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Humoral and cellular response to the COVID-19 vaccine in immunocompromised children
Heather A Morgans1,2, Todd Bradley3, Linda Flebbe-Rehwaldt4
1Children's Mercy Kansas City, Kansas City, MO, 64108, USA. hamorgans@cmh.edu.
Insights
A third dose of the COVID-19 vaccine significantly boosts antibody and T-cell responses in immunocompromised children. This enhanced immune response supports the importance of a third vaccine dose for this vulnerable population.
Area of Science:
- Immunology
- Vaccinology
- Pediatrics
Background:
- Suboptimal immune response to 2-dose COVID-19 vaccination in immunocompromised individuals.
- Recommendations for a 3rd primary vaccine dose in this population.
- Need to assess immune response to the 3rd dose in pediatric immunocompromised patients.
Purpose of the Study:
- To determine the humoral and cellular immune response to a 3rd COVID-19 vaccine dose in immunocompromised children.
- To evaluate antibody and T-cell responses following the third primary dose of mRNA COVID-19 vaccine.
Main Methods:
- Prospective cohort study of 37 immunocompromised children (5-21 years old) who received 2 prior mRNA COVID-19 vaccine doses.
- Measurement of humoral and CD4/CD8 T-cell responses to SARS-CoV-2 spike antigens before and 3-4 weeks after the 3rd vaccine dose.
- Inclusion of solid organ transplant recipients as a significant subgroup.
Main Results:
- A significant increase in antibody levels was observed after the 3rd vaccine dose.
- Humoral response was detected in 86.5% after the 2nd and 3rd doses, with augmentation after the third.
- Positive T-cell responses increased from 86.5% to 100% after the 3rd vaccine dose.
Conclusions:
- The 3rd COVID-19 vaccine dose significantly augments both humoral and cellular immune responses in immunocompromised children.
- This study provides the first prospective analysis of humoral and T-cell responses to the 3rd primary vaccine dose in this pediatric group.
- Results support the clinical utility of the 3rd vaccine dose and continued emphasis on COVID-19 vaccination for immunosuppressed children.
Background:
A suboptimal response to the 2-dose COVID-19 vaccine series in the immunocompromised population prompted recommendations for a 3rd primary dose. We aimed to determine the humoral and cellular immune response to the 3rd COVID-19 vaccine in immunocompromised children.
Methods:
Prospective cohort study of immunocompromised participants, 5-21 years old, who received 2 prior doses of an mRNA COVID-19 vaccine. Humoral and CD4/CD8 T-cell responses were measured to SARS-CoV-2 spike antigens prior to receiving the 3rd vaccine dose and 3-4 weeks after the 3rd dose was given.
Results:
Of the 37 participants, approximately half were solid organ transplant recipients. The majority (86.5%) had a detectable humoral response after the 2nd and 3rd vaccine doses, with a significant increase in antibody levels after the 3rd dose. Positive T-cell responses increased from being present in 86.5% to 100% of the cohort after the 3rd dose.
Conclusions:
Most immunocompromised children mount a humoral and cellular immune response to the 2-dose COVID-19 vaccine series, which is significantly augmented after receiving the 3rd vaccine dose. This supports the utility of the 3rd vaccine dose and the rationale for ongoing emphasis for vaccination against COVID-19 in this population.
Impact:
Most immunocompromised children mount a humoral and cellular immune response to the 2-dose COVID-19 vaccine series, which is significantly augmented after receiving the 3rd vaccine dose. This is the first prospective cohort study to analyze both the humoral and T-cell immune response to the 3rd COVID-19 primary vaccine dose in children who are immunocompromised. The results of this study support the utility of the 3rd vaccine dose and the rationale for ongoing emphasis for vaccination against COVID-19 in the immunosuppressed pediatric population.
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