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Galmiche S, Luong Nguyen LB, Tartour E, et al. Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review. Clin Microbiol Infect. 2021;doi: 10.1016/j.cmi.2021.09.036.
Galmiche, S., Luong Nguyen, L. B., Tartour, E., de Lamballerie, X., Wittkop, L., Loubet, P., & Launay, O. (2021). Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, . https://doi.org/10.1016/j.cmi.2021.09.036
Galmiche, Simon, et al. "Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review." Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases vol. (2021). doi: https://doi.org/10.1016/j.cmi.2021.09.036
Galmiche S, Luong Nguyen LB, Tartour E, de Lamballerie X, Wittkop L, Loubet P, Launay O. Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review. Clin Microbiol Infect. 2021 Oct 28; doi: 10.1016/j.cmi.2021.09.036. Epub 2021 Oct 28. PMID: 35020589; PMCID: PMC8595936.
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Clin Microbiol Infect. 2021 Oct 28; doi: 10.1016/j.cmi.2021.09.036. Epub 2021 Oct 28.

Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

Simon Galmiche, Liem Binh Luong Nguyen, Eric Tartour, Xavier de Lamballerie, Linda Wittkop, Paul Loubet, Odile Launay

Affiliations

  1. Assistance Publique - Hôpitaux de Paris (AP-HP), CIC Cochin Pasteur, Hôpital Cochin, Paris, France.
  2. AP-HP, Immunologie Biologique, Hôpital Européen Georges Pompidou, Paris, France.
  3. Aix Marseille Université, IRD 190, INSERM 1207, Unité des Virus Emergents, UVE, IHU Méditerranée Infection, Marseille, France.
  4. Institut de Santé Publique d'Epidémiologie et de Développement, INSERM, Bordeaux Population Health Research Center, UMR 1219, Centre d'Investigation Clinique-Epidémiologie Clinique 1401, University of Bordeaux, Service d'Information Médicale, CHU de Bordeaux, Pôle de Santé Publique, Bordeaux, France.
  5. INSERM U1047, Department of Infectious and Tropical Diseases, CHU Nîmes, Université Montpellier, Nîmes, France.
  6. Université de Paris, Faculté de Médecine Paris Descartes, AP-PH, Inserm, CIC Cochin Pasteur, Paris, France. Electronic address: [email protected].

PMID: 35020589 PMCID: PMC8595936 DOI: 10.1016/j.cmi.2021.09.036

Abstract

BACKGROUND: Available data show that COVID-19 vaccines may be less effective in immunocompromised populations, who are at increased risk of severe COVID-19.

OBJECTIVES: We conducted a systematic review of literature to assess immunogenicity, efficacy and effectiveness of COVID-19 vaccines in immunocompromised populations.

DATA SOURCES: We searched Medline and Embase databases.

STUDY ELIGIBILITY CRITERIA, PATIENTS, INTERVENTIONS: We included studies of COVID-19 vaccines after complete vaccination in immunocompromised patients until 31 August 2021. Studies with <10 patients, safety data only and case series of breakthrough infections were excluded.

METHODS: Risk of bias was assessed via the tool developed by the National Institutes of Health on interventional and observational studies. Immunogenicity was assessed through non-response rate defined as no anti-SARS-CoV-2 spike protein antibodies, efficacy and effectiveness by the relative reduction in risk of SARS-CoV-2 infection or COVID-19. We collected factors associated with the risk of non-response. We presented collected data by immunosuppression type.

RESULTS: We screened 5917 results, included 162 studies. There were 157 on immunogenicity in 25 209 participants, including 7835 cancer or haematological malignancy patients (31.1%), 6302 patients on dialysis (25.0%), 5974 solid organ transplant recipients (23.7%) and 4680 immune-mediated disease patients (18.6%). Proportion of non-responders seemed higher among solid organ transplant recipients (range 18-100%) and patients with haematological malignancy (range 14-61%), and lower in patients with cancer (range 2-36%) and patients on dialysis (range 2-30%). Risk factors for non-response included older age, use of corticosteroids, immunosuppressive or anti-CD20 agent. Ten studies evaluated immunogenicity of an additional dose. Five studies evaluated vaccine efficacy or effectiveness: three on SARS-CoV-2 infection (range 71-81%), one on COVID-19-related hospitalization (62.9%), one had a too small sample size.

CONCLUSIONS: This systematic review highlights the risk of low immunogenicity of COVID-19 vaccines in immunocompromised populations, especially solid organ transplant recipients and patients with haematological malignancy. Despite lack of vaccine effectiveness data, enhanced vaccine regimens may be necessary.

Copyright © 2021 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Keywords: COVID-19; Cancer; Dialysis; Effectiveness; Efficacy; Immunogenicity; SARS-CoV-2 immunocompromised; Solid organ transplant; Vaccine

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