Humoral and Cellular Response to the COVID-19 Vaccine in Immunocompromised Children

Overview

Journal Pediatr Res

Specialties Biology
Pediatrics

Date 2022 Nov 14

PMID 36376507

Authors

Heather A Morgans

Todd Bradley

Linda Flebbe-Rehwaldt

Rangaraj Selvarangan

Amber Bagherian

Aliessa P Barnes

Julie Bass

Ashley M Cooper

Ryan Fischer

Steve Kleiboeker

Brian R Lee

Cas LeMaster

Kelsey Markus

Stephen Morrison

Angela Myers

Doug Myers

Erin Payne

Jennifer E Schuster

Sarah Standley

Andrea Wieser

Bradley Warady

Affiliations

Soon will be listed here.

Abstract

Background: A suboptimal response to the 2-dose COVID-19 vaccine series in the immunocompromised population prompted recommendations for a 3rd primary dose. We aimed to determine the humoral and cellular immune response to the 3rd COVID-19 vaccine in immunocompromised children.

Methods: Prospective cohort study of immunocompromised participants, 5-21 years old, who received 2 prior doses of an mRNA COVID-19 vaccine. Humoral and CD4/CD8 T-cell responses were measured to SARS-CoV-2 spike antigens prior to receiving the 3rd vaccine dose and 3-4 weeks after the 3rd dose was given.

Results: Of the 37 participants, approximately half were solid organ transplant recipients. The majority (86.5%) had a detectable humoral response after the 2nd and 3rd vaccine doses, with a significant increase in antibody levels after the 3rd dose. Positive T-cell responses increased from being present in 86.5% to 100% of the cohort after the 3rd dose.

Conclusions: Most immunocompromised children mount a humoral and cellular immune response to the 2-dose COVID-19 vaccine series, which is significantly augmented after receiving the 3rd vaccine dose. This supports the utility of the 3rd vaccine dose and the rationale for ongoing emphasis for vaccination against COVID-19 in this population.

Impact: Most immunocompromised children mount a humoral and cellular immune response to the 2-dose COVID-19 vaccine series, which is significantly augmented after receiving the 3rd vaccine dose. This is the first prospective cohort study to analyze both the humoral and T-cell immune response to the 3rd COVID-19 primary vaccine dose in children who are immunocompromised. The results of this study support the utility of the 3rd vaccine dose and the rationale for ongoing emphasis for vaccination against COVID-19 in the immunosuppressed pediatric population.

Citing Articles

Immunological memory to COVID-19 vaccines in immunocompromised and immunocompetent children.

Russo C, Otero A, Uranga M, Seery V, Raiden S, Algieri S Front Cell Infect Microbiol. 2025; 15:1527573.

PMID: 40034392 PMC: 11873107. DOI: 10.3389/fcimb.2025.1527573.

Humoral and cellular response to SARS-CoV-2 mRNA vaccine in paediatric heart transplant recipients.

Bermejo-Gomez A, Tarancon-Diez L, Lazaro-Martin B, Santiago-Garcia B, Gil Villanueva N, Alonso R Heliyon. 2025; 11(1):e41584.

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Reduced durability of hybrid immunity to SARS-CoV-2 in immunocompromised children.

Zhong Y, Kottaiswamy A, Ang C, Li H, Yap G, Tay C Front Immunol. 2025; 15:1502598.

PMID: 39742263 PMC: 11685208. DOI: 10.3389/fimmu.2024.1502598.

Humoral and cellular immune response after mRNA SARS-CoV-2 vaccine in children on treatment for cancer: A pilot observational study.

Mastronuzzi A, Carsetti R, De Ioris M, Agrati C, Del Baldo G, Russo C Heliyon. 2024; 10(14):e34503.

PMID: 39713186 PMC: 11659958. DOI: 10.1016/j.heliyon.2024.e34503.

Cross-neutralization of distant coronaviruses correlates with Spike S2-specific antibodies from immunocompetent and immunocompromised vaccinated SARS-CoV-2-infected patients.

Patel S, Leeman B, Botros P, Folta J, Shahid D, Rocque A Res Sq. 2024; .

PMID: 39678346 PMC: 11643334. DOI: 10.21203/rs.3.rs-5487774/v1.

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