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Pediatr Int . Immunogenicity of SARS-CoV-2 vaccination in adolescents with cardiac disease

tetano

Editor, Senior Moderator
Pediatr Int


. 2022 Jan;64(1):e15329.
doi: 10.1111/ped.15329.
Immunogenicity of SARS-CoV-2 vaccination in adolescents with cardiac disease


Hiroki Hayashi[SUP] 1 [/SUP], Jun Narita[SUP] 2 [/SUP], Ryo Ishii[SUP] 2 [/SUP], Masaki Hirose[SUP] 2 [/SUP], Kazuhisa Hashimoto[SUP] 2 [/SUP], Yoshiaki Yamagishi[SUP] 2 3 [/SUP], Keiichi Ozono[SUP] 2 [/SUP], Hironori Nakagami[SUP] 1 4 [/SUP], Hidekazu Ishida[SUP] 2 [/SUP]



Affiliations

Abstract

Background: Although widely reported to affect older adults more, coronavirus disease 2019 (COVID-19) also affects adolescents, especially those with co-morbidities, including heart diseases. The safety and efficacy of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines has been established in healthy adolescents, yet there are few data for humoral and cellular immunogenicity in adolescents with cardiac diseases.
Methods: We evaluated anti-spike antibodies, neutralizing activities, and interferon-gamma production prior to and after SARS-CoV-2 vaccination in adolescents with cardiac diseases and healthy controls.
Results: Five healthy adolescents and 26 patients with cardiac diseases, including congenital heart disease (CHD, n = 10), dilated cardiomyopathy (DCM, n = 4), idiopathic pulmonary arterial hypertension (IPAH, n = 4), and those post-heart transplantation (post-HTx, n = 8) were enrolled. No severe adverse events, including myocarditis and pericarditis, were noted, even in patients with severe heart failure. Febrile events were noted after 21 of 62 injections (34%). All the healthy adolescents and 21 of the 26 patients (81%) showed sufficient elevation of neutralizing antibodies after the second dose of vaccination. Neutralizing antibodies and cellular immunity were absent in four of the eight post-HTx patients and one with single ventricle CHD. There was no correlation between the anti-spike and neutralizing antibody titers and interferon-gamma levels. When comparing the clinical characteristics of the patients post-HTx who did or did not acquire antibodies, there was no significant difference in the immunosuppressant types and trough levels.
Conclusions: SARS-CoV-2 mRNA vaccine has efficient immunogenicity for adolescents with CHD, IPAH, and DCM. Half of post-HTx patients could not acquire sufficient humoral immunity.

Keywords: COVID-19; SARS-CoV-2; antibody; congenital heart disease; quantiferon.
 
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