The following is a summary of “Immunogenicity of an Additional mRNA-1273 SARS-CoV-2 Vaccination in People With HIV With Hyporesponse After Primary Vaccination,” published in the March 2023 issue of Infectious Diseases by Jongkees, et al.
The COVIH study aimed to assess the efficacy of an additional COVID-19 vaccine dose in 66 people with HIV (PWH) who had a reduced immune response to their primary vaccination. Out of the 1,154 PWH who participated in the study, 14% had previously shown decreased antibody levels after receiving their primary vaccine.
The main outcome measure was the rise in antibodies 28 days after receiving fresh mRNA-1273 vaccinations. Neutralizing antibodies, S-specific T-cell and B-cell responses, and reactogenicity were secondary end goals.
About 40 of the 66 subjects had already received two doses of ChAdOx1-S, 22 had already gotten two doses of BNT162b2, and 4 had only received one dosage of Ad26.COV2.S. 86% of the population was male, the median CD4+ T-cell count was 650/μL (IQR, 423–941), and the median age was 63 years (interquartile range [IQR], 60-66). The mean level of S1-specific antibodies rose from 35 binding antibody units (BAU)/mL (95% CI, 24-46) to 4,317 BAU/mL (95% CI, 3275-5360) (P< .0001). 97% of subjects demonstrated a sufficient response, and all 45 persons tested negative for the antibody seroconverted. The percentage of PWH with ancestral S-specific CD42 T cells (P =.04) and S-specific B cells (P =.02) increased significantly.
In conclusion, the study demonstrated that an additional mRNA-1273 vaccination dose led to a robust immune response in PWH with hypo response after primary vaccination. The results suggested that an additional dose of the vaccine may be beneficial for people with HIV who show a reduced immune response to primary vaccination.