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Summary: On November 24, 2021, the sequence of a new SARS-CoV-2 variant, Omicron-B.1.1.529, was announced. Compared to previous variants, Omicron has a higher number of mutations in the Spike (S) protein. Serum neutralization of Omicron by individuals vaccinated or previously infected with Alpha, Beta, Gamma, or Delta variants is significantly reduced or ineffective. Third vaccine doses can boost neutralization titers against Omicron, and high titers are observed in both vaccinated individuals and those infected with the Delta variant. Most potent monoclonal antibodies and antibodies under development are unable to effectively neutralize Omicron due to mutations in its Spike protein. Omicron has structural changes compared to earlier viruses and utilizes mutations that enhance its binding to ACE2, allowing for immune escape. This results in a large number of mutations in the ACE2 binding site and a rebalancing of receptor affinity similar to earlier pandemic viruses.
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Bo Meng et al.
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Shabir A. Madhi et al.
Summary: The Omicron variant of SARS-CoV-2 spread more rapidly in South Africa, where two thirds of unvaccinated residents were found to have past infections. Omicron peaked just 1 month after being detected, with hospitalizations and deaths not increasing proportionately with the rise in cases. It remains unclear whether this change is due to widespread preexisting immunity or unique features of the virus.
NEW ENGLAND JOURNAL OF MEDICINE
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Fabian Schmidt et al.
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Daniel Re et al.
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Evangelos Terpos et al.
Summary: This study compared the neutralizing antibody levels after vaccination with BNT162b2 mRNA vaccine and ChAdOx1 (AZD1222) viral vector vaccine at different time points. The results showed that BNT162b2 induced stronger neutralizing antibody responses compared to AZD1222, and both vaccines showed a gradual decline in antibody titers over time. Additionally, the rate of antibody elimination was higher in those vaccinated with AZD1222 compared to BNT162b2. Age, gender, body mass index, or comorbidities did not significantly impact antibody levels over time.
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Summary: Vaccination guidelines for hematological patients are typically conservative. However, this study shows that most patients, even those with compromised immune systems, can develop sufficient antibody concentrations after receiving the Moderna vaccine. However, certain treatments may affect the vaccine's efficacy.
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Yinon M. Bar-On et al.
Summary: After administering the fourth dose of BNT162b2 vaccine to individuals aged 60 years and older during the period when the omicron variant was predominant, Israel observed lower rates of confirmed SARS-CoV-2 infection and severe Covid-19 compared to those who received only three doses. The protection against severe illness remained consistent, while the protection against confirmed infection decreased over time.
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Cristina Bergamaschi et al.
Summary: Immunocompromised individuals, such as patients with hematological malignancies, have a higher risk of severe disease after SARS-CoV-2 infection. Vaccination may provide limited protection in this population, and the reasons for reduced vaccine efficacy are not fully understood. This study compared the immune responses of patients who received bone marrow transplantation or CAR-T cells and healthy individuals after receiving two doses of the BNT162b2 mRNA vaccine. The results showed that the patients had significantly lower levels of SARS-CoV-2 Spike antibodies and reduced cross-recognition of different Spike-RBD proteins. The patients also exhibited diminished systemic cytokine responses compared to the healthy individuals. Changes in specific cytokines were associated with antibody development and could potentially be used as prognostic markers for vaccine effectiveness in transplant patients with hematological malignancies.
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Nicole P. Hachmann et al.
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John E. Bowen et al.
Summary: The Omicron variant of concern, characterized by numerous spike mutations, exhibits enhanced binding to ACE2, reduced fusogenicity, and reduced neutralizing activity against plasma induced by infection or vaccines. However, booster doses based on the Wuhan-Hu-1 spike sequence significantly increase neutralizing antibody titers and breadth against multiple Omicron sublineages.
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Frances H. Priddy et al.
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Sabine Haggenburg et al.
Summary: This study aimed to assess the effectiveness of a third mRNA-1273 vaccination in immunocompromised patients with hematologic cancers. The results showed that a third vaccination had a significant effect in patients with recovering immune systems, but yielded poorer results in certain specific patient groups. Therefore, the administration of a third dose of vaccine should be considered in patients with hematologic cancers and evaluated on an individual basis.
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Kirsten E. Lyke et al.
