Immunogenicity of an Additional mRNA-1273 SARS-CoV-2 Vaccination in People With HIV With Hyporesponse After Primary Vaccination

Abstract

Background The COVIH-study is a prospective SARS-CoV-2 vaccination study in 1154 people with HIV (PWH), of whom 14% showed a reduced or absent antibody response after primary vaccination. We evaluated whether an additional vaccination boosts immune responses in these hyporesponders. Methods Consenting hyporesponders received an additional 100µg mRNA-1273 vaccination. The primary endpoint was the increase in antibodies 28 days thereafter. Secondary endpoints were the correlation between participant characteristics and antibody response, levels of neutralizing antibodies, S-specific T-cell and B-cell responses, and reactogenicity. Results Of the 66 participants, 40 previously received two doses ChAdOx1-S, 22 two doses BNT162b2, and four a single dose Ad26.COV2.S. The median age was 63[IQR:60-66], 86% were male, pre-vaccination CD4+ T-cell count was median 650/μL[IQR:423-941] and 96% had HIV-RNA < 50 copies/mL. The mean S1-specific antibody level increased from 35 BAU/mL (95%CI:24–46) to 4317 BAU/mL (95%CI:3275–5360) post-vaccination (p < 0.0001). Of all participants, 97% showed an adequate response (>300 BAU/mL) and the 45 antibody negative participants all seroconverted (>33.8 BAU/mL). A significant increase in the proportion of PWH with detectable ancestral S-specific CD4+ T-cells (p = 0.04) and S-specific B-cells (p = 0.02) was observed. Conclusion An additional mRNA-1273 vaccination induced a robust serological response in 97% of PWH with a hyporesponse after primary vaccination.

The safety and immunogenicity of a two-dose schedule of CoronaVac, and the immune persistence of vaccination for six months, in people living with HIV: A multicenter prospective cohort study

“…The findings suggested that PLWH may need an additional booster dose on top of the two doses. In face of continuous epidemics, an additional dose of COVID-19 vaccine was proved to be effective and induced significant higher antibody levels compared with the second dose (32)(33)(34). Since PLWH have an increased risk of breakthrough infections compared to the general population, a booster dose to PLWH would be an alternative method to sustain sufficient protection.…”

Immune responses to mRNA‐based vaccines given as a third COVID‐19 vaccine dose in people living with HIV—a literature review

“…The initial search produced 772 articles, of which 323 were duplicate publications. Eight of the 449 remaining articles included studies involving measurements on the humoral immunity against SARS-CoV-2 in PLWH after a third dose of an mRNA-based COVID-19 vaccine and were eligible for inclusion in this study (9)(10)(11)(12)(13)(14)(15)(16). Five of the studies also investigated the cellular immunity (11,(13)(14)(15)(16).…”

“…Eight of the 449 remaining articles included studies involving measurements on the humoral immunity against SARS-CoV-2 in PLWH after a third dose of an mRNA-based COVID-19 vaccine and were eligible for inclusion in this study (9)(10)(11)(12)(13)(14)(15)(16). Five of the studies also investigated the cellular immunity (11,(13)(14)(15)(16). Out of the eight included studies, five were case-control studies (10)(11)(12)(13)(14) and three were case studies (9,15,16).…”

“…Five of the studies also investigated the cellular immunity (11,(13)(14)(15)(16). Out of the eight included studies, five were case-control studies (10)(11)(12)(13)(14) and three were case studies (9,15,16). A brief overview of patient and control group characteristics including HIVrelated health variables for each patient group is shown in Tables 1 and 2.…”

Effectiveness of COVID-19 primary and booster vaccination in HIV-infected individuals

“…However, although SARS-CoV-2 specific IFN-gamma production increased after the third dose, it remained significantly lower among SARS-CoV-2 naive PWH compared with HIV(À) controls [15]. In a Dutch cohort of PWH with a hypo-response after a primary vaccination regimen, an additional dose of mRNA-1273 induced a robust serological response in 64 of 66 PWH after 1 month, including neutralizing antibodies to wild-type virus, as well as T-cell responses, regardless of the primary vaccination regimen or patient characteristics [16]. A German study found that, after the second and the third vaccination, the titers of neutralizing antibodies against wild-type SARS-CoV-2 were slightly reduced in PWH compared with controls, but the reduction against Delta and Omicron variants was more pronounced.…”