Humoral and T-cell responses to SARS-CoV-2 vaccination in patients receiving immunosuppression
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  • Published on:
    Correspondence to ”Humoral and T-cell responses to SARS-CoV-2 vaccination in patients receiving immunosuppression”
    • Yun-Hsien Hsieh, Medical student Department of Medicine, Chung Shan Medical University, Taichung, Taiwan
    • Other Contributors:
      • Pui-Ying Leong, Allergy, Immunology and Rheumatology doctor

    Dear editor:
    We read with great interest in the article by Maria Prendecki, which reported repeated SARS-CoV-2 vaccinations could induce humoral and T-cell responses in those patients who are immunosuppressed. The authors collected data from a total 161 patients with immune-mediated glomerulonephritis and vasculitis from 17 January 2021 and 9 March 2021, and conducted a cohort study. However, some conclusions and findings in this study need to be further clarified.

    Firstly, in the sample collection and baseline data of the RESULTS section, we can see that a total of 114 patients have previously received rituximab treatment, 69 of which received Rituximab treatment in the past six months. However, in the statistical table 1, we see that there were only 99 patients who had previously treated with rituximab, and only 56 patients received rituximab treatment within six months. Is the difference in sample data between the two likely to affect the statistical results?
    Secondly, the article focused on patients in the IS group only for matching age and vaccine type. Does the article ignore the past medical history or past medication history for matching?
    Last but not least, there is a big difference in the interval between the first dose of vaccine and the second dose of the patient in the healthy group and the IS group, and the second dose of the healthy group can only choose the BNT vaccine. Will the above two likely to have interference factors in this...

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    Conflict of Interest:
    None declared.
  • Published on:
    Correspondence on “Humoral and T-cell responses to SARS-CoV-2 vaccination in patients receiving immunosuppression” by “Prendecki et al”
    • Wei-Teng Lin, Student School of Medicine, Chung Shan Medical University, Taichung, Taiwan
    • Other Contributors:
      • Ting Yu-Ting Chen, Student
      • Karen Yu-Hsien Weng, Student
      • James Cheng-Chung Wei, Rheumatologist

    We have a great interest in the article published by Prendecki et al studying on immune response to SARS-CoV2 vaccination (with either BNT162b2 mRNA or ChAdOx1 nCoV-19 vaccines) in patients receiving immunosuppression (IS) for autoimmune rheumatic and glomerular diseases.[1] They reported poor humeral and cellular responses to first-dose vaccine in IS group comparing to a cohort of healthy volunteer (HV), while the immune responses could be augmented by second dose. [1] We appreciate this important and timely study. However, we believe that some issues should be discussed in this study.
    First of all, the baseline comparability between IS and HV as well as between subgroups should be balanced, not only for age, but also for interval between 2 doses and types of vaccine. According to the recommendation for use of AstraZeneca COVID-19 vaccine published by World Health Organization (WHO), they suggested an interval of 8 to 12 weeks between the two doses due to the observation that two-dose efficacy and antibody level increase with a longer inter-dose interval. [2] However, IS group patients got second-dose vaccination at a median of 30 days (IQR 28-42 days), which didn’t categorize subgroup by different types of vaccine and was much earlier than the WHO recommendation timing. Although the significantly lower seroconversion rate was noticed in patients receiving ChAdOx1 than those receiving BNT2b162, we still concerned that short interval vaccination schedule would have i...

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    Conflict of Interest:
    None declared.