Safety and Reactogenicity of COVID-19 Vaccination in Severe Alpha-1 Antitrypsin Deficiency.
| Autor: | McElvaney OJ; Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.; National Centre for Alpha-1 Antitrypsin Deficiency, Beaumont Hospital, Dublin, Ireland.; Seattle Children's Research Institute, Seattle, Washington, United States.; Department of Medicine, University of Washington, Seattle, Washington, United States., Cleary B; Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland., Fraughen DD; Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.; National Centre for Alpha-1 Antitrypsin Deficiency, Beaumont Hospital, Dublin, Ireland., Kelly G; Alpha-1 Foundation of Ireland, Dublin, Ireland., McElvaney OF; Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland., Murphy MP; Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland., Branagan P; Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.; National Centre for Alpha-1 Antitrypsin Deficiency, Beaumont Hospital, Dublin, Ireland., Gunaratnam C; Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.; National Centre for Alpha-1 Antitrypsin Deficiency, Beaumont Hospital, Dublin, Ireland., Carroll TP; Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.; Alpha-1 Foundation of Ireland, Dublin, Ireland., Goss CH; Seattle Children's Research Institute, Seattle, Washington, United States.; Department of Medicine, University of Washington, Seattle, Washington, United States.; Department of Pediatrics, University of Washington, Seattle, Washington, United States., McElvaney NG; Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.; National Centre for Alpha-1 Antitrypsin Deficiency, Beaumont Hospital, Dublin, Ireland. |
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| Jazyk: | angličtina |
| Zdroj: | Chronic obstructive pulmonary diseases (Miami, Fla.) [Chronic Obstr Pulm Dis] 2024 Jan 25; Vol. 11 (1), pp. 3-12. |
| DOI: | 10.15326/jcopdf.2023.0432 |
| Abstrakt: | Background: Patients with alpha-1 antitrypsin deficiency (AATD) exhibit dysregulated inflammatory responses and a predilection for autoimmunity. While the adverse event (AE) profiles of COVID-19 vaccines in several chronic inflammatory conditions are now available, safety and tolerability data for patients with severe AATD have yet to be described. The feasibility of coadministering vaccines against COVID-19 and influenza in this population is similarly unclear. Methods: We conducted a prospective study of 170 patients with Pi*ZZ genotype AATD receiving their initial vaccination series with ChAdOx1 nCoV-19 (AstraZeneca). Patients were monitored clinically for AEs over the week that followed their first and second doses. In parallel, we conducted the same assessments in patients with Pi*MM genotype chronic obstructive pulmonary disease (COPD) (n=160) and Pi*MM individuals without lung disease (n=150). The Pi*ZZ cohort was subsequently followed through 2 consecutive mRNA-based booster vaccines (monovalent and bivalent BNT162b2, Pfizer/BioNTech). To assess the safety of combined vaccination against COVID-19 and influenza, the quadrivalent influenza vaccine was administered to participants attending for their second COVID-19 booster vaccination, either on the same day or following a 1-week interval. Results: Pi*ZZ AATD participants did not display increased AEs compared to Pi*MM COPD or Pi*MM non-lung disease controls. Although unexpected and serious vaccine-associated AEs did occur, the majority of AEs experienced across the 3 groups were mild and self-limiting. The AATD demographic at highest risk for AEs (especially systemic and prolonged AEs) was young females. No increase in AE risk was observed in patients with established emphysema, sonographic evidence of liver disease, or in those receiving intravenous augmentation therapy. AE incidence declined sharply following the initial vaccine series. Same-day coadministration of the COVID-19 mRNA bivalent booster vaccine and the annual influenza vaccine did not result in increased AEs compared to sequential vaccines 1 week apart. Conclusions: Despite their pro-inflammatory state, patients with severe AATD are not at increased risk of AEs or serious AEs compared to patients with nonhereditary COPD and patients without lung disease. Same-day coadministration of COVID-19 booster vaccines with the annual influenza vaccine is feasible, safe, and well-tolerated in this population. (JCOPDF © 2024.) |
| Databáze: | MEDLINE |
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