ArticleThe journal of allergy and clinical immunology. Global2026
Four doses of coronavirus disease 2019 vaccination for patients with inborn errors of immunity compared to 3 doses for healthy individuals.
Article in The journal of allergy and clinical immunology. Global, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04800133 (To Compare the Reactogenicity and Immunogenicity of Recommended COVID-19 Vaccines in Young Adolescents and Children in Hong Kong), which is not on this map. Not yet cited in PubMed.
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To Compare the Reactogenicity and Immunogenicity of Recommended COVID-19 Vaccines in Young Adolescents and Children in Hong Kong
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20 authors.
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Abstract
Background: Patients with inborn errors of immunity (IEI) have high risks of severe complications after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Although vaccination is effective in preventing severe coronavirus disease 2019 (COVID-19), boosters are required as the protection provided wanes over time. A greater number of boosters may be required in IEI patients compared to healthy individuals because of their immunodeficient state, but no such data are available. Objective: We investigated and compared the immunogenicity between 4 doses of COVID-19 vaccination for patients with IEI and 3 doses for healthy individuals. Methods: In the current study (NCT04800133), either BNT162b2 or CoronaVac was administered as dose 4. Healthy individuals who received 3 doses were included for comparison. Humoral and cellular immunogenicity against wild-type and JN.1 SARS-CoV-2 was assessed between IEI patients and healthy individuals. Results: IEI patients had lower humoral and cellular immunogenicity than healthy individuals after 3 doses of COVID-19 vaccination. After dose 4, IEI patients obtained immunogenicity similar to that of healthy individuals who received 3 doses. A fourth dose of BNT162b2 significantly enhanced humoral and cellular immunogenicity against wild-type SARS-CoV-2 and humoral responses against JN.1 SARS-CoV-2. In contrast, CoronaVac had minimal effect on humoral responses to wild-type and JN.1 SARS-CoV-2. Six patients experienced breakthrough infections, which did not result in hospitalization or death. Conclusion: A fourth dose of BNT162b2 was immunogenic and safe for most IEI patients. The fourth dose of vaccination is recommended for IEI patients to improve protection against COVID-19, particularly before travel to areas with high endemic transmission.
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