SARS-CoV-2-vaccination in primary humoral immunodeficiency - Experience from a German lung clinic

During the COVID-19 pandemic the effectiveness of vaccines against SARS-CoV-2 in immunodeficient patients did not only affect the individual risk of these vulnerable patients but endangered the selection of new variants of concern due to prolonged virus shedding by these patients. In a tertiary center for pulmonary diseases, we investigated the immune response of 11 patients with primary humoral immunodeficiency and 13 healthy controls on the humoral and cellular level after full vaccination with a mRNA or vector vaccine against SARS-CoV-2. In the majority of patients (73%), we found antibodies against the Spike protein above the thresh-old of positivity. Likewise, patients showed a promising cellular response: the upregulated production of INFγ, TNFα and CXCL10 by T cells did not differ from the response of healthy controls. These results stress the importance to further discern an adequate immunological correlate of protection and the need to follow the effect of booster immunizations in this population at risk.