The following is a summary of “Antibody and T-cell responses to coronavirus disease 2019 vaccination in common variable immunodeficiency and specific antibody deficiency,” published in the June 2023 issue of Allergy, Asthma & Immunology by Rosenthal et al.
Primary antibody deficiencies were excluded from the mRNA coronavirus disease 2019 (COVID-19) vaccine clinical trials. This study compares antibody and T-cell responses to mRNA COVID-19 vaccination between patients with common variable immunodeficiency (CVID), specific antibody deficiency (SAD), and healthy controls. Using peripheral blood mononuclear cells, the researchers measured antibody responses against the spike glycoprotein and the receptor-binding domain (RBD) as well as severe acute respiratory syndrome coronavirus 2 specific T-cell responses 2 to 8 weeks after the subjects completed the primary 2-dose vaccine series.
The study included 12 CVID patients, 7 SAD patients, and 10 controls. Individuals with CVID had lower immunoglobulin (Ig) G and Ig A levels against spike glycoprotein than those with SAD and controls (P =.01 and P=.004, respectively). The CVID group developed lower IgG titers against the RBD epitope than the control group (P =.01). The CVID group had significantly reduced neutralizing titers than the control group (P =.003). All SAD patients developed neutralizing antibodies.
After vaccination, all three groups (SAD, CVID, and control) developed antigen-specific CD4+ and CD8+ T-cell responses. Patients with CVID may have impaired antibody responses to COVID-19 vaccination but intact T-cell responses, whereas patients with SAD should have both intact antibody and T-cell responses.