Summary: This study assesses the magnitude and short-term durability of neutralizing antibodies after homologous and heterologous boosting with mRNA and Ad26.COV2.S vaccines. The results show that mRNA vaccine boosting generates higher neutralizing activity against the Omicron variant compared to Ad26.COV2.S boosting. These findings have implications for protecting against Omicron and future variants of SARS-CoV-2.
CELL REPORTS MEDICINE
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Ioannis Ntanasis-Stathopoulos et al.
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Sabine Haggenburg et al.
Summary: This study found that a third dose of mRNA-1273 vaccine can increase neutralizing antibody concentrations in immunocompromised patients with hematologic cancers, especially in those with recovering immune systems.
Letter
Oncology
Adolfo Aleman et al.
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Multidisciplinary Sciences
Matthew McCallum et al.
Summary: The transmission of SARS-CoV-2 leads to the emergence of variants, such as the B.1.617.2 (Delta) variant, which dampens the in vitro potency of vaccine-elicited serum neutralizing antibodies. Mutations in the B.1.617.1 (Kappa) and Delta spike glycoproteins alter key antigenic sites, affecting the recognition by monoclonal antibodies. The angiotensin-converting enzyme 2 binding affinities of Kappa and Delta are comparable to the Wuhan-Hu-1 isolate, while Delta+ exhibits significantly reduced affinity.
Letter
Hematology
Evangelos Terpos et al.
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Medicine, General & Internal
Evangelos Terpos et al.
Summary: The study found that antibody responses against SARS-CoV-2 decreased over time, with Spike antibodies showing longer persistence. The antibody decay followed a biphasic trend, with more pronounced decrease in the first 6 months. The longevity and neutralizing ability of antibodies against Spike and Spike-RBD should be considered in future vaccination strategies.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2021)
Article
Immunology
Margherita Rosati et al.
Summary: A study revealed that convalescent patients maintain robust antibody responses to SARS-CoV-2 for over a year after infection, providing long-lasting protection. The data showed that antibodies from convalescent patients persist over 14 months, continue to maintain cross-reactivity to current variants of concern, and exhibit strong functional properties.
FRONTIERS IN IMMUNOLOGY
(2021)
Review
Hematology
Heinz Ludwig et al.
Summary: Patients with multiple myeloma are at increased risk of infection and mortality related to SARS-CoV-2 virus, and may have suboptimal immune response to vaccination, highlighting the importance of monitoring and adapting vaccination strategies for this vulnerable population.
LANCET HAEMATOLOGY
(2021)
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Oncology
Evangelos Terpos et al.
Summary: Recent data shows suboptimal antibody response to COVID-19 vaccination in patients with hematological malignancies. Specifically, patients with multiple myeloma (MM) exhibit lower production of neutralizing antibodies (NAbs) after vaccination compared to healthy controls, especially when undergoing treatment with anti-CD38 or belamaf. Timely vaccination, possibly during treatment-free periods, is emphasized for this group of patients.
BLOOD CANCER JOURNAL
(2021)
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Cell Biology
Cristina Bergamaschi et al.
Summary: Early responses to vaccination play a crucial role in shaping both humoral and cellular protective immunity. This study characterizes cytokine and chemokine responses after the first and second dose of the BNT162b2 mRNA vaccine, highlighting the potential for biomarkers like IL-15 and IFN-gamma in predicting humoral immunity development. In previously COVID-19-infected individuals, a single vaccination can trigger strong cytokine induction and antibody responses similar to those seen in naive individuals upon booster vaccination, with implications for future public health recommendations.
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Hematology
Maria Gavriatopoulou et al.
Summary: Immunocompromised patients with hematologic malignancies, particularly those with Waldenstroeurom macroglobulinemia (WM), have lower production of neutralizing antibodies (NAbs) against SARS-CoV-2 after COVID-19 vaccination compared with healthy controls on days 22 and 50 post-vaccination. Disease-related immune dysregulation and therapy-related immunosuppression are likely contributors to this suboptimal humoral response. Active treatment with specific medications is also associated with a diminished antibody response following vaccination.
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Immunology
Fabian Schmidt et al.
JOURNAL OF EXPERIMENTAL MEDICINE
(2020)
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Davide F. Robbiani et al.
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Biotechnology & Applied Microbiology
Chee Wah Tan et al.
NATURE BIOTECHNOLOGY
(2020)
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Edward E. Walsh et al.
NEW ENGLAND JOURNAL OF MEDICINE
(2020)
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Evangelos Terpos et al.