Extending the dosing interval of COVID-19 vaccination leads to higher rates of seroconversion in people living with HIV

Front Immunol. 2023 Mar 2:14:1152695. doi: 10.3389/fimmu.2023.1152695. eCollection 2023.

Abstract

Introduction: Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is an effective way of protecting individuals from severe coronavirus disease 2019 (COVID-19). However, immune responses to vaccination vary considerably. This study dynamically assessed the neutralizing antibody (NAb) responses to the third dose of the inactivated COVID-19 vaccine administered to people living with human immunodeficiency virus (HIV; PLWH) with different inoculation intervals.

Methods: A total of 171 participants were recruited: 63 PLWH were placed in cohort 1 (with 3-month interval between the second and third doses), while 95 PLWH were placed in cohort 2 (with 5-month interval between the second and third doses); 13 individuals were enrolled as healthy controls (HCs). And risk factors associated with seroconversion failure after vaccination were identified via Cox regression analysis.

Results: At 6 months after the third vaccination, PLWH in cohort 2 had higher NAb levels (GMC: 64.59 vs 21.99, P < 0.0001) and seroconversion rate (68.42% vs 19.05%, P < 0.0001). A weaker neutralizing activity against the SARSCoV-2 Delta variant was observed (GMT: 3.38 and 3.63, P < 0.01) relative to the wildtype strain (GMT: 13.68 and 14.83) in both cohorts. None of the participants (including HCs or PLWH) could mount a NAb response against Omicron BA.5.2. In the risk model, independent risk factors for NAb seroconversion failure were the vaccination interval (hazed ration [HR]: 0.316, P < 0.001) and lymphocyte counts (HR: 0.409, P < 0.001). Additionally, PLWH who exhibited NAb seroconversion after vaccination had fewer initial COVID-19 symptoms when infected with Omicron.

Discussion: This study demonstrated that the third vaccination elicited better NAb responses in PLWH, when a longer interval was used between vaccinations. Since post-vaccination seroconversion reduced the number of symptoms induced by Omicron, efforts to protect PLWH with risk factors for NAb seroconversion failure may be needed during future Omicron surges.

Clinical trial registration: https://beta.clinicaltrials.gov/study/NCT05075070, identifier NCT05075070.

Keywords: dosing interval; inactivated COVID-19 vaccination; neutralizing antibody; people living with HIV; seroconversion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Neutralizing
  • COVID-19 Vaccines
  • COVID-19* / prevention & control
  • HIV
  • HIV Infections*
  • Humans
  • SARS-CoV-2
  • Seroconversion
  • Vaccination

Substances

  • COVID-19 Vaccines
  • Antibodies, Neutralizing

Supplementary concepts

  • SARS-CoV-2 variants

Associated data

  • ClinicalTrials.gov/NCT05075070

Grants and funding

This research was supported by grants from the Infectious Diseases of Hangzhou Medical Key Subject, Key Programs of Hangzhou Bureau of Science and Technology (202204A02), Hangzhou Biomedicine and Health Industry Development Project (2022WJCY174), Guidance Programs of Hangzhou Bureau of Science and Technology (20211231Y050), Medical Science and Technology Project of Hangzhou (A20210014) and Medical Science and Technology Project of Zhejiang Province (2023KY196 and 2023KY978).