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. 2022 Jul 7;76(3):e426–e438. doi: 10.1093/cid/ciac404

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© The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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Figure 6. — Impact of different therapy on immune response. Independently from the diseases, the patients were divided on the basis of therapy in 4 groups: untreated (white dots) or treated by therapy with a low (light violet dots), medium (dark violet dots), and high (blue dots) impact on the immune system. A group of HCW was added as a control. The immunogenicity of 2 or 3 doses of vaccine was compared among groups. A, The levels of anti-RBD in the 4 patient groups and in HCW are shown. Differences were evaluated by Kruskal-Wallis test. **P < .01; ***P < .001; ****P < .0001. Response after 2 doses: no therapy: median = 94.2 BAU/mL (IQR .4–1133.0 BAU/mL); low impact: 1144.0 BAU/mL (IQR 368.1–11,360.0 BAU/mL); medium impact: 420.3 BAU/mL (IQR 17.4–1563.0 BAU/mL); high impact: 0.2 (IQR 0.1–6.4 BAU/mL); HCW: 2405.0 BAU/mL (IQR 1343–3848 BAU/mL). Response after the third dose: no therapy: median = 1748 BAU/mL (IQR 95.4–3917.0 BAU/mL); low impact: 3044 BAU/mL (IQR 998.8–6175.0 BAU/mL); medium impact: 1088.0 BAU/mL (IQR 380.1–2536.0 BAU/mL); high impact: 3.5 (IQR .4–39.6 BAU/mL); HCW: post-3D: 4608.0 BAU/mL (IQR 3302.0–6030.0 BAU/mL). B, The level of neutralizing antibodies in the 4 groups is shown. Differences were evaluated by Kruskal-Wallis test. *P < .05; ****P < .0001. Response after 2 doses: no therapy: median = 80 reciprocal of dilution (IQR 10–160); low impact: 80 reciprocal of dilution (IQR 20–160); medium impact: 40 reciprocal of dilution (IQR 6.2–160.0); high impact: 5 reciprocal of dilution (IQR 5–20); HCW: 160 (IQR 80–320). Response after the third dose: no therapy: median = 120 reciprocal of dilution (IQR 10–560); low impact: 320 reciprocal of dilution (IQR 140–400); medium impact: 160 reciprocal of dilution (IQR 80–320); high impact: 5 reciprocal of dilution (IQR 5–10); HCW: 320 reciprocal of dilution (IQR 160–640). C: The T-cell response, analyzed by quantifying IFN-γ in the 4 groups is shown. Differences were evaluated by Kruskal-Wallis test. Response after 2 doses: no therapy: median = 74.9 pg/mL (IQR 2.7–338.4 pg/mL); low impact: 105.9 pg/mL (IQR 26.3–291.9 pg/mL); medium impact: 69.2 pg/mL (IQR 18.1–297.3 pg/mL); high impact: 186.3 pg/mL (IQR 22.7–390.0); HCW: 331.9 pg/mL (IQR 189.9–765.0 pg/mL). Response after the third dose: no therapy: median = 127.2 pg/mL (IQR 15.8–192.0 pg/mL); low impact: 158.9 pg/mL (IQR 87.2–536.4 pg/mL); medium impact: 243.4 pg/mL (IQR 69.3–799.7 pg/mL); high impact: 545.3 pg/mL (IQR 171.9–2049.0). HCW: 448.9 pg/mL (IQR 197.3–852.2 pg/mL). Abbreviations: HCW, health care workers; IQR, interquartile range; RBD, receptor binding domain; T2, 5–8 weeks from T0; Tpost-3D, 2–4 weeks from Tpre-3D.