COVID-19 Vaccination in Patients with Inborn Errors of Immunity Reduces Hospitalization and Critical Care Needs Related to COVID-19: a USIDNET Report
John McDonnell, Kimberley Cousins, M. Elizabeth M. Younger, Adam Lane, Hassan Abolhassani, Roshini S. Abraham, Salem Al‐Tamemi, Juan Carlos Aldave-Becerra, Eman Hesham Al-Faris, Alberto Alfaro-Murillo, Suzan A. AlKhater, Nouf Alsaati, Alexa Michelle Altman Doss, Melissa Anderson, Ernestina Angarola, Barbara Ariue, Danielle E. Arnold, Amal Assa’ad, Caner Aytekin, Meaghan Bank, Jenna Bergerson, Jack Bleesing, John Boesing, Carolina Bouso, Nicholas Brodszki, Diana Cabanillas, Carol Cady, Meghan Callahan, Roberta Caorsi, Javier Carbone, Maria Carrabba, Riccardo Castagnoli, Jason Catanzaro, Samantha Chan, Sharat Chandra, Hugo Chapdelaine, Zahra Chavoshzadeh, Hey Chong, Lori Connors, Filippo Consonni, Óscar Correa-Jiménez, Charlotte Cunningham‐Rundles, Katherine D’Astous-Gauthier, Ottavia M. Delmonte, Yeşim Yılmaz Demirdağ, Deepti Deshpande, Natalie M. Diaz-Cabrera, Victoria R. Dimitriades, Rasha El‐Owaidy, Gehad ElGhazali, Suleiman Al‐Hammadi, Giovanna Fabio, Astrid Schellnast Faure, Jin Feng, James Fernandez, Lauren Fill, Guacira R. Franco, Robert W. Frenck, Ramsay Fuleihan, Giuliana Giardino, Jessica Galant-Swafford, Eleonora Gambineri, Elizabeth Garabedian, Ashley V. Geerlinks, Ekaterini Goudouris, Octávio Grecco, Qiang Pan‐Hammarström, Hedieh Haji Khodaverdi Khani, Lennart Hammarström, Nicholas Hartog, Jennifer Heimall, Gabriela Hernández‐Molina, Caroline C. Horner, Robert Hostoffer, Nataliya Hristova, Kuang‐Chih Hsiao, Gabriela Ivankovich‐Escoto, Faris Jaber, Maaz Jalil, Mahnaz Jamee, Tiffany Jean, Stephanie Jeong, Devi Jhaveri, Michael B. Jordan, Avni Y. Joshi, Amanpreet Kalkat, Henry J. Kanarek, Erinn S. Kellner, Amer Khojah, Ruby Khoury, Cristina Maria Kokron, Ashish Kumar, Kelsey Lecerf, Heather K. Lehman, Jennifer W. Leiding, Harry Lesmana, Xin Rong Lim, João Pedro Lopes, Ana Laura López, Lucia M Tarquini
Abstract
BACKGROUND: The CDC and ACIP recommend COVID-19 vaccination for patients with inborn errors of immunity (IEI). Not much is known about vaccine safety in IEI, and whether vaccination attenuates infection severity in IEI. OBJECTIVE: To estimate COVID-19 vaccination safety and examine effect on outcomes in patients with IEI. METHODS: We built a secure registry database in conjunction with the US Immunodeficiency Network to examine vaccination frequency and indicators of safety and effectiveness in IEI patients. The registry opened on January 1, 2022, and closed on August 19, 2022. RESULTS: Physicians entered data on 1245 patients from 24 countries. The most common diagnoses were antibody deficiencies (63.7%). At least one COVID-19 vaccine was administered to 806 patients (64.7%), and 216 patients received vaccination prior to the development of COVID-19. The most common vaccines administered were mRNA-based (84.0%). Seventeen patients were reported to seek outpatient clinic or emergency room care for a vaccine-related complication, and one patient was hospitalized for symptomatic anemia. Eight hundred twenty-three patients (66.1%) experienced COVID-19 infection. Of these, 156 patients required hospitalization (19.0%), 47 required ICU care (5.7%), and 28 died (3.4%). Rates of hospitalization (9.3% versus 24.4%, p < 0.001), ICU admission (2.8% versus 7.6%, p = 0.013), and death (2.3% versus 4.3%, p = 0.202) in patients who had COVID-19 were lower in patients who received vaccination prior to infection. In adjusted logistic regression analysis, not having at least one COVID-19 vaccine significantly increased the odds of hospitalization and ICU admission. CONCLUSION: Vaccination for COVID-19 in the IEI population appears safe and attenuates COVID-19 severity.