Discordant Virus-Specific Antibody Levels, Antibody Neutralization Capacity, and T-cell Responses Following 3 Doses of SARS-CoV-2 Vaccination in a Patient With Connective Tissue Disease

Michael J Peluso; Sadie E Munter; Kara L Lynch; Cassandra Yun; Leonel Torres; Nikita S Iyer; Joanna Donatelli; Lindsay Ryan; Amelia N Deitchman; Steven G Deeks; Rachel L Rutishauser; Timothy J Henrich

doi:10.1093/ofid/ofab393

Discordant Virus-Specific Antibody Levels, Antibody Neutralization Capacity, and T-cell Responses Following 3 Doses of SARS-CoV-2 Vaccination in a Patient With Connective Tissue Disease

Open Forum Infect Dis. 2021 Jul 29;8(8):ofab393. doi: 10.1093/ofid/ofab393. eCollection 2021 Aug.

Affiliations

¹ Division of HIV, Infectious Disease and Global Medicine, University of California San Francisco, San Francisco, California, USA.
² Division of Experimental Medicine, University of California San Francisco, San Francisco, California, USA.
³ Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.
⁴ Department of Medicine, University of California San Francisco, San Francisco, California, USA.
⁵ Department of Clinical Pharmacology, University of California San Francisco, San Francisco, California, USA.

Abstract

We report a patient with connective tissue disease who developed modest severe acute respiratory syndrome coronavirus 2 receptor binding domain-specific antibody levels and a lack of neutralization capacity, despite having received 3 mRNA coronavirus disease 2019 vaccines and holding anti-B-cell therapy for >7 months before vaccination. The patient developed virus-specific T-cell responses.

Keywords: COVID-19 vaccine; SARS-CoV-2; T-cell immunity; neutralizing antibodies; rheumatological disease.