Table 2.
Efficacy of COVID-19 vaccination among immunocompromised patients.
| Vaccine Type | Author (Year) [Ref] | Number of IC Patients (Studies) | Reason for being IC | Description of Vaccine Efficacy | Interventions to Improve Vaccine Efficacy |
|---|---|---|---|---|---|
| COVID-19 (mRNA) | Akyol (2021) [10] |
1955 adults (18) | Dialysis and kidney transplant recipients | Pooled seroconversion rate of 27.2% for kidney transplantation, 88.5% for dialysis patients, and 100% for healthy controls after two doses of vaccine | Second vaccine dose |
| COVID-19 (various) | Becerril-Gaitan (2022) [21] |
8332 adults (35) | Malignancy | Pooled seroconversion rate in cancer patients of 51% after first dose vaccine and 73% after second dose vaccine. Seroconversion lower in patients with hematologic cancer versus solid tumors (65% vs. 94%) | Second vaccine dose |
| COVID-19 (various) |
Bhurwal (2022) [13] | 2484 adults (21) | Inflammatory bowel disease | Pooled seroconversion rate of 73.7% and 96.8% after one and two doses of vaccine respectively | Second vaccine dose |
| COVID-19 (mostly mRNA) | Cavanna (2021) [22] | 621 adults (6) | Malignancy | No reduced rate of seroconversion for patients with solid tumors compared with the control, but 38% reduced seroconversion for patients with hematologic cancer | Second vaccine dose |
| COVID-19 (various) | Corti (2022) [23] | 9260 adults (36) | Malignancy | Pooled seroconversion rate of 11–87.5% and 7.3–100% after one and two doses of vaccine, respectively. Exceptionally poor seroconversion for patients with hematologic cancer receiving B-cell-depleting agents within last 12 months | Second vaccine dose |
| COVID-19 (mRNA) | Efros (2022) [19] |
853 adults (7) | Solid organ transplant recipients | Pooled seroconversion rate of 50.3% after the third vaccine | Third vaccine dose |
| COVID-19 (various) | Gagelmann (2021) [24] |
11,086 adults (49) | Hematologic malignancies | Pooled seroconversion rate of 64% after 2 doses of mRNA or 1 dose of vector-based vaccines, versus 96% for solid cancer and 98% for healthy controls | Not studied |
| COVID-19 (various) | Galmiche (2022) [25] |
25,209 adults (162) | Malignancy, dialysis, transplant recipients, immune-mediated disease | No seroconversion among 18–100% of solid organ transplant recipients, 14–61% of patients with hematological malignancy, 2–36% of patients with cancer, and 2–30% of patients on dialysis | Not studied |
| COVID-19 (mRNA, viral vector) | Guven (2021) [27] |
1448 adults (17) | Malignancy | Cancer patients had significantly lower seroconversion rates than controls after first vaccine dose (37.3 vs. 74.1%) and after two doses (78.3 vs. 99.6%). The difference in seroconversion rates was more pronounced patients with hematologic cancer versus solid tumors | Second vaccine dose |
| COVID-19 (mRNA, viral vector) |
Guven (2022) [26] |
3187 adults (26) | Hematologic malignancies | Pooled seroconversion rate of 33.3% and 65.3% after one and two doses of vaccine, respectively; <70% seroconversion if on anti-CD20 or anti-CTLA-4 therapy | Second vaccine dose |
| COVID-19 (mRNA) | Jena (2022) [15] | 2286 adults (25) | Immune mediated inflammatory diseases | Pooled seroconversion rate 69.3% and 83.1%, after 1 and 2 doses of mRNA vaccination, respectively | Second dose vaccine |
| COVID-19 (various) | Jena (2022) [14] | 9447 adults (46) | Inflammatory bowel disease | Pooled seroconversion rate of 96% for complete vaccination. Decay of titers higher with anti-TNF immunomodulation | Not studied |
| COVID-19 (94% mRNA) | Lee (2022) [29] |
9974 adults (82) | Malignancy, immune-mediated inflammatory disorders, organ transplant recipients, HIV patients | Seroconversion 6–44% after 1 vaccine dose, 35–89% after 2 vaccine doses | Second vaccine dose |
| COVID-19 (99% mRNA) |
Ma (2022) [11] | 4264 adults (27) | Chronic kidney failure requiring kidney replacement therapy | After 2 vaccine doses, 44% decreased seropositivity compared to general population. Kidney transplant recipients had significantly lower seroconversion than patients on hemodialysis or peritoneal dialysis (26.1 vs. 84.3% and 92.4%, respectively) | Not studied |
| COVID-19 (mRNA) | Manothum-metha (2022) [20] | 11,713 adults (29) | Solid organ transplant recipients | Mean seroconversion rate was 10.4% after 1 dose, 44.9% after 2 doses, and 63.1% after 3 doses. Lower response given older age, deceased donor status, and use of immunosuppression (antimetabolite, rituximab, and antithymocyte globulin) | Multiple (up to 4) vaccine doses |
| COVID-19 (various) |
Marra (2022) [30] |
45,040 adults (24) | Solid organ transplant recipients, malignancy, inflammatory rheumatic diseases | Mean seroconversion rate of 25.2% in solid organ transplant recipients, 68% in patients with malignancy, and 86% in patients with inflammatory rheumatic diseases. Overall vaccine effectiveness of 70.4% against symptomatic infection | Not studied |
| COVID-19 (various) |
Mehrabi (2022) [31] |
3207 adults (26) | Autoimmune conditions, malignancy, transplant recipients | A 48% lower rate of seroconversion after 2 doses, worse with transplant recipients | Not studied |
| COVID-19 (mostly mRNA) |
Sakuraba (2022) [17] |
1453 adults (16) | Malignancy | Pooled seroconversion rate of 54.2% and 87.7% after one and two doses of vaccine, respectively; lower rates with hematologic compared to solid organ malignancy | Second vaccine dose |
| COVID-19 (mostly mRNA) |
Sakuraba (2022) [16] | 5360 adults (25) | Immune-mediated inflammatory diseases | Pooled seroconversion rate of 73.2% and 83.4% after one and two doses of vaccine, respectively; lower rates with patients on anti-CD20 therapy | Second vaccine dose |
| COVID-19 (various) |
Schietzel (2022) [18] |
1342 adults (23) | Anti-CD20 therapy | Pooled seroconversion rate of 40% for complete vaccination; lower rates with kidney transplant recipients | Not studied |
| COVID-19 (various) |
Swai (2022) [12] | 2789 adults (27) | Chronic kidney failure | Hemodialysis patients’ proportions of humoral (antibody) and cellular (T-helper cell) immune responses varied from 87.3% to 88.8% and from 62.9% to 85.8%, respectively, comparable to healthy control responses. Kidney transplant patients’ humoral and cellular immune responses ranged from 2.6% to 29.9% and from 5.1% to 59.8%, respectively, significantly lower than healthy control responses | Not studied |
| COVID-19 (various) |
Teh (2022) [28] |
7064 adults (44) | Hematologic malignancies | Overall seroconversion rate 37–51% after 1 dose of COVID-19 vaccine and 62–66% after 2 doses | Second vaccine dose |
CTLA-4: cytotoxic T-lymphocyte antigen-4; HIV: human immunodeficiency virus; IC: immunocompromised; mRNA: messenger ribonucleic acid; Ref: reference; TNF: tumor necrosis factor. Various vaccine types included mRNA, viral vector-based, and inactivated virus vaccines.