That is according to a new report in the European Respiratory Journal-Open Research journal. Clinicians and researchers at National Jewish Health in Denver came to those conclusions after studying COVID vaccine effectiveness in patients with underlying lung conditions, such as asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung disease (ILD).
The researchers’ findings suggested that nearly one-half of respiratory patients have lower vaccine-specific antibody and B- and T-cell responses compared with healthy individuals.
“Most of the studies for the COVID vaccine have focused on how well the vaccine protects healthy people,” said senior author R. Lee Reinhardt, PhD, associate professor in the Department of Immunology and Genomic Medicine at the University of Colorado Anschutz Medical Campus. “There is not a lot of data available to know if it protects people with respiratory conditions the same way.”
The study sought to offer more information on how chronic lung disease impacts SARS-CoV-2 vaccine–elicited immunity. To do that, researchers performed deep immune phenotyping of humoral and cell-mediated responses to the SARS-CoV-2 vaccine in patients with asthma, COPD, and ILD, comparing them with healthy controls.
The results indicated that 48% of vaccinated patients with chronic lung diseases had reduced antibody titers to the SARS-CoV-2 vaccine antigen relative to healthy controls. “Vaccine antibody titers were significantly reduced among asthma (P < 0.035), COPD (P < 0.022), and a subset of ILD patients as early as 3-4 months after vaccination, correlating with decreased vaccine-specific memory B cells in circulation,” the study team wrote. “Vaccine-specific memory T cells were significantly reduced in patients with asthma (CD8+ p<0.004; CD4+ P < 0.023) and COPD (CD8+ P < 0.008) compared to healthy controls. Impaired T-cell responsiveness was also observed in a subset of ILD patients (CD8+ 21.4%; CD4+ 42.9%). Additional heterogeneity between healthy and disease cohorts was observed among bulk and vaccine-specific follicular T helper cells.”
The study concluded that their study reveals the “complex nature of vaccine-elicited immunity and highlights the need for more personalized vaccination schemes in patients with underlying lung conditions.”
“If these patients with lung conditions have fewer antibodies, their pulmonologists may have to design a more personalized vaccine approach,” stated first author Haolin Liu, PhD, assistant professor in the Department of Immunology and Genomic Medicine at National Jewish Health, in Denver. “They are more susceptible to exposure and can have their vaccine schedule adjusted.”
Dr. Reinhardt added, “COVID-19 is still around, and we don’t know what the future holds. There could be a winter surge and we need to understand how the immune response affects everyone—not just healthy people.”
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