Effectiveness of vaccination against SARS-CoV-2 and the need for alternative preventative approaches in immunocompromised individuals: a narrative review of systematic reviews

ABSTRACT

Introduction

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including administration of booster doses, continues to be the most effective method for controlling COVID-19-related complications including progression to severe illness and death. However, there is mounting evidence that more needs to be done to protect individuals with compromised immune function.

Areas covered

Here, we review the effectiveness of COVID-19 vaccination in immunocompromised patients, including those with primary immunodeficiencies, HIV, cancer (including hematological malignancies), solid organ transplant recipients, and chronic kidney disease, as reported in systematic reviews/meta-analyses published over a 12-month period in PubMed. Given the varied responses to vaccination in patients with compromised immune function, a major goal of this analysis was to try to identify specific risk-factors related to vaccine failure.

Expert opinion

COVID-19 remains a global problem, with new variants of concern emerging at regular intervals. There is an ongoing need for optimal vaccine strategies to combat the pandemic. In addition, alternative treatment approaches are needed for immunocompromised patients who may not mount an adequate immune response to current COVID-19 vaccines. Identification of high-risk patients and the introduction of newer antiviral approaches such as monoclonal antibodies will offer physicians therapeutic options for such vulnerable individuals.

KEYWORDS:

• COVID-19
• COVID-19 vaccines
• immunocompromised patients
• monoclonal antibodies
• SARS-CoV-2

Declaration of interest

V Shetty and N Azmi are employees of AstraZeneca. S Clissold is a professional scientific writer (ContentEdNet, Singapore). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript, apart from those disclosed.

Reviewer disclosures

A reviewer of this manuscript has disclosed that they have provided consultancies for epidemiological research and data analyses for Moderna, Pfizer, GSK, Seqirus, and Astra Zeneca. Peer reviewers of this manuscript have received an honorarium for their review work.

Authors’ contributions

All authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, which was developed in line with Good Publishing Practice-3 guidelines. All authors contributed to the review’s conception and search strategy, focus, and interpretation, drafting, and/or revision of the manuscript and have given their approval for this version of the manuscript to be submitted for publication.

Additional information

Funding

This manuscript was funded by AstraZeneca, Singapore.