Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
[Preprint]. 2023 Aug 19:rs.3.rs-3194637.
doi: 10.21203/rs.3.rs-3194637/v1.

COVID-19 Vaccination In Patients with Inborn Errors of Immunity Reduces Hospitalization and Critical Care Needs Related to COVID-19: A USIDNET Report

John C McDonnell  1
Affiliations

COVID-19 Vaccination In Patients with Inborn Errors of Immunity Reduces Hospitalization and Critical Care Needs Related to COVID-19: A USIDNET Report

John C McDonnell. Res Sq. .

Update in

  • COVID-19 Vaccination in Patients with Inborn Errors of Immunity Reduces Hospitalization and Critical Care Needs Related to COVID-19: a USIDNET Report.
    McDonnell J, Cousins K, Younger MEM, Lane A, Abolhassani H, Abraham RS, Al-Tamemi S, Aldave-Becerra JC, Al-Faris EH, Alfaro-Murillo A, AlKhater SA, Alsaati N, Doss AMA, Anderson M, Angarola E, Ariue B, Arnold DE, Assa'ad AH, Aytekin C, Bank M, Bergerson JRE, Bleesing J, Boesing J, Bouso C, Brodszki N, Cabanillas D, Cady C, Callahan MA, Caorsi R, Carbone J, Carrabba M, Castagnoli R, Catanzaro JR, Chan S, Chandra S, Chapdelaine H, Chavoshzadeh Z, Chong HJ, Connors L, Consonni F, Correa-Jimenez O, Cunningham-Rundles C, D'Astous-Gauthier K, Delmonte OM, Demirdag YY, Deshpande DR, Diaz-Cabrera NM, Dimitriades VR, El-Owaidy R, ElGhazali G, Al-Hammadi S, Fabio G, Faure AS, Feng J, Fernandez JM, Fill L, Franco GR, Frenck RW, Fuleihan RL, Giardino G, Galant-Swafford J, Gambineri E, Garabedian EK, Geerlinks AV, Goudouris E, Grecco O, Pan-Hammarström Q, Khani HHK, Hammarström L, Hartog NL, Heimall J, Hernandez-Molina G, Horner CC, Hostoffer RW, Hristova N, Hsiao KC, Ivankovich-Escoto G, Jaber F, Jalil M, Jamee M, Jean T, Jeong S, Jhaveri D, Jordan MB, Joshi AY, Kalkat A, Kanarek HJ, Kellner ES, Khojah A, Khoury R, Kokron CM, Kumar A, Lecerf K, Lehman HK, Leiding JW, Lesmana H, Lim XR, Lopes … See abstract for full author list ➔ McDonnell J, et al. J Clin Immunol. 2024 Apr 5;44(4):86. doi: 10.1007/s10875-023-01613-5. J Clin Immunol. 2024. PMID: 38578389 Free PMC article.

Abstract

Background: The CDC and ACIP recommend COVID-19 vaccination for patients with inborn errors of immunity (IEI). Not much is known about vaccine safety in IEI and whether vaccination attenuates infection severity in IEI.

Objective: To estimate COVID-19 vaccination safety and examine effect on outcomes in patients with IEI.

Methods: We built a secure registry database in conjunction with the United States Immunodeficiency Network to examine vaccination frequency and indicators of safety and effectiveness in IEI patients. The registry opened on January 1, 2022 and closed on August 19, 2022.

Results: Physicians entered data on 1,245 patients from 24 countries. The most common diagnoses were antibody deficiencies (63.7%). At least 1 COVID-19 vaccine was administered to 806 patients (64.7%), and 216 patients received vaccination prior to the development of COVID-19. The most common vaccines administered were mRNA-based (84.0%). Seventeen patients were reported to seek outpatient clinic or emergency room care for a vaccine-related complication and one patient was hospitalized for symptomatic anemia. Eight hundred twenty-three patients (66.1%) experienced COVID-19 infection. Of these, 156 patients required hospitalization (19.0%), 47 required ICU care (5.7%), and 28 died (3.4%). Rates of hospitalization (9.3% versus 24.4%, p<0.001), ICU admission (2.8% versus 7.6%, p=0.013), and death (2.3% versus 4.3%, p=0.202) in patients who had COVID-19 were lower in patients who received vaccination prior to infection. In adjusted logistic regression analysis, not having at least one COVID-19 vaccine significantly increased the odds of hospitalization and ICU admission.

