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- Title
Lack of Specific Immune Response after Five Doses of mRNA SARS-CoV-2 Vaccine in a Patient with CD4 + T-Cell Lymphopenia but Preserved Responses to CMV.
- Authors
Alba-Cano, Trinidad; Fernández-Cruz, Eduardo; Alonso, Roberto; Muñoz-Gómez, Sara; Pérez de Diego, Rebeca; García Martínez, Elena; Sánchez-Mateos, Paloma; Navarro Caspistegui, Joaquín; Martín López, Mónica; Gil-Herrera, Juana
- Abstract
Immunogenicity of SARS-CoV-2 mRNA vaccines is highly heterogeneous in patients with inborn errors of immunity (IEIs). This case report analyzes the immune response to mRNA COVID-19 two-dose primary vaccination followed by three boosters in an IEI patient with marked CD4+ T-cell cytopenia and diminished thymic output, in comparison with that raised against latent, chronic cytomegalovirus (CMV) infection. Serum IgG antibodies anti-spike (S) protein of SARS-CoV-2 and anti-CMV were both determined by chemiluminescent microparticle immunoassays (CMIAs). SARS-CoV-2 and CMV memory CD4+ T-cell responses were simultaneously evaluated in vitro using an activation-induced marker (AIM) assay via multicolor flow cytometry. Throughout the 2-year follow-up that included the administration of five doses of SARS-CoV-2 mRNA vaccines, cellular anti-SARS-CoV-2-specific responses remained consistently negative, with extremely weak humoral responses, while the patient showed in vitro persistent CD4+ T-cell reactivity to CMV peptides and high-IgG CMV-specific titers. The assessment of immune responses to vaccines and prevalent viruses is essential in IEI patients in order to take adequate preventive measures.
- Subjects
COVID-19 vaccines; IMMUNE response; DYSTHYMIC disorder; T cells; VACCINE effectiveness; CD4 antigen; THYMUS tumors
- Publication
Vaccines, 2024, Vol 12, Issue 4, p386
- ISSN
2076-393X
- Publication type
Article
- DOI
10.3390/vaccines12040386