Antibody Responses in Pfizer-Vaccinated Immunocompromised Patients

January 3, 2022

Researchers in Israel conducted a prospective cohort study analyzing antibody responses in immunocompromised patients after receiving the Pfizer COVID-19 vaccine. This cohort of patients was not included in original COVID-19 vaccine clinical trials, but they may benefit most from vaccination as they experience higher mortality rates from COVID-19 compared to immunocompetent persons. Furthermore, “persistent infection of SARS-CoV-2 within immunocompromised hosts could serve as a reservoir for the generation of mutations and the subsequent emergence of novel strains with the potential to evade immune responses.” Weak antibody responses in immunocompromised patients may contribute to this phenomenon.

Antibodies from 1002 immunocompromised patients and 272 immunocompetent healthcare workers were measured 2-4 weeks after completion of a Pfizer COVID-19 primary series. Treatments taken during the study include prednisone, anti-metabolites, and glucocorticosteroids.

IgG antibodies were detected in:

  • 98.7% of patients with HIV
  • 83.3% of patients with solid malignancies
  • 79.7% of patients with myeloma
  • 74.8% of patients following hematopoietic stem cell transplants
  • 69.4% of patients following liver transplantation
  • 60.5% of patients with myelodysplastic syndrome
  • 51.0% of patients with chronic lymphocytic leukemia/non-Hodgkin’s lymphoma
  • 45.5% of patients following kidney transplantation
  • 18.8% of patients following heart transplantation
  • 98.9% of immunocompetent health care workers

The most robust antibody response was observed in HIV patients within the cohort of immunosuppressed patients; older age and those with underlying immunosuppression experienced a “significantly associated” antibody response.

The FDA and CDC’s COVID-19 vaccination guidance for immunocompromised persons has centered around solid organ transplantees and those with an “equivalent level of immunocompromise,” which includes autoimmune disease patients taking immunosuppressants (1). Even though this particular study did not include autoimmune disease patients, studies such as this can provide clarity for autoimmune disease patients navigating COVID-19 vaccination.

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