ArticleFrontiers in immunology2026
Safety and antibody responses to inactivated COVID-19 vaccines among elderly patients with COPD: a prospective cohort study.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Elderly patients with chronic obstructive pulmonary disease (COPD) are at increased risk of severe coronavirus disease 2019 (COVID-19) outcomes. We aimed to assess the safety and longitudinal antibody dynamics of a three-dose schedule of the inactivated COVID-19 vaccine (Vero cell, Covilo) in elderly patients with COPD. Methods: This prospective cohort study enrolled 410 COPD patients (aged≥60), 80 younger healthy controls (HCs, 18-59 years), and 108 older HCs (≥60 years) in Zhejiang Province, China. COPD patients received a three-dose regimen (Day 0, 21, and 111), while HCs received a standard two-dose series. Neutralizing antibodies (NAbs), anti-receptor-binding domain IgG (anti-RBD IgG), and anti-spike & nucleocapsid IgG (anti-S&N IgG) were measured at five time points to evaluate the immunogenicity. Safety was assessed within 7 days after each dose and throughout follow-up. Results: The overall incidence of adverse events in COPD patients was 10.24%, predominantly mild (Grade 1), with decreasing frequency across doses. After the two-dose primary series, NAbs seroconversion rates at 28-35 days were comparable between COPD patients (60.19%) and HCs (63.64%-66.67%). However, antibody concentration declined markedly within three months, particularly for NAbs. Strong positive correlations were observed among NAbs, anti-RBD IgG, and anti-S&N IgG (Spearman's ρ = 0.754-0.905; p< 0.001). A third dose administered after approximately three months significantly increased NAbs seroconversion rate to 83.50% and markedly elevated antibody concentrations to 207.22 U/mL. Despite the booster, NAbs declined significantly six months after the third dose. Conclusions: A three-dose regimen of Covilo is safe and effectively elicits antibody responses in elderly COPD patients. However, the rapid waning of antibody levels suggests a need for optimized booster strategies to maintain long-term protection in this vulnerable group.
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