mRNA COVID-19 vaccines induce superior immunoglobulin A titers in patients with cancer compared with viral vector vaccines: implications for immunization strategies
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: Immunoglobulin (Ig) A antibodies are involved in mucosal immunity and eliminate pathogens immediately at the point of entry. Vaccine-induced IgA antibodies could contribute to an additional layer of protection against SARS-CoV-2 for infection-prone patients with cancer. This might be particularly relevant for patients with cancer because they mount reduced IgG antibody titers after dual-dose BNT162b2 COVID-19 vaccination and even lower responses after double-dose ChAdOx1 vaccination than healthy individuals. However, data on vaccine-induced IgA antibodies are scarce, especially in patients with cancer. METHODS: This study compares SARS-CoV-2 anti-spike (S1) IgA antibodies after dual-dose BNT162b2 vs ChAdOx1 vaccination in patients with cancer. SARS-CoV-2 anti-S1 IgA antibodies were quantified in serum samples collected 7 days after the second vaccination dose (N = 213) (IEQ-CoVS1RBD-IgA-1-RB enzyme-linked immunosorbent assay kit, RayBiotech) and analyzed with colorimetric detection. In addition, correlations with different aspects of humoral immunity were assessed (neutralizing and IgG antibodies). RESULTS: Significantly lower anti-S1 IgA antibody titers were reported in patients with cancer after dual-dose ChAdOx1 than BNT162b2 vaccination. Moreover, patients with cancer who received dual-dose BNT162b2 vaccination had a significant 16.44-fold increased chance to mount detectable IgA antibodies compared with patients receiving ChAdOx1 vaccination. CONCLUSIONS: These findings highlight the potential role of boosters or alternative strategies to sustain mucosal immunity.
Institutions: University of Antwerp, Antwerp University Hospital
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,900
OpenAlex ID: W4410635338