Vaccines and therapeutics for immunocompromised patients with COVID-19

Shmuel Shoham¹, Carolina Batista^{2

3}, Yanis Ben Amor⁴, Onder Ergonul⁵, Mazen Hassanain⁶, Peter Hotez⁷, Gagandeep Kang⁸, Jerome H Kim⁹, Bhavna Lall¹⁰, Heidi J Larson¹¹, Denise Naniche¹², Timothy Sheahan¹³, Nathalie Strub-Wourgaft^{12

14}, Samba O Sow^{15

16}, Annelies Wilder-Smith^{11

17}, Prashant Yadav^{18

19

20}, Maria Elena Bottazzi⁷; Lancet Commission on COVID-19 Vaccines and Therapeutics Task Force

Affiliations

¹ Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Médecins Sans Frontières, Rio de Janeiro, Brazil.
³ Baraka Impact Finance, Geneva, Switzerland.
⁴ Center for Sustainable Development, Columbia University, New York, NY, USA.
⁵ Koc University Research Center for Infectious Diseases, Istanbul, Turkey.
⁶ College of Medicine, King Saud University, Riyadh, Saudi Arabia.
⁷ Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, TX, USA.
⁸ Christian Medical College, Vellore, India.
⁹ International Vaccine Institute, Seoul, South Korea.
¹⁰ University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA.
¹¹ London School of Hygiene & Tropical Medicine, London, UK.
¹² ISGlobal, Barcelona Institute for Global Health, Hospital Clinic, University of Barcelona, Spain.
¹³ University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC, USA.
¹⁴ Drugs for Neglected Diseases Initiative, Geneva, Switzerland.
¹⁵ Center for Vaccine Development, Bamako, Mali.
¹⁶ University of Maryland, MD, USA.
¹⁷ Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
¹⁸ Center for Global Development, Washington, DC, USA.
¹⁹ Harvard Medical School, Boston, MA, USA.
²⁰ Technology and Operations Management, INSEAD, Fontainebleau, France.

PMID: 37070102
PMCID: PMC10091856
DOI: 10.1016/j.eclinm.2023.101965

Review

Vaccines and therapeutics for immunocompromised patients with COVID-19

Shmuel Shoham et al. EClinicalMedicine. 2023 May.

. 2023 May:59:101965.

doi: 10.1016/j.eclinm.2023.101965. Epub 2023 Apr 12.

Authors

Affiliations

¹ Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Médecins Sans Frontières, Rio de Janeiro, Brazil.
³ Baraka Impact Finance, Geneva, Switzerland.
⁴ Center for Sustainable Development, Columbia University, New York, NY, USA.
⁵ Koc University Research Center for Infectious Diseases, Istanbul, Turkey.
⁶ College of Medicine, King Saud University, Riyadh, Saudi Arabia.
⁷ Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, TX, USA.
⁸ Christian Medical College, Vellore, India.
⁹ International Vaccine Institute, Seoul, South Korea.
¹⁰ University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA.
¹¹ London School of Hygiene & Tropical Medicine, London, UK.
¹² ISGlobal, Barcelona Institute for Global Health, Hospital Clinic, University of Barcelona, Spain.
¹³ University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC, USA.
¹⁴ Drugs for Neglected Diseases Initiative, Geneva, Switzerland.
¹⁵ Center for Vaccine Development, Bamako, Mali.
¹⁶ University of Maryland, MD, USA.
¹⁷ Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
¹⁸ Center for Global Development, Washington, DC, USA.
¹⁹ Harvard Medical School, Boston, MA, USA.
²⁰ Technology and Operations Management, INSEAD, Fontainebleau, France.

