Third BNT162b2 mRNA SARS-CoV-2 Vaccine Dose Significantly Enhances Immunogenicity in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation

Henig, Israel; Isenberg, Jonathan; Yehudai-Ofir, Dana; Leiba, Ronit; Ringelstein-Harlev, Shimrit; Ram, Ron; Avni, Batia; Amit, Odelia; Grisariu, Sigal; Azoulay, Tehila; Slouzkey, Ilana; Zuckerman, Tsila

doi:10.3390/vaccines11040775

Cited by 5 publications

(6 citation statements)

References 40 publications

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“…Based on the threshold of 1700 U/mL, considered protective against infection according to Dimeglio et al [8], 88% of patients were responders versus 90% of controls (p > 0.05). These results are consistent with those reported by other studies [9,[11][12][13][14], which reported a humoral response rate between 66% and 83% in ASCT patients who received mRNA vaccination. However, other studies reported lower quality humoral responses in ASCT patients.…”

Section: Discussionsupporting

confidence: 93%

“…Another study conducted by Chevallier et al found that the humoral response of ASCT patients was similar to that of the control group only in ASCT patients for more than 2 years [ 16 ]. Finally, in the recent study by Henig et al [ 14 ], the humoral response rates for ASCT patients vaccinated at later (>12 months), intermediate (between 6 and 12 months), or early (between 3 and 6 months) time points were 83.7%, 52.4%, and 30.7%, respectively. Notably, several other factors impacting the humoral response have been identified in the literature.…”

Section: Discussionmentioning

confidence: 97%

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Immunogenicity and Tolerance of BNT162b2 mRNA Vaccine in Allogeneic Hematopoietic Stem Cell Transplant Patients

Ben Khlil,

Zamali,

Belloumi

et al. 2024

Vaccines

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Background: Allogeneic hematopoietic stem cell transplantation (ASCT) induces acquired immunodeficiency, potentially altering vaccine response. Herein, we aimed to explore the clinical tolerance and the humoral and cellular immune responses following anti-SARS-CoV-2 vaccination in ASCT recipients. Methods: A prospective, non-randomized, controlled study that involved 43 ASCT subjects and 31 healthy controls. Humoral response was investigated using the Elecsys® test anti-SARS-CoV-2. Cellular response was assessed using the QFN® SARS-CoV-2 test. The lymphocyte cytokine profile was tested using the LEGENDplex™ HU Th Cytokine Panel Kit (12-plex). Results: Adverse effects (AE) were observed in 69% of patients, encompassing pain at the injection site, fever, asthenia, or headaches. Controls presented more side effects like pain in the injection site and asthenia with no difference in the overall AE frequency. Both groups exhibited robust humoral and cellular responses. Only the vaccine transplant delay impacted the humoral response alongside a previous SARS-CoV-2 infection. Noteworthily, controls displayed a Th1 cytokine profile, while patients showed a mixed Th1/Th2 profile. Conclusions: Pfizer-BioNTech® anti-SARS-CoV-2 vaccination is well tolerated in ASCT patients, inducing robust humoral and cellular responses. Further exploration is warranted to understand the impact of a mixed cytokine profile in ASCT patients.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 97%

Immunogenicity and Tolerance of BNT162b2 mRNA Vaccine in Allogeneic Hematopoietic Stem Cell Transplant Patients

Ben Khlil,

Zamali,

Belloumi

et al. 2024

Vaccines

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“…This suggests that additional doses of the vaccine may be beneficial in inducing a detectable antibody response in HSCT recipients who fail to respond to the initial two-dose regimen. This is in line with recent observations of the antibody response to the third vaccination [27][28][29].…”

Section: Discussionsupporting

confidence: 92%

Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis

Nikoloudis,

Neumann,

Buxhofer-Ausch

et al. 2023

Vaccines

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(1) Background: mRNA COVID-19 vaccines are effective but show varied efficacy in immunocompromised patients, including allogeneic hematopoietic stem cell transplant (HSCT) recipients. (2) Methods: A retrospective study on 167 HSCT recipients assessed humoral response to two mRNA vaccine doses, using the manufacturer cut-off of ≥7.1 BAU/mL, and examined factors affecting non-response. (3) Results: Twenty-two percent of HSCT recipients failed humoral response. Non-responders received the first vaccine a median of 10.2 (2.5–88.9) months post-HSCT versus 35.3 (3.0–215.0) months for responders (p < 0.001). Higher CD19 (B cell) counts favored vaccination response (adjusted odds ratio (aOR) 3.3 per 100 B-cells/microliters, p < 0.001), while ongoing mycophenolate mofetil (MMF) immunosuppression hindered it (aOR 0.04, p < 0.001). By multivariable analysis, the time from transplant to first vaccine did not remain a significant risk factor. A total of 92% of non-responders received a third mRNA dose, achieving additional 77% seroconversion. Non-converters mostly received a fourth dose, with an additional 50% success. Overall, a cumulative seroconversion rate of 93% was achieved after up to four doses. (4) Conclusion: mRNA vaccines are promising for HSCT recipients as early as 3 months post-HSCT. A majority seroconverted after four doses. MMF usage and low B cell counts are risk factors for non-response.

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“…The third BNT162b2 vaccine dose was reported to elevate immunogenicity in bone marrow transplantation patients [ 60 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

Response Rate of the Third and Fourth Doses of the BNT162b2 Vaccine Administered to Cancer Patients Undergoing Active Anti-Neoplastic Treatments

Agbarya,

Sarel,

Ziv-Baran

et al. 2023

Diseases

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The BNT162b2 vaccine is globally used for preventing morbidity and mortality related to COVID-19. Cancer patients have had priority for receiving the vaccine due to their diminished immunity. This study reports the response rate of administering the third and fourth vaccine doses to cancer patients receiving active anti-neoplastic treatment. A total of 142 patients received two doses of the mRNA-based BNT162b2 COVID-19 vaccine, while 76 and 25 patients received three and four doses, respectively. The efficacy of the humoral response following two vaccine doses was diminished in cancer patients, especially in the group of patients receiving chemotherapy. In a multivariate analysis, patients who received three and four BNT162b2 vaccine doses were more likely to have antibody titers in the upper tertile compared to patients who received two doses of the vaccine (odds ratio (OR) 7.62 (95% CI 1.38–42.12), p = 0.02 and 17.15 (95% CI 5.01–58.7), p < 0.01, respectively). Unlike the response after two doses, the third and fourth BNT162b2 vaccine booster doses had an increased efficacy of 95–100% in cancer patients while undergoing active treatment. This result could be explained by different mechanisms including the development of memory B cells.

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Third BNT162b2 mRNA SARS-CoV-2 Vaccine Dose Significantly Enhances Immunogenicity in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation

Cited by 5 publications

References 40 publications

Immunogenicity and Tolerance of BNT162b2 mRNA Vaccine in Allogeneic Hematopoietic Stem Cell Transplant Patients

Immunogenicity and Tolerance of BNT162b2 mRNA Vaccine in Allogeneic Hematopoietic Stem Cell Transplant Patients

Successful SARS-CoV-2 mRNA Vaccination Program in Allogeneic Hematopoietic Stem Cell Transplant Recipients—A Retrospective Single-Center Analysis

Response Rate of the Third and Fourth Doses of the BNT162b2 Vaccine Administered to Cancer Patients Undergoing Active Anti-Neoplastic Treatments

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