Humoral and cellular immune response after COVID-19 vaccination in patients with sickle cell disease on hydroxyurea
Year: 2025
Type: article
Abstract: ABSTRACT: Patients with sickle cell disease (SCD) are at increased risk of COVID-19-related mortality compared with healthy individuals, even after vaccination. To what extent impaired vaccine-induced immunity contributes to this risk is unknown. We prospectively investigated vaccine immunogenicity in 31 patients with SCD who received COVID-19 mRNA vaccines. All patients used hydroxyurea. We quantified humoral and cellular immune responses 4 weeks after the second and third vaccinations and compared the results with those of age-, sex-, and vaccine-matched healthy individuals. Irrespective of higher naïve and lower memory B-cell subsets, serum neutralizing spike glycoprotein 1 immunoglobulin G antibody concentrations and frequencies of spike-specific memory B cells were similar to those in healthy individuals at each time point. Frequencies of CD4+ and CD8+ T cells in patients with SCD were also comparable with controls; however, type 1 cytokine production by spike-specific T cells was reduced. Reduced cytokine production and lower antibody production correlated with higher serum fetal hemoglobin levels, suggesting an association with hydroxyurea use. Although a third vaccination improved neutralizing antibody and memory B-cell responses, T helper 1 cytokine production tended to remain lower in patients than in controls. Our data point toward delayed or reduced vaccine-induced immunity, in line with previous reports, which may contribute to the increased risk of COVID-19-related mortality reported in these patients. This trial was registered at www.ccmo.nl as NL-OMON51241.
Source: Blood Advances
Authors: Sabine Haggenburg, Cilia R. Pothast, Quincy Hofsink, Nienke J. E. Haverkate, Michel S. Bhoekhan, Mathieu Claireaux, Rob S. van Binnendijk, Gerco den Hartog, Birgit I. Lissenberg-Witte, Rory D. de Vries, Charlotte van Tuijn, Bart J. Biemond, Erfan Nur, Corine H. Geurts van Kessel, Pim G. N. J. Mutsaers, Annoek E. C. Broers, Abraham Goorhuis, Inger S. Nijhof, Marit J. van Gils, Mirjam H. M. Heemskerk, Mette D. Hazenberg, Caroline E. Rutten, Johan J.H. van Meerloo, Gaby P. Smit, Dorine Wouters, Ester M.M. van Leeuwen, Hetty J. Bontkes, Neeltje Kootstra, Iris M.J. Kant, Thecla Graas, Belle Toussaint, Sterre de Jong, Shahan Darwesh, Sandjiv S. Mahes, Dora Kamminga, Matthijs Koelewijn, Gino Faber, Guus Beaumont, Marije D. Engel, R. Cheyenne N. Pierie, Suzanne R. Janssen, Gino Faber, Kazimierz Groen, Judith A. Burger, Joey H. Bouhuijs, Paul A. Baars, Edith van Dijkman, Jarom Heijmans, Yara Y. Witte, Rogers A. Nahui Palomino, Said Z. Omar, Sonja Zweegman, Arnon P. Kater, Caya van den Vegt, Ilonka Arends-Halbesma, Emma de Pater, Margriet J. Dijkstra, Josien van Beek, Nynke Y. Rots, Esther Siteur-van Rijnstra, Dennis M. de Rooij, Rogier W. Sanders, Meliawati Poniman, Wouter Olijhoek, Jacqueline van Rijswijk, Tim Beaumont, Lusia Çetinel, Louis Schellekens, Yvonne M. den Hartogh, Jacqueline Cloos, Suzanne S. Weijers, Saïda Tonouh-Aajoud, Selime Avci, Elianne Roelandse-Koop, Willem A. Dik, Sandra Vogels-Nooijen
Institutions: Amsterdam University Medical Centers, Cancer Center Amsterdam, Amsterdam institute for Immunology and Infectious Diseases, University of Amsterdam, Leiden University Medical Center, National Institute for Public Health and the Environment, Radboud University Nijmegen, Radboud University Medical Center, Vrije Universiteit Amsterdam, Amsterdam UMC Location Vrije Universiteit Amsterdam, Erasmus MC, Erasmus University Rotterdam, Erasmus MC Cancer Institute, St. Antonius Ziekenhuis, Sanquin, American Society of Hematology
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,800
Award: G1874363701
OpenAlex ID: W4416716946