Conclusion: Vaccination for COVID-19 in the IEI population appears safe and attenuates COVID-19 severity.

Keywords: immunization; immunodeficiency; outcomes; viruses: respiratory diseases.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interests/Competing Interests Deepti Deshpande is employed by Regeneron Pharmaceuticals, spouse employed by Arch Oncology. Elizabeth Ristagno owns stock in Moderna and Pfizer. Kathleen Sullivan is a consultant for the Immune Deficiency Foundation. Rebecca Marsh is an employee of Pharming Healthcare, Inc.

Figures

Figure 1
Figure 1
Patient diagnoses in USIDNET Registry, categorized by International Union of Immunologic Societies (IUIS) schema. General IUIS categories further subclassified based on phenotype or genetic defect. Abbreviations: SCID, severe combined immune deficiency; CID, combined immune deficiency; A-T, ataxia-telangiectasia; WAS, Wiskott-Aldrich syndrome; CHARGE, coloboma/heart defects/atresia choanae/growth retardation/genital abnormalities/ear abnormalities; NEMO, nuclear factor-kappa B essential modulator deficiency; CVID, common variable immune deficiency; hypogamma, hypogammaglobulinemia; agamma, agammaglobulinemia; Comp. Def., complement deficiency; SAD, specific antibody deficiency; Subclass Def., IgG subclass deficiency; IgA Def., IgA Deficiency; HLH/EBV Susc., hemophagocytic lymphohistiocytosis and EBV susceptibility; ALPS, autoimmune lymphoproliferative syndrome; IPEX, immune dysregulation/polyendocrinopathy/enteropathy/X-linked syndrome; VEO-IBD, very early onset inflammatory bowel disease; CGD, chronic granulomatous disease; MSMD, Mendelian susceptibility to mycobacterial disease; Cong. Neut., congenital neutropenia; Marrow Fail., bone marrow failure; Viral Predisp., predisposition to severe viral infection
Figure 2
Figure 2
Hospitalization, ICU admission, and death among USIDNET Registry cohort. Categorization was adapted from International Union of Immunological Societies (IUIS) phenotypic classification. Age quartile (years) is based on patient age at time of COVID-19 infection. Three infected patients lacked data on age. COVID-19 risk factors included history of lung disease, immunosuppressive medication use in the 3 months preceding infection, obesity, and renal disease. Additionally, a measure of “other risk factors” was determined, representing a composite of uncommonly observed risk factors in the cohort - neuromuscular disease, tracheostomy, heart disease, sickle cell disease, and diabetes. Any patient with at least one of these uncommonly observed risk factors was counted for this measure. Vaccination was determined as receipt of at least 1 COVID-19 vaccine prior to COVID-19 infection. Sixty-six patients lacked adequate information on timing of vaccination relative to infection and were not included.
See this image and copyright information in PMC

References

    1. V’Kovski P, Kratzel A, Steiner S, Stalder H, Thiel V. Coronavirus biology and replication: implications for SARS-CoV-2. Nat Rev Microbiol. 2021;19(3):155–70. - PMC - PubMed
    1. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239–42. - PubMed
    1. Kompaniyets L, Pennington AF, Goodman AB, Rosenblum HG, Belay B, Ko JY et al. Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020–March 2021. Prev Chronic Dis. 2021;18. - PMC - PubMed
    1. Meyts I, Bucciol G, Quinti I, Neven B, Fischer A, Seoane E, et al. Coronavirus disease 2019 in patients with inborn errors of immunity: An international study. J Allergy Clin Immunol. 2021;147(2):520–31. - PMC - PubMed
    1. Delmonte OM, Castagnoli R, Notarangelo LD. COVID-19 and Inborn Errors of Immunity. Physiol (Bethesda). 2022;37(6):0. - PMC - PubMed

Publication types

LinkOut - more resources