Immunologically relevant aspects of the new COVID-19 vaccines-an ÖGAI (Austrian Society for Allergology and Immunology) and AeDA (German Society for Applied Allergology) position paper

doi:10.1007/s40629-021-00178-2

. 2021;30(5):155-168.

doi: 10.1007/s40629-021-00178-2. Epub 2021 Jun 18.

Immunologically relevant aspects of the new COVID-19 vaccines-an ÖGAI (Austrian Society for Allergology and Immunology) and AeDA (German Society for Applied Allergology) position paper

Eva Untersmayr¹, Elisabeth Förster-Waldl², Michael Bonelli³, Kaan Boztug^{4

5

6

7}, Patrick M Brunner⁸, Thomas Eiwegger^{9

10

11}, Kathrin Eller¹², Lisa Göschl³, Katharina Grabmeier-Pfistershammer¹³, Wolfram Hötzenecker¹⁴, Galateja Jordakieva¹⁵, Alexander R Moschen¹⁶, Birgit Pfaller¹⁷, Winfried Pickl¹³, Walter Reinisch¹⁸, Ursula Wiedermann¹⁹, Ludger Klimek²⁰, Karl-Christian Bergmann²¹, Randolf Brehler²², Wolfgang Pfützner²³, Natalija Novak²⁴, Hans Merk²⁵, Uta Rabe²⁶, Wolfgang Schlenter²⁷, Johannes Ring²⁸, Wolfgang Wehrmann²⁹, Norbert Mülleneisen³⁰, Holger Wrede³¹, Thomas Fuchs³², Erika Jensen-Jarolim^{1

33}

Affiliations

¹ Institute of Pathophysiology and Allergy Research, Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
² Department of Neonatology, Paediatric Intensive Care Medicine and Neuropaediatrics with Centre for Congenital Immunodeficiencies, University Clinics of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
³ Clinical Department of Rheumatology, University Clinics of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
⁴ Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria.
⁵ St. Anna Children's Hospital and University Clinic for Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
⁶ St. Anna Kinderkrebsforschung GmbH, Vienna, Austria.
⁷ CeMM Research Centre for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.
⁸ University Clinics of Dermatology, Medical University of Vienna, Vienna, Austria.
⁹ Translational Medicine Program, Research Institute, Hospital for Sick Children, Toronto, Ontario Canada.
¹⁰ Department of Immunology, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada.
¹¹ Clinical Department of Pediatrics, University Hospital St. Pölten, St. Pölten, Austria.
¹² Clinical Department of Nephrology, Internal Medicine, Medical University of Graz, Graz, Austria.
¹³ Institute of Immunology, Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
¹⁴ University Clinics of Dermatology and Venereology, Kepler University Hospital, Comprehensive Allergy Centre, Linz, Austria.
¹⁵ University Clinics of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria.
¹⁶ University Clinics of Internal Medicine, Department of Gastroenterology and Hepatology, Kepler University Hospital, Linz, Austria.
¹⁷ Department of Internal Medicine 1, Karl Landsteiner University of Health Sciences, University Hospital, St. Pölten, Austria.
¹⁸ Clinical Division of Gastroenterology and Hepatology, University Clinics of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
¹⁹ Institute of Specific Prophylaxis and Tropical Medicine, Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
²⁰ Centre for Rhinology and Allergology, Wiesbaden, Germany.
²¹ Department of Dermatology, Venereology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
²² Department of Skin Diseases-General Dermatology and Venereology-Outpatient Clinic for Allergology, Occupational Dermatology and Environmental Medicine, University Hospital Münster, Münster, Germany.
²³ Department of Dermatology and Allergology, University Hospital Marburg (UKGM), Philipps University Marburg, Marburg, Germany.
²⁴ Clinic and Polyclinic for Dermatology and Allergology, University Hospital Bonn, Bonn, Germany.
²⁵ Department of Dermatology and Allergology, RWTH Aachen University, Aachen, Germany.
²⁶ Clinic for Allergology, Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH, Treuenbrietzen, Germany.
²⁷ AeDA-Ärzteverband Deutscher Allergologen, Langen-Dreieich, Germany.
²⁸ Skin and Laser Centre at the Opera, Munich, Germany.
²⁹ Dermatological Group Practice Wehrmann, Münster, Germany.
³⁰ Asthma and Allergy Centre Leverkusen, Leverkusen, Germany.
³¹ Nasal and Ear Specialist, Herford, Germany.
³² Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany.
³³ Interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University of Vienna, University of Vienna, Vienna, Austria.

PMID: 34178577
PMCID: PMC8212077
DOI: 10.1007/s40629-021-00178-2

Immunologically relevant aspects of the new COVID-19 vaccines-an ÖGAI (Austrian Society for Allergology and Immunology) and AeDA (German Society for Applied Allergology) position paper

Eva Untersmayr et al. Allergo J Int. 2021.

. 2021;30(5):155-168.

doi: 10.1007/s40629-021-00178-2. Epub 2021 Jun 18.

