Greater preservation of SARS-CoV-2 neutralising antibody responses following the ChAdOx1-S (AZD1222) vaccine compared with mRNA vaccines in haematopoietic cell transplant recipients.

Colton, Hayley, Barratt, Natalie, Temperton, Nigel J., Hornsby, Hailey, Angyal, Adrienn, Grouneva, Irina, Lindsey, Benjamin B., Kearns, Pamela, Barnes, Eleanor, Goodyear, Carl S., and others. (2024) Greater preservation of SARS-CoV-2 neutralising antibody responses following the ChAdOx1-S (AZD1222) vaccine compared with mRNA vaccines in haematopoietic cell transplant recipients. British journal of haematology, . ISSN 1365-2141. (doi:10.1111/bjh.19874) (KAR id:107851)

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Official URL: https://doi.org/10.1111/bjh.19874

Abstract

Whilst SARS-CoV-2 mRNA vaccines generate high neutralising antibodies (nAb) in most individuals, haematopoietic stem cell transplant (HSCT) and chimeric antigen receptor T-cell (CAR-T) recipients respond poorly. HSCT/CAR-T treatment ablates existing immune memory, with recipients requiring revaccination analogous to being vaccine naive. An optimal revaccination strategy for this cohort has not been defined. Factors predicting immunogenicity following three ancestral SARS-CoV-2 vaccines were assessed in 198 HSCT/CAR-T recipients and 96 healthcare workers (HCWs) recruited to multicentre studies. Only 25% of HSCT/CAR-T recipients generated nAbs following one dose, with titres 167-fold and 7-fold lower than that in HCWs after the first and second doses, respectively. Lower post-second dose nAb titres were associated with older age, rituximab use, and previous HSCT. ChAdOx1-S recipients were more likely to generate nAbs compared with mRNA vaccines, with titres comparable to HCWs. In contrast, nAbs were significantly lower in HSCT/CAR-T recipients than HCWs after mRNA vaccination. The poor first-dose immunogenicity in HSCT/CAR-T recipients suggests a minimum licensed dosing interval could limit the period of vulnerability following HSCT/CAR-T. The relative preservation of nAbs with ChAdOx1-S vaccination highlights the importance of evaluating alternative platforms to mRNA vaccination within this highly vulnerable clinical cohort.

Item Type:	Article
DOI/Identification number:	10.1111/bjh.19874
Uncontrolled keywords:	SARS-CoV-2; stem cell transplant; vaccination
Subjects:	Q Science > QR Microbiology > QR355 Virology
Divisions:	Divisions > Division of Natural Sciences > Medway School of Pharmacy
Funders:	University of Birmingham (https://ror.org/03angcq70) Huo Family Foundation (https://ror.org/02cc3ss06) NIHR Wellcome Trust Southampton Clinical Research Facility (https://ror.org/046xy0k58) Medical Research Council (https://ror.org/03x94j517) Cancer Research UK (https://ror.org/054225q67) British Society for Haematology (https://ror.org/02fndbp74) Sheffield Teaching Hospitals NHS Foundation Trust (https://ror.org/018hjpz25) Blood Cancer UK (https://ror.org/0055acf80)
Depositing User:	Nigel Temperton
Date Deposited:	18 Nov 2024 08:42 UTC
Last Modified:	19 Nov 2024 10:06 UTC
Resource URI:	https://kar.kent.ac.uk/id/eprint/107851 (The current URI for this page, for reference purposes)

University of Kent Author Information

Temperton, Nigel J..

Creator's ORCID:	https://orcid.org/0000-0002-7978-3815
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