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Vaccination in PADs.

Cinzia Milito¹, Valentina Soccodato¹, Giulia Collalti¹

¹Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy.

|July 2, 2021

Summary

Primary antibody deficiencies (PADs), the most common primary immunodeficiencies, impact humoral immunity. Vaccination strategies vary, with inactivated vaccines recommended and live attenuated vaccines cautioned against in PAD patients.

Keywords:

antibody deficiency immunization immunodeficiency vaccination recommendations

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Area of Science:

Immunology
Vaccinology
Clinical Medicine

Background:

Primary antibody deficiencies (PADs) are the most common primary immunodeficiencies (PIDs).
PADs encompass various conditions including agammaglobulinemia, CVID, and specific antibody deficiencies.
Vaccination plays a crucial role in managing PADs, offering therapeutic, diagnostic, and prognostic benefits.

Purpose of the Study:

To review the role and safety of different vaccine types in patients with primary antibody deficiencies.
To discuss current recommendations for vaccination in PAD patients, including COVID-19 vaccines.
To highlight the importance of tailored vaccination strategies based on immunodeficiency type and vaccine characteristics.

Main Methods:

Literature review of vaccination strategies in primary immunodeficiencies.
Analysis of vaccine classifications (live attenuated, inactivated, mRNA, vector).
Examination of European Medicines Agency (EMA) and European Society for Immunodeficiencies (ESID) recommendations.

Main Results:

Inactivated vaccines can be administered to PAD patients, though protective responses may be limited.
Live attenuated vaccines are generally not recommended for individuals with major antibody deficiencies.
COVID-19 vaccinations are recommended for PAD patients per ESID guidelines, despite limited specific safety and efficacy data.

Conclusions:

Vaccination is a key component of PAD management, requiring careful selection of vaccine types.
Inactivated and mRNA vaccines are generally considered safer options for PAD patients.
Further research is needed to establish definitive safety and efficacy data for various vaccines in PAD populations.