Dear editor
I have read the article titled to ‘COVID-19 vaccine hesitancy—reasons and solutions to achieve a successful global vaccination campaign to tackle the ongoing pandemic’ by Dhama et al. with great interest.Citation1 We also want to share our experience on COVID-19 vaccine hesitancy in our primary immunodeficiency disease, especially common variable immunodeficiency disease (CVID), patients.
We know that the most powerful weapon against coronavirus disease 2019 (COVID-19) is vaccination.Citation2 We wanted to evaluate the vaccination rate of our CVID patients receiving immunoglobulin replacement therapy in our society where anti-vaccination behavior (vaccine hesitancy) is increasing day by day.Citation3
In this study, 20 patients over the age of 12, out of 95 patients who received immunoglobulin replacement therapy with the diagnosis of primary immunodeficiency diseases in our clinic, were evaluated.
Thirteen of the 20 CVID patients (65%) included in the evaluation had been vaccinated against COVID-19. Nine of these patients received at least two doses of inactivated virus Sinovac® (Sinopharm), three of them at least two doses of mRNA BioNTech®, and one of them received two doses of Sinovac and one dose of BioNTech vaccines. Post-vaccination side effects were observed in 4 of 13 vaccinated patients. It was learned that among the patients who received the Sinovac vaccine, one patient had a headache for 1 day after the first dose, one patient had pain in the arm after the third dose, and one patient had a headache, joint pain, and fever for 3 days after the second dose. In the patient who received one dose of BioNTech vaccine after two doses of Sinovac, darkening of the eyes, dizziness, and fainting occurred 10 minutes after the BioNTech vaccine, and the patient came to his senses 5 minutes later. This condition was evaluated as vasovagal syncope. During the follow-up period of at least 5 months, there was no reported complication due to these vaccinations. Vaccination was discussed with the rest of seven patients who were not vaccinated, and patients and their families were tried to be persuaded for vaccination.
Our vaccination rate seems to be relatively low. In this limited experiment, both inactivated virus Sinovac® and mRNA BioNTech® vaccine applications in our CVID patients look safe and reliable. No serious side effects were seen due to either inactive or mRNA vaccinations.
Results from COVID-19 vaccine applications involving thousands of participants worldwide show that efficacy is remarkably high and the rate of serious side effects low.Citation4 We believe that COVID-19 vaccines offer potential benefits with minimal risk, even in immunodeficient individuals involving CVID patients.Citation5–7 We strongly support the vaccination of our immunocompromised or immunodeficient patients and encourage our patients and their families in this regard.Citation8
Abbreviations
CVID | = | common variable immunodeficiency disease |
COVID-19 | = | coronavirus disease 2019 |
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References
- Dhama K, Sharun K, Tiwari R, Dhawan M, Emran TB, Rabaan AA, Alhumaid S. COVID-19 vaccine hesitancy - reasons and solutions to achieve a successful global vaccination campaign to tackle the ongoing pandemic. Hum Vacin Immunother. 2021;17(10):3495–2. doi:10.1080/21645515.2021.1926183.
- Gerber JS, Offit PA. COVID-19 vaccines for children. Science. 2021;374(6570):913. doi:10.1126/science.abn2566.
- Yigit M, Ozkaya-Parlakay A, Senel E. Evaluation of COVID-19 vaccine refusal in parents. Pediatr Infect Dis J. 2021;40(4):e134–e136. doi:10.1097/INF.0000000000003042.
- Luxi N, Giovanazzi A, Capuano A, Crisafulli S, Cutroneo PM, Fantini MP, Ferrajolo C, Moretti U, Poluzzi E, Raschi E, et al. COVID-19 vaccination in pregnancy, paediatrics, immunocompromised patients, and persons with history of allergyor prior SARS-CoV-2 infection: overview of current recommendations and pre- and post-marketing evidence for vaccine efficacy and safety. Drug Saf. 2021;44(12):1247–69. doi:10.1007/s40264-021-01131-6.
- Bergman P, Blennow O, Hansson L, Mielke S, Nowak P, Chen P, Söderdahl G, Österborg A, Smith CIE, Wullimann D, et al. Safety and efficacy of the mRNA BNT162b2 vaccine against SARS-CoV-2 in five groups of immunocompromised patients and healthy controls in a prospective open-label clinical trial. EBioMedicine. 2021;74:103705. doi:10.1016/j.ebiom.2021.103705.
- Ameratunga R, Woon S-T, Steele R, Lehnert K, Leung E, Edwards ESJ, Brooks AES. Common variable immunodeficiency disorders as a model for assessing COVID-19 vaccine responses in immunocompromised patients. Front Immunol. 2022;12:798389. doi:10.3389/fimmu.2021.798389.
- Amodio D, Ruggiero A, Sgrulletti M, Pighi C, Cotugno N, Medri C, Morrocchi E, Colagrossi L, Russo C, Zaffina S, et al. Humoral and cellular response following vaccination with the BNT162b2 mRNA COVID-19 vaccine in patients affected by primary immunodeficiencies. Front Immunol. 2021;12:727850. doi:10.3389/fimmu.2021.727850.
- Lee ARYB, Wong SY, Chai LYA, Lee SC, Lee MX, Muthiah MD, Tay SH, Teo CB, Tan BKJ, Chan YH, et al. Efficacy of Covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis. BMJ. 2022;376:e068632. doi:10.1136/bmj-2021-068632.