tetano
Editor, Senior Moderator
Front Immunol
. 2026 Jun 11:17:1840305.
doi: 10.3389/fimmu.2026.1840305. eCollection 2026.
Safety and antibody responses to inactivated COVID-19 vaccines among elderly patients with COPD: a prospective cohort study
Xuan Deng[SUP] #[/SUP][SUP] 1 [/SUP], Lijuan Xu[SUP] #[/SUP][SUP] 2 [/SUP], Lifeng Chen[SUP] 3 [/SUP], Pinjing Sun[SUP] 4 [/SUP], Hexiang Jia[SUP] 5 [/SUP], Renping Shu[SUP] 6 [/SUP], Zheren Wu[SUP] 6 [/SUP], Hangjie Zhang[SUP] 7 8 [/SUP], Xiaoping Xu[SUP] 1 [/SUP]
Affiliations
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.
Keywords: COPD; COVID-19; immunogenicity; safety; vaccine.
. 2026 Jun 11:17:1840305.
doi: 10.3389/fimmu.2026.1840305. eCollection 2026.
Safety and antibody responses to inactivated COVID-19 vaccines among elderly patients with COPD: a prospective cohort study
Xuan Deng[SUP] #[/SUP][SUP] 1 [/SUP], Lijuan Xu[SUP] #[/SUP][SUP] 2 [/SUP], Lifeng Chen[SUP] 3 [/SUP], Pinjing Sun[SUP] 4 [/SUP], Hexiang Jia[SUP] 5 [/SUP], Renping Shu[SUP] 6 [/SUP], Zheren Wu[SUP] 6 [/SUP], Hangjie Zhang[SUP] 7 8 [/SUP], Xiaoping Xu[SUP] 1 [/SUP]
Affiliations
- PMID: 42367765
- PMCID: PMC13294153
- DOI: 10.3389/fimmu.2026.1840305
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.
Keywords: COPD; COVID-19; immunogenicity; safety; vaccine.