Authors

Affiliations

¹ Institute of Pathophysiology and Allergy Research, Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
² Department of Neonatology, Paediatric Intensive Care Medicine and Neuropaediatrics with Centre for Congenital Immunodeficiencies, University Clinics of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
³ Clinical Department of Rheumatology, University Clinics of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
⁴ Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria.
⁵ St. Anna Children's Hospital and University Clinic for Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
⁶ St. Anna Kinderkrebsforschung GmbH, Vienna, Austria.
⁷ CeMM Research Centre for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.
⁸ University Clinics of Dermatology, Medical University of Vienna, Vienna, Austria.
⁹ Translational Medicine Program, Research Institute, Hospital for Sick Children, Toronto, Ontario Canada.
¹⁰ Department of Immunology, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada.
¹¹ Clinical Department of Pediatrics, University Hospital St. Pölten, St. Pölten, Austria.
¹² Clinical Department of Nephrology, Internal Medicine, Medical University of Graz, Graz, Austria.
¹³ Institute of Immunology, Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
¹⁴ University Clinics of Dermatology and Venereology, Kepler University Hospital, Comprehensive Allergy Centre, Linz, Austria.
¹⁵ University Clinics of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria.
¹⁶ University Clinics of Internal Medicine, Department of Gastroenterology and Hepatology, Kepler University Hospital, Linz, Austria.
¹⁷ Department of Internal Medicine 1, Karl Landsteiner University of Health Sciences, University Hospital, St. Pölten, Austria.
¹⁸ Clinical Division of Gastroenterology and Hepatology, University Clinics of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
¹⁹ Institute of Specific Prophylaxis and Tropical Medicine, Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
²⁰ Centre for Rhinology and Allergology, Wiesbaden, Germany.
²¹ Department of Dermatology, Venereology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
²² Department of Skin Diseases-General Dermatology and Venereology-Outpatient Clinic for Allergology, Occupational Dermatology and Environmental Medicine, University Hospital Münster, Münster, Germany.
²³ Department of Dermatology and Allergology, University Hospital Marburg (UKGM), Philipps University Marburg, Marburg, Germany.
²⁴ Clinic and Polyclinic for Dermatology and Allergology, University Hospital Bonn, Bonn, Germany.
²⁵ Department of Dermatology and Allergology, RWTH Aachen University, Aachen, Germany.
²⁶ Clinic for Allergology, Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH, Treuenbrietzen, Germany.
²⁷ AeDA-Ärzteverband Deutscher Allergologen, Langen-Dreieich, Germany.
²⁸ Skin and Laser Centre at the Opera, Munich, Germany.
²⁹ Dermatological Group Practice Wehrmann, Münster, Germany.
³⁰ Asthma and Allergy Centre Leverkusen, Leverkusen, Germany.
³¹ Nasal and Ear Specialist, Herford, Germany.
³² Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany.
³³ Interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University of Vienna, University of Vienna, Vienna, Austria.

PMID: 34178577
PMCID: PMC8212077
DOI: 10.1007/s40629-021-00178-2

Abstract

Background: The vaccines against the coronavirus disease 2019 (COVID-19) approved in the European Union represent a decisive step in the fight against the pandemic. The application of these available vaccines to patients with pre-existing immunological conditions leads to a multitude of questions regarding efficacy, side effects and the necessary patient information.

Results: This review article provides insight into mechanisms of action of the currently available severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines and summarises the current state of science as well as expert recommendations regarding tolerability of the vaccines. In addition, the potential to develop protective immune responses is determined. A special focus is given on patients under immunosuppression or in treatment with immunomodulatory drugs. Special groups of the population such as children, pregnant women and the elderly are also considered.

Conclusion: Despite the need for a patient-specific risk-benefit assessment, the consensus among experts is that patients with immunological diseases in particular benefit from the induced immune protection after COVID-19 vaccination and do not have an increased risk of side effects.

Keywords: COVID-19 vaccination; Immune response; Immunomodulation; Immunosuppression; Vaccination effect.

