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
("Hetenyi Geza" Fund of the Faculty of Medicine, University of Szeged)
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.MethodsForty-nine
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 (TNF-α, IFN-γ, CD40L) was measured in CD4+
or CD8+ T-cells ex vivo.ResultsThe
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
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.ConclusionWe
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.
