AUTHOR=Amodio Donato , Ruggiero Alessandra , Sgrulletti Mayla , Pighi Chiara , Cotugno Nicola , Medri Chiara , Morrocchi Elena , Colagrossi Luna , Russo Cristina , Zaffina Salvatore , Di Matteo Gigliola , Cifaldi Cristina , Di Cesare Silvia , Rivalta Beatrice , Pacillo Lucia , Santilli Veronica , Giancotta Carmela , Manno Emma Concetta , Ciofi Degli Atti Marta , Raponi Massimiliano , Rossi Paolo , Finocchi Andrea , Cancrini Caterina , Perno Carlo Federico , Moschese Viviana , Palma Paolo TITLE=Humoral and Cellular Response Following Vaccination With the BNT162b2 mRNA COVID-19 Vaccine in Patients Affected by Primary Immunodeficiencies JOURNAL=Frontiers in Immunology VOLUME=12 YEAR=2021 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.727850 DOI=10.3389/fimmu.2021.727850 ISSN=1664-3224 ABSTRACT=

Mass SARS-Cov-2 vaccination campaign represents the only strategy to defeat the global pandemic we are facing. Immunocompromised patients represent a vulnerable population at high risk of developing severe COVID-19 and thus should be prioritized in the vaccination programs and in the study of the vaccine efficacy. Nevertheless, most data on efficacy and safety of the available vaccines derive from trials conducted on healthy individuals; hence, studies on immunogenicity of SARS-CoV2 vaccines in such populations are deeply needed. Here, we perform an observational longitudinal study analyzing the humoral and cellular response following the BNT162b2 mRNA COVID-19 vaccine in a cohort of patients affected by inborn errors of immunity (IEI) compared to healthy controls (HC). We show that both IEI and HC groups experienced a significant increase in anti-SARS-CoV-2 Abs 1 week after the second scheduled dose as well as an overall statistically significant expansion of the Ag-specific CD4+CD40L+ T cells in both HC and IEI. Five IEI patients did not develop any specific CD4+CD40L+ T cellular response, with one of these patients unable to also mount any humoral response. These data raise immunologic concerns about using Ab response as a sole metric of protective immunity following vaccination for SARS-CoV-2. Taken together, these findings suggest that evaluation of vaccine-induced immunity in this subpopulation should also include quantification of Ag-specific T cells.