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Vaccine . Immunogenicity and safety of a recombinant spike protein COVID vaccine in patients with inflammatory bowel disease and transplant recipien

tetano

Editor, Senior Moderator
Vaccine


. 2026 Jan 16:75:128208.
doi: 10.1016/j.vaccine.2026.128208. Online ahead of print.
Immunogenicity and safety of a recombinant spike protein COVID vaccine in patients with inflammatory bowel disease and transplant recipient

Ahamed Lazim Vattoth[SUP] 1 [/SUP], Mary S Hayney[SUP] 2 [/SUP], Amir Masoud Forati[SUP] 3 [/SUP], Brandy Warren[SUP] 4 [/SUP], Raj Kalkeri[SUP] 4 [/SUP], Miranda R Cai[SUP] 4 [/SUP], Zhaohui Cai[SUP] 4 [/SUP], MingZhu Zhu[SUP] 4 [/SUP], Shane Cloney-Clark[SUP] 4 [/SUP], Joyce S Plested[SUP] 4 [/SUP], Sandesh Parajuli[SUP] 5 [/SUP], Freddy Caldera[SUP] 6 [/SUP]


Affiliations
Free article Abstract

Introduction: Immunosuppressed individuals are at increased risk of coronavirus disease (COVID-19). Although mRNA vaccines have shown efficacy in these populations, data on protein-based vaccines remain limited. We evaluated the immunogenicity and safety of Novavax COVID-19 vaccine (NVX-CoV2601) in immunosuppressed patients.
Methods: This single-center, prospective ARMOR study included adults with inflammatory bowel disease (IBD) or solid organ transplant recipients receiving immunosuppressive therapy who had received ≥3 prior COVID-19 vaccine doses. Participants received one NVX-CoV2601 booster with follow-up at one and six months. The primary outcome was change in humoral immunogenicity from baseline to one month post-vaccination.
Results: Twenty-one immunosuppressed patients (18 IBD, 3 solid organ transplant recipients) were enrolled and compared with 57 age/sex-matched healthy controls. In ARMOR participants, anti-spike IgG GMT increased significantly post-immunization (22,969 to 66,639 EU/mL; 2.9-fold increase, p = 0.001). Healthy controls increased from 54,812 to 129,813 EU/mL (2.4-fold increase; p < 0.001). After baseline adjustment, no significant difference existed between groups at day 28. At 6 months, antibodies waned faster in immunosuppressed subjects. NVX-CoV2601 was well tolerated without IBD flares or organ rejection.
Conclusion: NVX-CoV2601 was safe and immunogenic with similar humoral responses compared to healthy controls, making it a viable alternative for immunosuppressed patients.

Keywords: Cell mediated immunity; Crohn's disease; Humoral immunity; NVX-CoV2601; Neutralizing antibodies.

 
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