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Front Immunol . Reduced durability of hybrid immunity to SARS-CoV-2 in immunocompromised children

tetano

Editor, Senior Moderator
Front Immunol


. 2024 Dec 17:15:1502598.
doi: 10.3389/fimmu.2024.1502598. eCollection 2024. Reduced durability of hybrid immunity to SARS-CoV-2 in immunocompromised children

Youjia Zhong[SUP] 1 2 3 [/SUP], Amuthavalli Kottaiswamy[SUP] 1 [/SUP], Chen Xiang Ang[SUP] 3 [/SUP], Hui' En Li[SUP] 1 [/SUP], Gaik Chin Yap[SUP] 1 [/SUP], Carina J X Tay[SUP] 1 [/SUP], Nurul Elyana Osman[SUP] 1 [/SUP], Siti Namirah Binte Roslan[SUP] 1 [/SUP], Chee Wah Tan[SUP] 4 [/SUP], Wee Chee Yap[SUP] 4 [/SUP], Elizabeth Y Ang[SUP] 3 [/SUP], Pauline P L Chan Ng[SUP] 1 3 [/SUP], Hui Kim Yap[SUP] 1 3 [/SUP], Liangjian Lu[SUP] 3 [/SUP], Marion M Aw[SUP] 1 3 [/SUP], Sivaraman V Karthik[SUP] 3 [/SUP], Seng Hock Quak[SUP] 3 [/SUP], Thuan Chong Quah[SUP] 3 [/SUP], Elizabeth H Tham[SUP] 1 3 [/SUP], Lynette P Shek[SUP] #[/SUP][SUP] 1 3 [/SUP], Eng Eong Ooi[SUP] #[/SUP][SUP] 2 5 6 [/SUP]



Affiliations
Abstract

Background: In endemic COVID-19, immunocompromised children are vulnerable until vaccinated but the optimal primary vaccination regime and need for booster doses remains uncertain.
Methods: We recruited 19 immunocompromised children (post-solid organ transplantation, have autoimmune disease or were on current or recent chemotherapy for acute lymphoblastic leukemia), and followed them from the start of primary vaccination with BNT162b2 mRNA SARS-CoV-2 until 1-year post-vaccination. We investigated the quality of vaccine immunogenicity, and longevity of hybrid immunity, in comparison to healthy children.
Results: Immunocompromised children failed to produce T cell and memory B cell (MBC) responses reaching thresholds of protection after 2 doses; a third dose however improved both responses. Initially robust hybrid immunity demonstrated significantly more decline in T cell and MBC responses in immunocompromised compared to healthy children, to levels below the protective threshold by month 12.
Discussion: Immunocompromised children may benefit from a 3-dose primary vaccination regime, with yearly or twice-yearly booster doses for sustained immunity.

Keywords: COVID-19; T cells; adaptive immunity; correlates of protection; memory B cells; vaccine durability; vaccine immunogenicity.

 
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