PMID: 37070102
PMCID: PMC10091856
DOI: 10.1016/j.eclinm.2023.101965

Abstract

The COVID-19 pandemic has disproportionately impacted immunocompromised patients. This diverse group is at increased risk for impaired vaccine responses, progression to severe disease, prolonged hospitalizations and deaths. At particular risk are people with deficiencies in lymphocyte number or function such as transplant recipients and those with hematologic malignancies. Such patients' immune responses to vaccination and infection are frequently impaired leaving them more vulnerable to prolonged high viral loads and severe complications of COVID-19. Those in turn, have implications for disease progression and persistence, development of immune escape variants and transmission of infection. Data to guide vaccination and treatment approaches in immunocompromised people are generally lacking and extrapolated from other populations. The large clinical trials leading to authorisation and approval of SARS-CoV-2 vaccines and therapeutics included very few immunocompromised participants. While experience is accumulating, studies focused on the special circumstances of immunocompromised patients are needed to inform prevention and treatment approaches.

Keywords: COVID-19; Immunocompromised; Malignancy; SARS-CoV-2; Transplantation.

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Conflict of interest statement

The authors report the following potential competing interests: PH and MEB are co-inventors of a COVID-19 recombinant protein vaccine technology owned by Baylor College of Medicine (BCM) that was licensed by BCM non-exclusively and with no patent restrictions to several companies committed to advancing vaccines for low- and middle-income countries. The co-inventors have no involvement in license negotiations conducted by BCM. Similar to other research universities, a long-standing BCM policy provides its faculty and staff, who make discoveries that result in a commercial license, a share of any royalty income. To date, BCM has not distributed any royalty income to the co-inventors on the COVID-19 recombinant protein vaccine technology. Any such distribution will be undertaken in accordance with BCM policy. MH is Founder and Managing Director of SaudiVax. GK is a member of the WHO SAGE Working Group on COVID-19 vaccines. GK is independent director appointed by the Wellcome Trust, MSD Wellcome Trust Hilleman Laboratories Private Limited and Vice Chair of the Board, Coalition of Epidemic Preparedness Innovations (CEPI). HL reports grants and honoraria from GlaxoSmithKline for training talks and from Merck as a member of the Merck Vaccine Confidence Advisory Board, grants from J&J outside the submitted work. AWS serves as Consultant to WHO. The views presented here reflect her views and not necessarily those of WHO. TS reports grants from National Institute of Allergy and Infectious Disease and Fast Grants and research contracts from GlaxoSmithKline, and ViiV Healthcare. SS reports grants or contracts made to institution from U.S. Department of Defense (Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense), Defense Health Agency, Shionogi, Shire, Ansun, Cidara, Zeteo Tech Inc., F2G, Emergent Biosolutions, Bloomberg Philanthropies, the State of Maryland, NIH National Center for Advancing Translational Sciences, Mental Wellness Foundation, Moriah Fund, Octopharma, Shear Family Foundation, HealthNetwork Foundation, Mayo Clinic, University of Nebraska; consulting fees made directly to author from Immunome, Adagio Therapeutics, Celltrion Healthcare, Karius; payment or honoraria to author for lectures, presentations, speakers bureaus, manuscript writing or educational events from Prime Inc. and Peerview; travel support from Peerview for American Transplant Congress 2022, from NCCN for NCCN Guideline meeting, and from ACP for ACP board of governors meeting; paid participation on a Data Safety Monitoring Board or Advisory Board for Intermountain Health, Karyopharm, Adamis Health; a role on guideline panels for NCCN, IDSA, MSG/EORTC, on RSV vaccine workgroup for ACIP/CDC, as Governor of Washington DC Chapter of ACP, and as member of Board of Governors of ACP; stock or stock options from Immunome. JHK reports personal fees from SK biosciences. CB, YBA, OE, BL, DN, NSW, SOS, and PY declare no conflict of interests. The authors views and opinions in the Review do not necessarily represent the views, decisions, or policies of the institutions, universities, or health systems with which they are affiliated.

References

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Vaccines and therapeutics for immunocompromised patients with COVID-19

Affiliations

Vaccines and therapeutics for immunocompromised patients with COVID-19

Authors

Affiliations

Abstract

Conflict of interest statement

References

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Miscellaneous