Aberumand Babak, Ayoub Goulstone Whitney, Betschel Stephen
Division of Allergy & Immunology, Department of Medicine, University of Toronto, 30 Bond St., Toronto, ON, M5B 1W8, Canada.
Canadian Immunodeficiencies Patient Organization, Victoria, BC, Canada.
Allergy Asthma Clin Immunol. 2022 May 9;18(1):38. doi: 10.1186/s13223-022-00679-x.
Patients with primary immunodeficiency (PID) are at increased risk for infections such as SARS-CoV-2 (COVID-19), due to the nature of their diseases and being immunocompromised. At this time, four vaccines against COVID-19 (Pfizer-BioNtech's Comirnaty, Moderna's Spikevax, AstraZeneca's Vaxzevria, Johnson & Johnson's Janssen) have been approved for use by Health Canada. Due to the novelty of these vaccines, clinical studies in patients with PID are ongoing. Despite limited evidence, Canada's National Advisory Committee on Immunization (NACI) recommend that patients with PID without any contraindications should be vaccinated with any of the approved vaccines as the potential benefits of being immunized against the virus likely outweigh the risks of contracting a severe infection. The aim of this study was to understand the perceptions regarding COVID-19 vaccination among patients with PID and to identify specific factors related to vaccine hesitancy.
The Canadian Immunodeficiencies Patient Organization (CIPO) conducted an online survey of its members to evaluate uptake of the COVID-19 vaccines by patients with PID. Data was collected using a self-administered online questionnaire. The survey was conducted between March and April 2021.
At the time of survey, among 370 respondents who had not received the COVID-19 vaccine, 302 respondents (81.6%) indicated they were very or somewhat likely to get vaccinated against COVID-19; and 68 respondents (18.4%) indicated they were somewhat or very unlikely, undecided, or not planning to get vaccinated. A large majority of respondents indicated they had a diagnosis of PID (67.8%) and/or specified their type of PID (27.7%). The most common reason for vaccine hesitancy was primarily due to uncertainty about immune response given an underlying immunodeficiency. Other concerns included unknown long-term side effects of COVID-19 vaccination, pre-existing history of allergic reactions, limited amount of data, lack of investigation of safety and effectiveness of COVID-19 vaccines in those with medical conditions, and skepticism of the underlying science and/or the medical system.
The results point to the importance of ongoing patient outreach, education, and up-to-date information on the rapidly evolving scientific knowledge and evidence on COVID-19 relevant to the PID community, from clinical trials to real-world evidence and observational studies.
原发性免疫缺陷（PID）患者由于其疾病性质以及免疫功能低下，感染如严重急性呼吸综合征冠状病毒2（SARS-CoV-2，即新冠病毒病）等感染的风险增加。目前，加拿大卫生部已批准四种新冠病毒疫苗用于接种（辉瑞-生物科技公司的Comirnaty、莫德纳公司的Spikevax、阿斯利康公司的Vaxzevria、强生公司的杨森疫苗）。由于这些疫苗尚属新型，针对PID患者的临床研究正在进行中。尽管证据有限，但加拿大国家免疫咨询委员会（NACI）建议，无任何禁忌证的PID患者应接种任何一种获批疫苗，因为接种疫苗预防该病毒的潜在益处可能超过感染严重疾病的风险。本研究的目的是了解PID患者对新冠病毒疫苗接种的看法，并确定与疫苗犹豫相关的具体因素。
加拿大免疫缺陷患者组织（CIPO）对其成员进行了一项在线调查，以评估PID患者对新冠病毒疫苗的接种情况。数据通过自行填写的在线问卷收集。调查于2021年3月至4月进行。
在调查时，在370名未接种新冠病毒疫苗的受访者中，302名受访者（81.6%）表示他们非常或有点可能接种新冠病毒疫苗；68名受访者（18.4%）表示他们有点或非常不可能、未决定或不打算接种疫苗。绝大多数受访者表示他们被诊断患有PID（67.8%）和/或明确了其PID类型（27.7%）。疫苗犹豫的最常见原因主要是由于存在潜在免疫缺陷，对免疫反应存在不确定性。其他担忧包括新冠病毒疫苗未知的长期副作用、既往过敏反应史、数据量有限、缺乏对患有疾病者中新冠病毒疫苗安全性和有效性的研究，以及对基础科学和/或医疗系统的怀疑。
结果表明，持续开展患者宣传教育以及提供与PID群体相关的、关于新冠病毒的快速发展的科学知识和证据（从临床试验到真实世界证据和观察性研究）的最新信息非常重要。
