PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

Research Article

Volume 2 Issue 4

COVID-19 Vaccination in Patients under Medical Conditions, Immunogenicity and Safety: A Systematic Review and Meta-Analysis

Attapon Cheepsattayakorn*, Ruangrong Cheepsattayakorn and Porntep Siriwanarangsun

March 24, 2023

View PDF

Abstract

A comprehensive search was carried out in mainstream bibliographic databases or Medical Subject Headings, including ScienDirect, PubMed, Scopus, and ISI Web of Science. The search was applied to the articles that were published between January 2020 and early 2023 With strict literature search and screening processes, it yielded 14 articles from 373 articles of initial literature database. Among 14 study results, there was acceptable for immunogenicity, both humoral and cellular immune responses in 11 studies (78.57 %), whereas acceptable potent immunogenicity was found in patients aged more than 40 years with chronic diseases, particularly, chronic respiratory diseases and coronary artery diseases. Only potent T-cell response was identified in one study. No significant difference in vaccine safety compared with healthy subjects and effective neutralizing antibodies (two doses completion) against SARS-CoV-2 (COVID-19) in patients older than 60 years with diabetes and/or hypertension were demonstrated after completion of COVID-19 vaccination. Immunogenicity and safety in aged people and individuals living with various chronic diseases (both infectious and non-infectious) is highlighted in this study. In conclusion, specified local and systemic AEs and unsolicited AEs, AESI, and SAEs after each vaccination and after the second dose should be monitored. Recording the adverse events of special interest (AESI) and serious adverse events (SAEs) throughout the patients’ vaccination course should be performed and can decrease COVID-19 vaccination hesitancy in these persons.

Keywords: adverse reactions; COVID-19; immunogenicity; neutralizing antibody; safety; vaccine

