Universität zu Köln

Kreuzberger, Nina ORCID: 0000-0001-8922-0488, Hirsch, Caroline, Andreas, Marike, Boehm, Lena, Broeckelmann, Paul J., Di Cristanziano, Veronica, Golinski, Martin, Hausinger, Renate Ilona, Mellinghoff, Sibylle ORCID: 0000-0003-3928-2503, Lange, Berit, Lischetzki, Tina, Kappler, Verena, Mikolajewska, Agata, Monsef, Ina, Park, Yun Soo, Piechotta, Vanessa, Schmaderer, Christoph, Stegemann, Miriam, Vanshylla, Kanika ORCID: 0000-0003-4552-9170, Weber, Florencia, Weibel, Stephanie, Stephani, Caspar and Skoetz, Nicole (2022). Immunity after COVID-19 vaccination in people with higher risk of compromised immune status: a scoping review. Cochrane Database Syst Rev. (8). HOBOKEN: WILEY. ISSN 1361-6137

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Abstract

Background High efficacy in terms of protection from severe COVID-19 has been demonstrated for several SARS-CoV-2 vaccines. However, patients with compromised immune status develop a weaker and less stable immune response to vaccination. Strong immune response may not always translate into clinical benefit, therefore it is important to synthesise evidence on modified schemes and types of vaccination in these population subgroups for guiding health decisions. As the literature on COVID-19 vaccines continues to expand, we aimed to scope the literature on multiple subgroups to subsequently decide on the most relevant research questions to be answered by systematic reviews. Objectives To provide an overview of the availability of existing literature on immune response and long-term clinical outcomes after COVID-19 vaccination, and to map this evidence according to the examined populations, specific vaccines, immunity parameters, and their way of determining relevant long-term outcomes and the availability of mapping between immune reactivity and relevant outcomes. Search methods We searched the Cochrane COVID-19 Study Register, the Web of Science Core Collection, and the World Health Organization COVID-19 Global literature on coronavirus disease on 6 December 2021. Selection criteria We included studies that published results on immunity outcomes after vaccination with BNT162b2, mRNA-1273, AZD1222, Ad26.COV2.S, Sputnik V or Sputnik Light, BBIBP-CorV, or CoronaVac on predefined vulnerable subgroups such as people with malignancies, transplant recipients, people undergoing renal replacement therapy, and people with immune disorders, as well as pregnant and breastfeeding women, and children. We included studies if they had at least 100 participants (not considering healthy control groups); we excluded case studies and case series. Data collection and analysis We extracted data independently and in duplicate onto an online data extraction form. Data were represented as tables and as online maps to show the frequency of studies for each item. We mapped the data according to study design, country of participant origin, patient comorbidity subgroup, intervention, outcome domains (clinical, safety, immunogenicity), and outcomes. Main results Out of 25,452 identified records, 318 studies with a total of more than 5 million participants met our eligibility criteria and were included in the review. Participants were recruited mainly from high-income countries between January 2020 and 31 October 2021 (282/318); the majority of studies included adult participants (297/318). Haematological malignancies were the most commonly examined comorbidity group (N = 54), followed by solid tumours (N = 47), dialysis (N = 48), kidney transplant (N = 43), and rheumatic diseases (N = 28, 17, and 15 for mixed diseases, multiple sclerosis, and inflammatory bowel disease, respectively). Thirty-one studies included pregnant or breastfeeding women. The most commonly administered vaccine was BNT162b2 (N = 283), followed by mRNA-1273 (N = 153), AZD1222 (N = 66), Ad26.COV2.S (N = 42), BBIBP-CorV (N = 15), CoronaVac (N = 14), and Sputnik V (N = 5; no studies were identified for Sputnik Light). Most studies reported outcomes after regular vaccination scheme. The majority of studies focused on immunogenicity outcomes, especially seroconversion based on binding antibody measurements and immunoglobulin G (IgG) titres (N = 179 and 175, respectively). Adverse events and serious adverse events were reported in 126 and 54 studies, whilst SARS-CoV-2 infection irrespective of severity was reported in 80 studies. Mortality due to SARS-CoV-2 infection was reported in 36 studies. Please refer to our evidence gap maps for more detailed information. Authors' conclusions Up to 6 December 2021, the majority of studies examined data on mRNA vaccines administered as standard vaccination schemes (two doses approximately four to eight weeks apart) that report on immunogenicity parameters or adverse events. Clinical outcomes were less commonly reported, and if so, were often reported as a secondary outcome observed in seroconversion or immunoglobulin titre studies. As informed by this scoping review, two effectiveness reviews (on haematological malignancies and kidney transplant recipients) are currently being conducted.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kreuzberger, Nina UNSPECIFIED orcid.org/0000-0001-8922-0488 UNSPECIFIED Hirsch, Caroline UNSPECIFIED UNSPECIFIED UNSPECIFIED Andreas, Marike UNSPECIFIED UNSPECIFIED UNSPECIFIED Boehm, Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Broeckelmann, Paul J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Di Cristanziano, Veronica UNSPECIFIED UNSPECIFIED UNSPECIFIED Golinski, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Hausinger, Renate Ilona UNSPECIFIED UNSPECIFIED UNSPECIFIED Mellinghoff, Sibylle UNSPECIFIED orcid.org/0000-0003-3928-2503 UNSPECIFIED Lange, Berit UNSPECIFIED UNSPECIFIED UNSPECIFIED Lischetzki, Tina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kappler, Verena UNSPECIFIED UNSPECIFIED UNSPECIFIED Mikolajewska, Agata UNSPECIFIED UNSPECIFIED UNSPECIFIED Monsef, Ina UNSPECIFIED UNSPECIFIED UNSPECIFIED Park, Yun Soo UNSPECIFIED UNSPECIFIED UNSPECIFIED Piechotta, Vanessa UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmaderer, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Stegemann, Miriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Vanshylla, Kanika UNSPECIFIED orcid.org/0000-0003-4552-9170 UNSPECIFIED Weber, Florencia UNSPECIFIED UNSPECIFIED UNSPECIFIED Weibel, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Stephani, Caspar UNSPECIFIED UNSPECIFIED UNSPECIFIED Skoetz, Nicole UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-693105
DOI:	10.1002/14651858.CD015021
Journal or Publication Title:	Cochrane Database Syst Rev.
Number:	8
Date:	2022
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1361-6137
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SARS-COV-2; ANTIBODY; VACCINES Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69310