@ARTICLE{10.3389/fimmu.2022.869042, AUTHOR={Zaffina, Salvatore and Piano Mortari, Eva and Di Prinzio, Reparata Rosa and Cappa, Marco and Novelli, Antonio and Agolini, Emanuele and Raponi, Massimiliano and Dallapiccola, Bruno and Locatelli, Franco and Perno, Carlo Federico and Carsetti, Rita}, TITLE={Case Report: Precision COVID-19 Immunization Strategy to Overcome Individual Fragility: A Case of Generalized Lipodystrophy Type 4}, JOURNAL={Frontiers in Immunology}, VOLUME={13}, YEAR={2022}, URL={https://www.frontiersin.org/articles/10.3389/fimmu.2022.869042}, DOI={10.3389/fimmu.2022.869042}, ISSN={1664-3224}, ABSTRACT={A 48-year-old patient affected with congenital generalized lipodystrophy type 4 failed to respond to two doses of the BNT162b2 vaccine, consisting of lipid nanoparticle encapsulated mRNA. As the disease is caused by biallelic variants of CAVIN1, a molecule indispensable for lipid endocytosis and regulation, we complemented the vaccination cycle with a single dose of the Ad26.COV2 vaccine. Adenovirus-based vaccine entry is mediated by the interaction with adenovirus receptors and transport occurs in clathrin-coated pits. Ten days after Ad26.COV2 administration, S- and RBD-specific antibodies and high-affinity memory B cells increased significantly to values close to those observed in Health Care Worker controls.} }