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Differential T-cell and Antibody Responses induced by mRNA versus adenoviral vectored COVID-19 vaccines in Patients with Immunodeficiencies

Aguinam, Ernest T., Nadesalingam, Angalee, Chan, Andrew, Smith, Peter, Paloniemi, Minna, Cantoni, Diego, Gronlund, Jessica, Gronlund, Helen, Carnell, George W., Castillo-Olivares, Javier, and others. (2023) Differential T-cell and Antibody Responses induced by mRNA versus adenoviral vectored COVID-19 vaccines in Patients with Immunodeficiencies. Journal of Allergy and Clinical Immunology: Global, 2 (2). Article Number 100091. ISSN 2772-8293. (doi:10.1016/j.jacig.2023.100091) (KAR id:100493)


Background: Immunodeficient patients (IDPs) are at higher risk of contracting severe COVID-19 disease. Targeted vaccination strategies have been implemented to enhance vaccine-induced protection. In this population however, clinical effectiveness is variable and duration of protection unknown.

Objective: To understand the cellular and humoral immune responses to mRNA and adenoviral vectored COVID-19 vaccines in patients with immunodeficiency.

Methods: Immune responses to SARS-COV-2 spike were assessed after two doses of homologous ChAdOx1-nCoV-19 or BNT162b2 vaccines in 112 infection-naïve IDPs and 131 healthy health care workers (HCWs) as controls. Predictors of vaccine responsiveness were investigated.

Results: Immune responses to vaccination were low, and viral neutralisation by antibody not detected despite high titre binding responses in many IDPs. In those responding, the frequency of specific T-cell responses in IDPs was similar to controls whilst antibody responses were lower. Sustained vaccine specific differences were identified: T-cell responses were greater in ChAdOx1-nCoV-19 compared with BNT162b2 immunised IDPs and antibody binding and neutralisation was greater in all cohorts immunised with BNT162b2. The positive correlation between T-cell and antibody responses was weak and increased with subsequent vaccination.

Conclusion: Immunodeficient patients have impaired immune responses to mRNA and viral vector COVID-19 vaccines that appear influenced by vaccine formulation. Understanding the relative roles of T-cell and antibody mediated protection and potential of heterologous prime and boost immunization protocols is needed to optimise the vaccination approach in these high-risk groups.

Item Type: Article
DOI/Identification number: 10.1016/j.jacig.2023.100091
Uncontrolled keywords: COVID-19; SARS-CoV-2; vaccine; ChAdOx1-nCoV-19; BNT162b2; immunodeficiency; antibodies; T-cells; immunoglobulins; healthcare workers
Subjects: Q Science > QR Microbiology > QR355 Virology
Divisions: Divisions > Division of Natural Sciences > Medway School of Pharmacy
Funders: UK Research and Innovation (
Depositing User: Nigel Temperton
Date Deposited: 16 Mar 2023 00:44 UTC
Last Modified: 04 Mar 2024 19:29 UTC
Resource URI: (The current URI for this page, for reference purposes)

University of Kent Author Information

Cantoni, Diego.

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Temperton, Nigel.

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