Infectious Disease

Study supports additional doses of COVID-19 vaccine for immunocompromised patients

11/02/2021

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Embi does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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COVID-19 vaccination is less effective in immunocompromised adults than it is in the general population, according to a large study that supports recent recommendations for additional doses.

In August, the FDA approved a third dose of the COVID-19 messenger RNA vaccine for certain immunocompromised people – “particularly recipients of solid organ transplants or those diagnosed with conditions that have an equivalent level of immunodeficiency”.

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Since then, the FDA has approved booster doses for millions more people, and the CDC now says that immunocompromised people can receive a booster dose of the COVID-19 vaccine 6 months after a third dose.

In the new study published in MMWR, Peter J. Embi, MD, President and CEO of the Regenstrief Institute in Indianapolis, and colleagues evaluated the effectiveness of mRNA vaccines in immunocompromised adults using data from the VISION Network, a collaboration between the CDC and seven US health systems. The data comes from adults who were hospitalized at 187 hospitals in nine states with COVID-19-like symptoms from January 17 to September 5.

They evaluated the vaccine’s effectiveness against COVID-19-associated hospital admissions using a test-negative design that compared 20,101 immunocompromised adults – 53% of whom received a two-dose mRNA COVID-19 series of vaccines – with 69,116 immunocompetent adults, of of which 43% were fully vaccinated with a two-dose mRNA series.

The effectiveness of the vaccine was 77% (95% CI, 74% -80%) in immunocompromised adults compared to 90% (95% CI, 89% -91%) in those who are immunocompetent, the researchers reported.

The difference in efficacy persisted regardless of which mRNA patients received, how old they were, when they were hospitalized, or whether the delta variant was predominant.

In addition, efficacy differed between immunocompromised subgroups, such as those who received an organ or stem cell transplant (59%) compared to those with a rheumatoid or inflammatory disease (81%).

“Immunocompromised individuals benefit from COVID-19 vaccines and should receive them,” the authors wrote. “Given that [vaccine effectiveness] is lower than in immunocompetent patients, immunocompromised individuals receiving mRNA vaccines should receive three doses and 6 months after the third dose, in accordance with CDC recommendations. “

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