Vaccines and Therapeutics for Immunocompromised Patients with COVID-19

Authors

Shmuel Shoham
Carolina Batista
Yanis Ben Amor
Onder Ergonul
Mazen Hassanain
Peter Hotez
Gagandeep Kang
Jerome H Kim
Bhavna Lall
Heidi J Larson
Denise Naniche
Timothy Sheahan
Nathalie Strub-Wourgaft
Samba O Sow
Annelies Wilder-Smith
Prashant Yadav
Maria Elena Bottazzi
Lancet Commission on COVID-19 Vaccines and Therapeutics Task Force

Publication Date

5-1-2023

Journal

EClinicalMedicine

DOI

10.1016/j.eclinm.2023.101965

PMID

37070102

PMCID

PMC10091856

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

COVID-19, SARS-CoV-2, Immunocompromised, Transplantation, Malignancy

Abstract

The COVID-19 pandemic has disproportionately impacted immunocompromised patients. This diverse group is at increased risk for impaired vaccine responses, progression to severe disease, prolonged hospitalizations and deaths. At particular risk are people with deficiencies in lymphocyte number or function such as transplant recipients and those with hematologic malignancies. Such patients' immune responses to vaccination and infection are frequently impaired leaving them more vulnerable to prolonged high viral loads and severe complications of COVID-19. Those in turn, have implications for disease progression and persistence, development of immune escape variants and transmission of infection. Data to guide vaccination and treatment approaches in immunocompromised people are generally lacking and extrapolated from other populations. The large clinical trials leading to authorisation and approval of SARS-CoV-2 vaccines and therapeutics included very few immunocompromised participants. While experience is accumulating, studies focused on the special circumstances of immunocompromised patients are needed to inform prevention and treatment approaches.