Vaccination in sickle cell disease: Immunocompromised or immunocompetent?

Abstract

Sickle cell disease (SCD) is an immunocompromised condition and patients with SCD may have a reduced immune response to certain vaccinations. The report by Nakahara et al. demonstrated that SCD patients exhibited elevated and more sustained IgG production following COVID‐19 vaccination, when compared to healthy controls. This suggests that the immune response to vaccinations may vary among different types of vaccines in individuals with SCD.Commentary on: Nakahara et al. Enhanced IgG immune response to COVID‐19 vaccination in patients with sickle cell disease. Br J Haematol 2023 (Online ahead of print). doi: 10.1111/bjh.18899.

Guarding Health: A Comprehensive Review of Nosocomial Infections in Sickle Cell Anemia, a Multifaceted Approach to Prevention

“…The chronic anemia inherent in SCA and the frequent occurrence of functional asplenia in affected individuals collectively contribute to a weakened immune response. This perpetual state of immune compromise places such individuals at an elevated risk of contracting infections, exacerbating the intricate health challenges associated with SCA [ 6 ]. The relentless nature of SCA necessitates frequent hospitalizations for the management of debilitating pain, required blood transfusions, and various other medical interventions.…”

Evaluating the effectiveness of COVID-19 vaccines in adults with sickle cell disease during the Omicron period of COVID-19 pandemic

“…One crucial factor is functional asplenia, which reduces the body's ability to filter blood and increases the risk of infections from encapsulated organisms. Additionally, innate immunity through the complement system and adaptive immunity involving regulatory T-cell function and IgM-secreting memory B cells are impaired in SCD patients (4,5). This impairment of cellular immunity encompasses a decrease in the percentage of CD4+ and CD8+ T cells circulating in the bloodstream, a decrease in the ratio of CD4+ helper T cells to CD8+ suppressor T cells, and the loss of memory B cells (6).…”

“…At the time of this paper's writing, there is limited data on how well patients with SCD respond to SARS-CoV-2 vaccination. Recognizing these challenges is critical for developing tailored interventions to enhance vaccination strategies for this vulnerable population (4,7).…”