PubMed Disclaimer

Conflict of interest statement

Conflict of interestP.M. Brunner is an employee of the Medical University of Vienna and has received personal fees from LEO Pharma, Pfizer, Sanofi Genzyme, Eli Lilly, Novartis, Celgene, UCB Pharma, Biotest, Boehringer Ingelheim, AbbVie, Amgen and Arena Pharmaceuticals. He also works as an investigator on behalf of Novartis and has received grants for his institute. T. Eiwegger serves as principal investigator for DBV’s company-sponsored studies and as a secondary investigator (sub-investigator) for Regeneron. He also receives grants from Innovation Fund Denmark and the Canadian Institutes of Health Research (CIHR) outside the submitted work. He is co-investigator or scientific lead in three investigator-initiated oral immunotherapy studies supported by the Food Allergy and Anaphylaxis Program‘SickKids’. In addition, serves as Associate Editor for Allergy. He/his laboratory has received unconditional in-kind support from Macro Array Diagnostics and ALK. He also serves as an Advisory Board Member for ALK. W. Reinisch has acted in an advisory capacity for: Abbvie, Algernon, Amgen, AM Pharma, AMT, AOP Orphan, Arena Pharmaceuticals, Astellas, Astra Zeneca, Avaxia, Roland Berger GmBH, Bioclinica, Biogen IDEC, Boehringer-Ingelheim, Bristol-Myers Squibb, Cellerix, Chemocentryx, Celgene, Centocor, Celltrion, Covance, Danone Austria, DSM, Elan, Eli Lilly, Ernest & Young, Falk Pharma GmbH, Ferring, Galapagos, Gatehouse Bio Inc., Genentech, Gilead, Grünenthal, ICON, Index Pharma, Inova, Intrinsic Imaging, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, LivaNova, Mallinckrodt, Medahead, MedImmune, Millenium, Mitsubishi Tanabe Pharma Corporation, MSD, Nash Pharmaceuticals, Nestle, Nippon Kayaku, Novartis, Ocera, OMass, Otsuka, Parexel, PDL, Periconsulting, Pharmacosmos, Philip Morris Institute, Pfizer, Procter & Gamble, Prometheus, Protagonist, Provention, Quell Therapeutics, Robarts Clinical Trial, Sandoz, Schering-Plough, Second Genome, Seres Therapeutics, Setpointmedical, Sigmoid, Sublimity, Takeda, Therakos, Theravance, Tigenix, UCB, Vifor, Zealand, Zyngenia and 4SC. E. Untersmayr, E. Förster-Waldl, M. Bonelli,K. Boztug, K. Eller, L. Göschl, K. Grabmeier-Pfistershammer, W. Hötzenecker, G. Jordakieva, A.R. Moschen, B. Pfaller, W. Pickl, U. Wiedermann, L. Klimek, K.-C. Bergmann, R. Brehler, W. Pfützner, N. Novak, H. Merk, U. Rabe, W. Schlenter, J. Ring, W. Wehrmann, N. Mülleneisen, H. Wrede, T. Fuchs and E. Jensen-Jarolim declare that they have no competing interests.

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[1] Hodgson SH, Mansatta K, Mallett G, Harris V, Emary KRW, Pollard AJ. What defines an efficacious COVID-19 vaccine? A review of the challenges assessing the clinical efficacy of vaccines against SARS-CoV-2. Lancet Infect Dis. 2021;21:e26–e35. doi: 10.1016/S1473-3099(20)30773-8. - DOI - PMC - PubMed

[2] Hodgson SH, Mansatta K, Mallett G, Harris V, Emary KRW, Pollard AJ. What defines an efficacious COVID-19 vaccine? A review of the challenges assessing the clinical efficacy of vaccines against SARS-CoV-2. Lancet Infect Dis. 2021;21:e26–e35. doi: 10.1016/S1473-3099(20)30773-8. - DOI - PMC - PubMed

[3] Pollard AJ, Bijker EM. A guide to vaccinology: from basic principles to new developments. Nat Rev Immunol. 2021;21:83–100. doi: 10.1038/s41577-020-00479-7. - DOI - PMC - PubMed

[4] Pollard AJ, Bijker EM. A guide to vaccinology: from basic principles to new developments. Nat Rev Immunol. 2021;21:83–100. doi: 10.1038/s41577-020-00479-7. - DOI - PMC - PubMed

[5] Robert Koch Institute. Epidemiological bulletin. 2021. www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2021/Ausgaben/02_21.pdf?__b.... Accessed 15 Feb 2021.

[6] Robert Koch Institute. Epidemiological bulletin. 2021. www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2021/Ausgaben/02_21.pdf?__b.... Accessed 15 Feb 2021.

[7] World Health Organisation. Draft landscape and tracker of COVID-19 candidate vaccines. 2021. www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-va.... Accessed 16 Mar 2021.

[8] World Health Organisation. Draft landscape and tracker of COVID-19 candidate vaccines. 2021. www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-va.... Accessed 16 Mar 2021.

[9] Logunov DY, Dolzhikova IV, Shcheblyakov DV, Tukhvatulin AI, Zubkova OV, Dzharullaeva AS, et al. Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: an interim analysis of a randomised controlled phase 3 trial in Russia. Lancet. 2021;397:671–681. doi: 10.1016/S0140-6736(21)00234-8. - DOI - PMC - PubMed

[10] Logunov DY, Dolzhikova IV, Shcheblyakov DV, Tukhvatulin AI, Zubkova OV, Dzharullaeva AS, et al. Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: an interim analysis of a randomised controlled phase 3 trial in Russia. Lancet. 2021;397:671–681. doi: 10.1016/S0140-6736(21)00234-8. - DOI - PMC - PubMed

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Immunologically relevant aspects of the new COVID-19 vaccines-an ÖGAI (Austrian Society for Allergology and Immunology) and AeDA (German Society for Applied Allergology) position paper

Affiliations

Immunologically relevant aspects of the new COVID-19 vaccines-an ÖGAI (Austrian Society for Allergology and Immunology) and AeDA (German Society for Applied Allergology) position paper

Authors

Affiliations

Abstract

Conflict of interest statement

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