Adrian M. Shields, Sian E. Faustini, Harriet J. Hill, Saly Al-Taei, Chloe Tanner, Fiona Ashford, Sarita Workman, Fernando Moreira, Nisha Verma, Hollie Wagg, Gail Heritage, Naomi Campton, Zania Stamataki, Mark T. Drayson, Paul Klenerman, James E. D. Thaventhiran, Shuayb Elkhalifa, Sarah Goddard, Sarah Johnston, Aarnoud Huissoon, Claire Bethune, Suzanne Elcombe, David M. Lowe, Smita Y. Patel, Sinisa Savic, Alex G. Richter, Siobhan O. Burns, the COV-AD consortium, Zahra Ahmed, Angus Best, Joanne Dasgin, Mohammad Dinally, Elena Efstathiou, Theresa McCarthy, Madeeha Hoque, Shannon Page, Timothy Plant, Zehra Suleiman, Neil Townsend, Charlotte Trinham, Sinead Walder, Hollie Bancroft, Michelle Bates, Hayley Clifford, Christopher McGee, Samuel Chee, Lucy Common, Archana Herwadkar, Karen Knowles, Maria Poulaka, Georgina Davis, Daniel Mullan, Stuart Wareham, Fatima Dhalla, Rashmi Jain, Hadeil Morsi, Nicholas Peters, Mark Gompels, Malgorzata Slowinsksa, Dan Hartland, Emily Heritage, Joe Humphreys, Deborah Hughes, Ann Ivory, Sinead Kelly, Eileen O’Grady, Archana Shajidevadas
Abstract
Patients with primary and secondary antibody deficiency are vulnerable to COVID-19 and demonstrate diminished responses following two-dose SARS-CoV-2 vaccine schedules. Third primary vaccinations have been deployed to enhance their humoral and cellular immunity.
To determine the immunogenicity of the third primary SARS-CoV-2 immunisation in a heterogeneous cohort of patients with antibody deficiency.
Participants enrolled in the COV-AD study were sampled before and after their third vaccine dose. Serological and cellular responses were determined using ELISA, live-virus neutralisation and ELISPOT assays.
Following a two-dose schedule, 100% of healthy controls mounted a serological response to SARS-CoV-2 vaccination, however, 38.6% of individuals with antibody deficiency remained seronegative. A third primary SARS-CoV-2 vaccine significantly increased anti-spike glycoprotein antibody seroprevalence from 61.4% to 76.0%, the magnitude of the antibody response, its neutralising capacity and induced seroconversion in individuals who were seronegative after two vaccine doses. Vaccine-induced serological responses were broadly cross-reactive against the SARS-CoV-2 B.1.1.529 variant of concern, however, seroprevalence and antibody levels remained significantly lower than healthy controls. No differences in serological responses were observed between individuals who received AstraZeneca ChAdOx1 nCoV-19 and Pfizer BioNTech 162b2 during their initial two-dose vaccine schedule. SARS-CoV-2 infection-naive participants who had received a heterologous vaccine as a third dose were significantly more likely to have a detectable T cell response following their third vaccine dose (61.5% vs 11.1%).
These data support the widespread use of third primary immunisations to enhance humoral immunity against SARS-CoV-2 in individuals with antibody deficiency.
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 November 2022.
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#8,755,399
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Altmetric has tracked 26,178,577 research outputs across all sources so far. This one has received more attention than most of these and is in the 66th percentile.
So far Altmetric has tracked 32,859 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.6. This one has gotten more attention than average, scoring higher than 66% of its peers.
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