AUTHOR=Szabó Enikő , Modok Szabolcs , Rónaszéki Benedek , Faragó Anna , Gémes Nikolett , Nagy Lajos I. , Hackler László , Farkas Katalin , Neuperger Patrícia , Balog József Á. , Balog Attila , Puskás László G. , Szebeni Gabor J. 

TITLE=Comparison of humoral and cellular immune responses in hematologic diseases following completed vaccination protocol with BBIBP-CorV, or AZD1222, or BNT162b2 vaccines against SARS-CoV-2

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1176168

DOI=10.3389/fmed.2023.1176168

ISSN=2296-858X

ABSTRACT=Background: Vaccination has proven the potential to control the COVID-19 pandemic worldwide. Although recent evidence suggests a poor humoral response against SARS-CoV-2 in vaccinated hematological disease (HD) patients, data on vaccination in these patients is limited with the comparison of mRNA-based, vector-based or inactivated virus-based vaccines. Methods: 49 HD patients and 46 healthy controls (HCs) were enrolled who received two-doses complete vaccination with BNT162b2, or AZD1222, or BBIBP-CorV, respectively. The antibodies reactive to the receptor binding domain of spike protein of SARS-CoV-2 were assayed by Siemens ADVIA Centaur assay. The reactive cellular immunity was assayed by flow cytometry. The PBMCs were reactivated with SARS-CoV-2 antigens and the production of activation-induced markers (TNFα, IFN-γ, CD40L) was measured in CD4+ or CD8+ T-cells ex vivo. Results: The anti-RBD IgG level was the highest upon BNT162b2 vaccination in HDs (1264 BAU/ml) vs. HCs (1325 BAU/ml) among the studied groups. The BBIBP-CorV vaccination in HDs (339.8 BAU/ml ***p<0.001) and AZD1222 in HDs (669.9 BAU/ml *p<0.05) resulted in weaker antibody This is a provisional file, not the final typeset article response vs. BNT162b2 in HCs. The response rate of IgG production of HC vs. HD patients above the diagnostic cut-off value was 100% vs. 72% for the mRNA-based BNT162b2 vaccine; 93% vs. 56% for the vector-based AZD1222, or 69% vs. 33% for the inactivated vaccine BBIBP-CorV, respectively. Cases that underwent the anti-CD20 therapy resulted in significantly weaker (**p<0.01) anti-RBD IgG level (302 BAU/ml) than without CD20 blocking in the HD group (928 BAU/ml). The response rates of CD4+TNF-α+, CD4+IFN-γ+, or CD4+CD40L+ cases were lower in HDs vs. HCs in all vaccine groups. However, the BBIBP-CorV vaccine resulted the highest CD4+TNF-α and CD4+IFN-γ+ T-cell mediated immunity in the HD group.We have demonstrated a significant weaker overall response to vaccines in the immunologically impaired HD population vs. HCs regardless of vaccine type. Although, the humoral immune activity against SARS-CoV-2 can be highly evoked by mRNA-based BNT162b2 vaccination compared to vector-based AZD1222 vaccine, or inactivated virus vaccine BBIBP-CorV, whereas the CD4+ T-cell mediated cellular activity was highest in HDs vaccinated with BBIBP-CorV.