Humoral and Cellular Response Following Vaccination With the BNT162b2 mRNA COVID-19 Vaccine in Patients Affected by Primary Immunodeficiencies

Donato Amodio, Alessandra Ruggiero, Mayla Sgrulletti, Chiara Pighi, Nicola Cotugno, Chiara Medri, Elena Morrocchi, Luna Colagrossi, Cristina Russo, Salvatore Zaffina, Gigliola Di Matteo, Cristina Cifaldi, Silvia Di Cesare, Beatrice Rivalta, Lucia Pacillo, Veronica Santilli, Carmela Giancotta, Emma Concetta Manno, Marta Ciofi Degli Atti, Massimiliano RaponiPaolo Rossi, Andrea Finocchi, Caterina Cancrini, Carlo Federico Perno, Viviana Moschese, Paolo Palma

Research output: Contribution to journalArticlepeer-review


Mass SARS-Cov-2 vaccination campaign represents the only strategy to defeat the global pandemic we are facing. Immunocompromised patients represent a vulnerable population at high risk of developing severe COVID-19 and thus should be prioritized in the vaccination programs and in the study of the vaccine efficacy. Nevertheless, most data on efficacy and safety of the available vaccines derive from trials conducted on healthy individuals; hence, studies on immunogenicity of SARS-CoV2 vaccines in such populations are deeply needed. Here, we perform an observational longitudinal study analyzing the humoral and cellular response following the BNT162b2 mRNA COVID-19 vaccine in a cohort of patients affected by inborn errors of immunity (IEI) compared to healthy controls (HC). We show that both IEI and HC groups experienced a significant increase in anti-SARS-CoV-2 Abs 1 week after the second scheduled dose as well as an overall statistically significant expansion of the Ag-specific CD4+CD40L+ T cells in both HC and IEI. Five IEI patients did not develop any specific CD4+CD40L+ T cellular response, with one of these patients unable to also mount any humoral response. These data raise immunologic concerns about using Ab response as a sole metric of protective immunity following vaccination for SARS-CoV-2. Taken together, these findings suggest that evaluation of vaccine-induced immunity in this subpopulation should also include quantification of Ag-specific T cells.

Original languageEnglish
Pages (from-to)727850
JournalFront. Immunol.
Publication statusPublished - 2021


  • Adolescent
  • Adult
  • Antibodies, Neutralizing/blood
  • Antibodies, Viral/blood
  • BNT162 Vaccine
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes/immunology
  • COVID-19/prevention & control
  • COVID-19 Vaccines/immunology
  • Female
  • Humans
  • Immunity, Cellular/immunology
  • Immunity, Humoral/immunology
  • Immunocompromised Host/immunology
  • Immunogenicity, Vaccine/immunology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Primary Immunodeficiency Diseases/immunology
  • SARS-CoV-2/immunology
  • Vaccination
  • Young Adult


Dive into the research topics of 'Humoral and Cellular Response Following Vaccination With the BNT162b2 mRNA COVID-19 Vaccine in Patients Affected by Primary Immunodeficiencies'. Together they form a unique fingerprint.

Cite this