Immunogenicity assessment of elder hepatocellular carcinoma patients after inactivated whole-virion SARS-CoV-2 vaccination

ABSTRACT

Background

Research on immunogenicity after 3^rd SARS-CoV-2 vaccine in elder hepatocellular carcinoma (HCC) was limited. This study aimed to investigate the efficacy and influencing factors of inactivated SARS-CoV-2 vaccine in elder HCC.

Research design and methods

We assessed total antibodies, anti-RBD IgG, and neutralizing antibodies (NAb) toward SARS-CoV-2 wild type (WT) as well as BA.4/5 in 304 uninfected HCC, 147 matched healthy control (HC), and 53 SARS-CoV-2 infected HCC, all aged over 60 years. The levels of antibodies were compared in the period 7–90, 91–180, and >180 days after 2^nd or 3^rd vaccination, respectively.

Results

HCC had lower seropositivity than HC after 2^nd dose (total antibodies, 64% vs. 92%, P < 0.0001; anti-RBD IgG, 50% vs. 77%, P < 0.0001). But 3^rd dose can efficaciously close the gap (total antibodies, 96% vs. 100%, P = 0.1212; anti-RBD IgG: 87% vs. 87%, P > 0.9999). Booster effect of 3^rd dose can persist >180 days in HCC (2^nd vs. 3^rd: total antibodies, 0.60 vs. 3.20, P < 0.0001; anti-RBD IgG, 13.86 vs. 68.85, P < 0.0001; WT NAb, 11.70 vs. 22.47, P < 0.0001). Vaccinated HCC had more evident humoral responses than unvaccinated ones after infection (total antibodies: 3.85 vs. 3.20, P < 0.0001; anti-RBD IgG: 910.92 vs. 68.85, P < 0.0001; WT NAb: 96.09 vs. 22.47, P < 0.0001; BA.4/5 NAb: 86.53 vs. 5.59, P < 0.0001).

Conclusions

Our findings highlight the booster effect and protective role of 3^rd dose. Our results could provide a theoretical foundation for informing decisions regarding SARS-CoV-2 vaccination in elder HCC.

KEYWORDS:

• SARS-CoV-2
• hepatocellular carcinoma
• vaccination
• Omicron
• immune response
• antibodies

Declaration of interests

The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

XHH conceived and designed the research. RYG, MWY, CLZ, LYD, CC, JRY, ZSZ, and LT performed the experiments. RYG extracted data, performed software analyses, and visualized graphs and tables. RYG and MWY wrote the paper. CLZ and YKS provided the clinical samples and data of participants. All authors are responsible for all aspects of the study and attest to the accuracy and completeness of the results. All authors have read and approved the final manuscript as submitted.

Ethics approval and consent to participate

This study was approved by the Medical Ethics Committee of the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital (22/363–3565) and the Medical Ethics Committee of Peking Union Medical College Hospital (I-22PJ354). Informed consent was obtained from individual or guardian participants.

Acknowledgments

We would like to thank all patients, their families, and study investigators.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14760584.2023.2274484

Additional information

Funding

The study was funded by Beijing Natural Science Foundation (L222070).