Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China.
Department of Emergency, The Fifth Medical Center of Chinese PLA Hospital, Beijing 100039, China.
Chin Med J (Engl). 2022 Nov 20;135(22):2656-2666. doi: 10.1097/CM9.0000000000002505.
The coronavirus disease 2019 (COVID-19) pandemic poses a great threat to public health. Individuals who are immunocompromised because of the progression of the primary disease or receiving immunosuppressive medications are prone to severe COVID-19 complications and poor outcomes. Abundant data have shown that many COVID-19 vaccines are safe and effective in large-scale populations; however, these clinical trials have excluded immunocompromised populations. Available evidence indicates that immunocompromised populations have a blunted immune response to other vaccines, raising concerns regarding the efficacy of COVID-19 vaccination in these populations. Thus, there is an urgent need to delineate the efficacy of COVID-19 vaccines in these vulnerable populations. Here, we review the characteristics of specific humoral and cellular responses to COVID-19 vaccination in immunocompromised populations, including HIV-infected patients and those receiving immunosuppressive treatment, especially solid organ transplant recipients and those undergoing anti-CD20 treatment. We also addressed the challenges that immunocompromised populations will face in the future pandemic and the need for basic and clinical translational studies to highlight the best vaccination strategies for these populations.
新型冠状病毒病 2019(COVID-19)大流行对公共卫生构成了巨大威胁。由于基础疾病的进展或接受免疫抑制药物治疗而免疫功能低下的个体易发生严重的 COVID-19 并发症和不良结局。大量数据表明,许多 COVID-19 疫苗在大规模人群中是安全有效的;然而,这些临床试验排除了免疫功能低下的人群。现有证据表明,免疫功能低下的人群对其他疫苗的免疫反应减弱,这让人对这些人群 COVID-19 疫苗的疗效产生了担忧。因此,迫切需要描述 COVID-19 疫苗在这些脆弱人群中的疗效。在这里,我们回顾了 COVID-19 疫苗在包括 HIV 感染者和接受免疫抑制治疗的人群在内的免疫功能低下人群中的体液和细胞反应的特征,特别是实体器官移植受者和接受抗 CD20 治疗的人群。我们还讨论了免疫功能低下人群在未来大流行中面临的挑战,以及基础和临床转化研究的必要性,以突出这些人群的最佳疫苗接种策略。