Safety and Immunogenicity After a Three-Dose SARS-CoV-2 Vaccine Schedule in Allogeneic Stem Cell Transplant Recipients

Kimura, Muneyoshi; Ferreira, Victor H; Kothari, Sagar; Pašić, Ivan; Mattsson, Jonas; Kulasingam, Vathany; Humar, Atul; Mah, Allison; Delisle, Jean-Sébastien; Ierullo, Matthew; Majchrzak-Kita, Beata; Kumar, Deepali; Hosseini-Moghaddam, Seyed M

doi:10.1016/j.jtct.2022.07.024

Cited by 34 publications

(65 citation statements)

References 32 publications

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“…Moreover, in all patients and controls, a subset of T cells was demonstrated to be capable of polyfunctionality, concomitantly producing two or three of the cytokines tested: IFN-γ, TNF-α and IL-2, respectively. This again is in line with the report of Kimura et al [16], mentioned above, where a positive CD4+ T-cell response was observed in 55-80% of allo-HSCT recipients (varying based on functionality) while frequencies of CD4+ polyfunctional T cells significantly increased after the third dose. Relationships between the levels of T-cell subset responses (CD4+ and CD8+), viral clearance kinetics and asymptomatic or paucisymptomatic control of SARS-CoV-2 infection are not well-defined and the reasons are multifaceted.…”

Section: Discussionsupporting

confidence: 92%

“…Of note, 85% of these patients were shown to have also developed a specific T-cell response evidenced by the detection of IFN-γ-secreting cells upon stimulation with SARS-CoV-2 spike peptides. Again, this is in line with the results provided by Kimura et al after one booster, where a positive T-cell response was documented in around 80% of 20 allo-HSCT patients [16]. Similarly, the proportion of patients with positive T cells did not vary much between the third and fourth doses.…”

Section: Discussionsupporting

confidence: 90%

“…Finally, no GVHD reactivation has been observed after V3 or V4 vaccines in our cohort, better even than the results shown by Kimura et al [16] where the incidence of new onset of acute GVHD was only 5.4% and worsening of pre-existing acute GVHD was 1.4% after three doses of the vaccine.…”

Section: Discussioncontrasting

confidence: 57%

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Strong SARS-CoV-2 T-Cell Responses after One or Two COVID-19 Vaccine Boosters in Allogeneic Hematopoietic Stem Cell Recipients

Clémenceau

Bourgeois

Guillaume

et al. 2022

Cells

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A full exploration of immune responses is deserved after anti-SARS-CoV-2 vaccination and boosters, especially in the context of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Although several reports indicate successful humoral responses in such patients, the literature is scarce on cellular specific immunity. Here, both B- (antibodies) and T-cell responses were explored after one (V3 n = 40) or two (V4 n = 12) BNT162b2 mRNA vaccine boosters in 52 allo-HSCT recipients at a median of 755 days post-transplant (<1 year n = 9). Results were compared with those of 12 controls who had received only one booster (BNT162b2 n = 6; mRNA-1273 n = 6). All controls developed protective antibody levels (>250 BAU/mL) and anti-spike T-cell responses. Similarly, 81% of the patients developed protective antibody levels, without difference between V3 and V4 (82.5% vs. 75%, p = 0.63), and 85% displayed T-cell responses. The median frequency of anti-spike T cells did not differ either between controls or the whole cohort of patients, although it was significantly lower for V3 (but not V4) patients. COVID-19 infections were solely observed in individuals having received only one booster. These results indicate that four vaccine injections help to achieve a satisfactory level of both humoral and cellular immune protection in allo-HSCT patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

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Strong SARS-CoV-2 T-Cell Responses after One or Two COVID-19 Vaccine Boosters in Allogeneic Hematopoietic Stem Cell Recipients

Clémenceau

Bourgeois

Guillaume

et al. 2022

Cells

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“…As in our previous study, there were no severe adverse events in this study ( > grade 3). Kimura et al mentioned a 5.4% incidence of GVHD induction or worsening after the third vaccine, 12 which we did not experience in our cohort. This difference might be associated with our exclusion of acute and chronic GVHD patients, ethnicity and number of patients.…”