Reference

  1. Keech C., et al. “Phase 1-2 trial of a SARS-CoV-2 recombinant spike protein nanoparticle vaccine”. N Engl J Med 383.24 (2020): 2320-2332.
  2. Hall VG., et al. “Randomized trial of a third dose of mRNA-1273 vaccine in transplant recipients”. N Engl J Med 385 (2021): 1244-1246.
  3. Kamar N., et al. “Three doses of an mRNA COVID-19 vaccine in solid-organ transplant recipients”. N Engl J Med 385 (2021): 661-662.
  4. Benotmane I., et al. “Antibody response after a third dose of the mRNA-1273 SARS-CoV-2 vaccine in kidney-transplant recipients with minimal serologic response to 2 doses”. JAMA 326 (2021): 1063-1065.
  5. Saiag E., et al. “The effect of a third-dose BNT162b2 vaccine on anti-SARS-CoV-2 antibody levels in immunosuppressed patients”. Clin Microbiol Infect 28 (2022): 735.e5-735.e8.
  6. Aikawa NE., et al. “Increment of immunogenicity after third dose of a homologous inactivated SARS-CoV-2 vaccine in a large population of patients with autoimmune rheumatic diseases”. Ann Rheum Dis 81 (2022): 1036-1043.
  7. Azzolini E., et al. “mRNA COVID-19 vaccine booster fosters B- and T-cell responses in immunocompromised patients”. Life Sci Alliance 5 (2022): e202201381.
  8. Tenforde MW., et al. “Effectiveness of a third dose of Pfizer-BioNTech and Moderna vaccines in preventing COVID-19 hospitalization among immunocompetent and immunocompromised adults-United States, August-December 2021”. MMWR Morb Mortal Wkly Rep 71 (2021): 118-124.
  9. Yue L., et al. “Antibody response elicited by a third boost dose of inactivated SARS-CoV-2 vaccine can neutralize SARS-CoV-2 variants of concern”. Emerg Microbes Infect 10 (2021): 2125-2127.
  10. Schmiedeberg K., et al. “Efficacy and tolerability of a third dose of an mRNA anti-SARS-CoV-2 vaccine in patients with rheumatoid arthritis with absent or minimal serological response to two previous doses”. Lancet Rheumatol 4 (2022): e11-e13.
  11. Karaba All., et al. “A third dose of SARS-CoV-2 vaccine increases neutralizing antibodies against variants of concern in solid-organ transplant recipients”. medRxiv (2021).
  12. Bar-On YM., et al. “Protection of BNT162b2 vaccine booster against COVID-19 in Israel”. N Engl J Med 385 (2021): 1393-1400.
  13. Bensouna I., et al. “SARS-CoV-2 antibody response after a third dose of the BNT162b2 vaccine in patients receiving maintenance hemodialysis or peritoneal dialysis”. American Journal of Kidney Diseases 79 (2022): 185-192.
  14. Bertrand D., et al. “Antibody and T-cell response to a third dose of SARS-CoV-2 mRNA BNT162b2 vaccine in kidney-transplant recipients”. Kidney Int 100 (2021): 1337-1340.
  15. Le Bougeois A., et al. “Interest of a third dose of BNT162b2 anti—SARS-CoV-2 messenger-RNA vaccine after allotransplant”. Br J Haematol 196 (2022): e38-e40.
  16. Marlet J., et al. “Antibody responses after a third dose of COVID-19 vaccine in kidney-transplant recipients and patients treated for chronic lymphocytic leukemia”. Vaccines 9 (2021): 1055.
  17. Reindl-Schwaighofer R., et al. “Comparison of SARS-CoV-2 antibody response 4 weeks after homologous vs heterologous third vaccine dose in kidney-transplant recipients: a randomized clinical trial”. JAMA Intern Med 182 (2022): 165-171.
  18. Mair MJ., et al. “Third dose of SARS-CoV-2 vaccination in hemato-oncological patients and healthcare workers: immune responses and adverse events-a retrospective cohort study”. Eur J Cancer 165 (2022): 184-194.
  19. Kartnig F., et al. “Safety and immunogenicity of a third COVID-19 vaccination in patients with immune-mediated inflammatory diseases compared with healthy controls”. Ann Rheum Dis 82 (2023): 292-300.
  20. Kulkarni PS., et al. “Safety and immunogenicity of SII-NVX-CoV2373 (COVID-19 vaccine) in adults in a phase 2/3, observer-blind, randomized controlled study”. The Lancet 10 (2023): 100139.
  21. Kang L., et al. “Immunogenicity and safety of COVID-19 vaccines among people living with HIV: a systematic review and meta-analysis”. Vaccines 10 (2022): 1569.
  22. Hibino M., et al. “Safety and immunogenicity of mRNA vaccines against severe acute respiratory syndrome coronavirus 2 in patients with lung cancer receiving immune checkpoint inhibitors: a multicenter observational study in Japan”. Journal of Thoracic Oncology 17.8 (2022): 1002-1013.
  23. Xia S., et al. “Safety and immunogenicity of an inactivated COVID-19 vaccine, WIBP-CorV, in healthy children: interim analysis of a randomized, double-blind, controlled, phase ½ trial”. Frontiers in Immunology 13 (2022): 898151.
  24. Huang R., et al. “Safety and immunogenicity of inactivated SARS_CoV-2 vaccine (BBIBP-CorV) in hypertensive and/or diabetic people aged over 60 years: a prospective open-label study”. Diabetes Ther 14 (2023): 139-151.
  25. Yang B., et al. “Immunogenicity, efficacy, and safety of SARS-CoV-2 vaccine dose fractionation: a systematic review and meta-analysis”. BMC Medicine 20 (2022): 409.
  26. Li C., et al. “Retrospective study of the CoronaVac SARS-CoV-2 vaccine in people with underlying medical conditions”. Communications Medicine 2.1 (2022): 151.
  27. Song J-W., et al. “Safety and immunogenicity of COVID-19 vaccination in immunocompromised patients”. Chinese Medical Journal 135.22 (2022): 2656-2666.
  28. Zakarya K., et al. “Safety and immunogenicity of a QazCovid-in® inactivated whole-virion vaccine against COVID-19 in healthy adults: a single-centre, randomized, single-blind, placebo-controlled phase 1 and open-label phase 2 clinical trials with a 6 months follow-up in Kazakhstan”. EClinical Medicine 39 (2021): 101078.
  29. French RWJr., et al. “Safety, immunogenicity, and efficacy of the BNT162b2 COVID-19 vaccine in adolescents”. N Engl J Med 385.3 (2021): 239-250.
  30. Munro APS., et al. “Safety and immunogenicity of seven COVID-19 vaccines as a third dose (booster) following two doses of ChAdOx1 nCoV-19 or BNT162b2 in the UK (COV-BOOST): a blinded, multicentre, randomized, controlled, phase 2 trial”. Lancet 398 (2021): 2258-2276.
  31. Xia S., et al. “Effect of an inactivated vaccine against SARS-CoV-2 on safety and immunogenicity outcomes: interim analysis of 2 randomized clinical trials”. JAMA 324.10 (2020): 951-960.
  32. Walsh EE., et al. “Safety and immunogenicity of two RNA-based COVID-19 vaccine candidates”. N Engl J Med 383 (2020): 2439-2450.