromised patients, Taiwan, July to August 2021

J Formos Med Assoc. 2022 Dec;121(12):2438-2445. doi: 10.1016/j.jfma.2022.08.017. Epub 2022 Aug 31.

Authors

Kuan-Yin Lin¹, Ming-Ju Hsieh², Sui-Yuan Chang³, Si-Man Ieong⁴, Chien-Yu Cheng⁵, Wang-Huei Sheng⁶, Shan-Chwen Chang⁷

Affiliations

¹ Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
² Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Occupational Safety and Health Office, National Taiwan University Hospital, Taipei, Taiwan.
³ Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁴ Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan.
⁵ Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
⁶ Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan. Electronic address: whsheng@ntu.edu.tw.
⁷ Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan.

Abstract

Background: Whether immunocompromising conditions affect the immunogenicity of COVID-19 booster vaccination remains a concern, which impedes the vaccination campaign in people most vulnerable to COVID-19-associated morbidity and mortality. We aimed to evaluate the effect of immune dysfunction on immunogenicity of homologous and heterologous prime-boost COVID-19 vaccination.

Methods: Between July and August, 2021, 399 participants were randomized to receive ChAdOx1/ChAdOx1 8 weeks apart, ChAdOx1/mRNA-1273 8 weeks apart, ChAdOx1/mRNA-1273 4 weeks apart, and mRNA-1273/mRNA-1273 4 weeks apart. The anti-SARS-CoV-2 spike IgG antibody titers on the day before booster vaccination and 4 weeks after booster vaccination were compared between participants with and without immunocompromising conditions.

Results: Among ChAdOx1-primed participants, a trend of lower anti-SARS-CoV-2 spike IgG titers before booster vaccination were found in participants with autoimmune diseases (geometric means, 34.76 vs. 84.25 binding antibody units [BAU]/mL, P = 0.173), compared to those without. Participants receiving immunosuppressants and/or immunomodulators had significant lower anti-SARS-CoV-2 spike IgG titers before booster vaccination than those without (geometric means, 36.39 vs. 83.84 BAU/mL; P = 0.001). Among mRNA-1273-boosted participants, anti-SARS-CoV-2 spike IgG titers 4 weeks after booster vaccination were similar across all the strata. Participants with autoimmune diseases and receiving immunosuppressants and/or immunomodulators, had numerically lower anti-SARS-CoV-2 spike IgG titers 4 weeks after booster vaccination compared to those without (geometric means, 1474.34 vs. 1923.23 and 1590.61 vs. 1918.38 BAU/mL; P > 0.05).

Conclusion: The immunogenicity of prime vaccination with ChAdOx1 decreased by immune dysfunction, but enhanced after receiving boost vaccination with mRNA-1273. Our study results support the efficacy of mRNA-1273 booster dose among immunocompromised hosts.

Keywords: Autoimmune disease; Immunocompromised; Non-steroidal anti-inflammatory drug; Serologic response; mRNA vaccine.

Publication types

Randomized Controlled Trial

MeSH terms

2019-nCoV Vaccine mRNA-1273
Adjuvants, Immunologic
Antibodies, Viral
Autoimmune Diseases*
COVID-19* / prevention & control
Humans
Immunization, Secondary / methods
Immunocompromised Host
Immunoglobulin G
Immunosuppressive Agents
Taiwan
Vaccination

Substances

2019-nCoV Vaccine mRNA-1273
Antibodies, Viral
Immunoglobulin G
Adjuvants, Immunologic
Immunosuppressive Agents

Supplementary concepts

heterologous prime boost COVID-19 vaccination