Section: Discussioncontrasting

confidence: 59%

“…6 Regarding the third vaccination, Kimura et al reported that 89% of allogeneic HSCT patients obtained seroconversion after the third dose of vaccine. 12 They pointed out that chronic kidney disease, haploidentical donor status, and median lymphocyte counts at the third dose were significantly associated with suboptimal antibody response. In our study, 21/22 (95%) patients achieved seroconversion after a third dose of vaccination.…”

Section: Discussionmentioning

confidence: 99%

A Third Dose COVID-19 Vaccination in Allogeneic Hematopoietic Stem Cell Transplantation Patients

Watanabe

Yakushijin

Funakoshi

et al. 2022

Preprint

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We previously reported that a second dose of COVID-19 mRNA vaccine was safe and effective for allogeneic hematopoietic stem cell transplantation (HSCT) patients. However, some of these patients did not achieve seroconversion. Here, we investigated the safety and efficacy of a third dose of COVID-19 mRNA vaccine in Japanese allogeneic HSCT patients. Antibody titers against the S1 spike protein were measured using the QuaResearch COVID-19 Human IgM IgG ELISA kit. The previous study included 25 allogeneic HSCT patients who received two doses of COVID-19 mRNA vaccine. Following the exclusion of three patients because of the development of COVID-19 (n = 2) and loss to follow-up (n = 1), the study evaluated 22 allogeneic HSCT patients who received a third dose of COVID19 mRNA vaccine (BNT162b2 [n = 15] and mRNA1273 [n = 7]). Median age at the time of the first vaccination was 56 (range, 23-71) years. Median time from HSCT to the third vaccination and from the second to the third vaccination was 1842 (range, 378-4279) days and 219 (range, 194-258) days, respectively. Five patients were receiving immunosuppressants at the third vaccination, namely calcineurin inhibitors (CI) alone (n = 1), steroids alone (n = 2), or CI combined with steroids (n = 2). Median optical density of S1 IgG titers before and after the third dose was 0.099 (range, 0.001-0.713) and 1.315 (range, 0.006-1.730), respectively. Among 22 evaluable patients, 21 (95%) seroconverted after the third dose. Four of the five patients treated with steroids or CI seroconverted after the third vaccination. One patient with a serum IgG level of 173 mg/dL who received steroids did not achieve seroconversion. On one-week follow-up, none of our patients had > grade 3 or serious adverse events, new onset graft versus host disease (GVHD), or GVHD exacerbation after vaccination. The most frequent adverse event was mild pain at the injection site. A third dose of the BNT162b2 and mRNA-1273 COVID-19 vaccines was safe and effective for allogeneic HSCT patients.

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Safety and immunogenicity of a third dose of mRNA‐1273 vaccine among cancer patients

Giuliano

Kuter

Pilon‐Thomas

et al. 2023

Cancer Communications

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Background: Compared to the general population, cancer patients are at higher risk of morbidity and mortality following SARS-CoV-2 infection. The immune response to a two-dose regimen of mRNA vaccines in cancer patients is generally lower than in immunocompetent individuals. Booster doses may meaningfully augment immune response in this population. We conducted an observational study with the primary objective of determining the immunogenicity of vaccine dose three (100 μg) of mRNA-1273 among cancer patients and a secondary objective of evaluating safety at 14 and 28 days. Methods: The mRNA-1273 vaccine was administered ∼7 to 9 months after administering two vaccine doses (i.e., the primary series). Immune responses (enzyme-linked immunosorbent assay [ELISA]) were assessed 28 days post-dose three. Adverse events were collected at days 14 (± 5) and 28 (+5) post-dose three.

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Safety and Immunogenicity After a Three-Dose SARS-CoV-2 Vaccine Schedule in Allogeneic Stem Cell Transplant Recipients

Cited by 34 publications

References 32 publications

Strong SARS-CoV-2 T-Cell Responses after One or Two COVID-19 Vaccine Boosters in Allogeneic Hematopoietic Stem Cell Recipients

Strong SARS-CoV-2 T-Cell Responses after One or Two COVID-19 Vaccine Boosters in Allogeneic Hematopoietic Stem Cell Recipients

A Third Dose COVID-19 Vaccination in Allogeneic Hematopoietic Stem Cell Transplantation Patients

Safety and immunogenicity of a third dose of mRNA‐1273 vaccine among cancer patients

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