COVID-19 Vaccination in Patients with Inborn Errors of Immunity Reduces Hospitalization and Critical Care Needs Related to COVID-19: a USIDNET Report


John McDonnell, Cleveland Clinic Foundation
Kimberley Cousins, Icahn School of Medicine at Mount Sinai
M. Elizabeth M. Younger, Johns Hopkins University School of Medicine
Adam Lane, Cincinnati Children's Hospital Medical Center
Hassan Abolhassani, Karolinska Institutet
Roshini S. Abraham, Nationwide Children’s Hospital
Salem Al-Tamemi, Sultan Qaboos University Hospital
Juan Carlos Aldave-Becerra, Hospital Nacional Edgardo Rebagliati Martins, EsSalud
Eman Hesham Al-Faris, King Fahad Specialist Hospital, Dammam
Alberto Alfaro-Murillo, Hospital San Juan de Dios Costa Rica
Suzan A. AlKhater, Imam Abdulrahman Bin Faisal University
Nouf Alsaati, The Children's Hospital of Philadelphia
Alexa Michelle Altman Doss, St. Louis Children's Hospital
Melissa Anderson, UMKC School of Medicine
Ernestina Angarola, Immunology and Histocompatibility Unit
Barbara Ariue, Loma Linda University Children's Hospital
Danielle E. Arnold, National Cancer Institute (NCI)
Amal H. Assa'ad, Cincinnati Children's Hospital Medical Center
Caner Aytekin, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital
Meaghan Bank, LSU Health Sciences Center - New OrleansFollow
Jenna R.E. Bergerson, National Institute of Allergy and Infectious Diseases (NIAID)
Jack Bleesing, Cincinnati Children's Hospital Medical Center
John Boesing, Cincinnati Children's Hospital Medical Center
Carolina Bouso, Fundacion Hospital de Pediatria Professor Dr. Juan P. Garrahan
Nicholas Brodszki, Skånes Universitetssjukhus
Diana Cabanillas, Hospital de Ninos Sor Maria Ludovica
Carol Cady, Community Medical Center
Meghan A. Callahan, Lake Erie College of Osteopathic Medicine
Luke Wall, LSU Health Sciences Center - New OrleansFollow
et al

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Journal of Clinical Immunology


BACKGROUND: The CDC and ACIP recommend COVID-19 vaccination for patients with inborn errors of immunity (IEI). Not much is known about vaccine safety in IEI, and whether vaccination attenuates infection severity in IEI. OBJECTIVE: To estimate COVID-19 vaccination safety and examine effect on outcomes in patients with IEI. METHODS: We built a secure registry database in conjunction with the US Immunodeficiency Network to examine vaccination frequency and indicators of safety and effectiveness in IEI patients. The registry opened on January 1, 2022, and closed on August 19, 2022. RESULTS: Physicians entered data on 1245 patients from 24 countries. The most common diagnoses were antibody deficiencies (63.7%). At least one COVID-19 vaccine was administered to 806 patients (64.7%), and 216 patients received vaccination prior to the development of COVID-19. The most common vaccines administered were mRNA-based (84.0%). Seventeen patients were reported to seek outpatient clinic or emergency room care for a vaccine-related complication, and one patient was hospitalized for symptomatic anemia. Eight hundred twenty-three patients (66.1%) experienced COVID-19 infection. Of these, 156 patients required hospitalization (19.0%), 47 required ICU care (5.7%), and 28 died (3.4%). Rates of hospitalization (9.3% versus 24.4%, p < 0.001), ICU admission (2.8% versus 7.6%, p = 0.013), and death (2.3% versus 4.3%, p = 0.202) in patients who had COVID-19 were lower in patients who received vaccination prior to infection. In adjusted logistic regression analysis, not having at least one COVID-19 vaccine significantly increased the odds of hospitalization and ICU admission. CONCLUSION: Vaccination for COVID-19 in the IEI population appears safe and attenuates COVID-19 severity.

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