Vaccines and therapeutics for immunocompromised patients with COVID-19

The COVID-19 pandemic has disproportionately impacted immunocompromised patients. This diverse group is at increased risk for impaired vaccine responses, progression to severe disease, prolonged hospitalizations and deaths. At particular risk are people with deficiencies in lymphocyte number or function such as transplant recipients and those with hematologic malignancies. Such patients' immune responses to vaccination and infection are frequently impaired leaving them more vulnerable to prolonged high viral loads and severe complications of COVID-19. Those in turn, have implications for disease progression and persistence, development of immune escape variants and transmission of infection. Data to guide vaccination and treatment approaches in immunocompromised people are generally lacking and extrapolated from other populations. The large clinical trials leading to authorisation and approval of SARS-CoV-2 vaccines and therapeutics included very few immunocompromised participants. While experience is accumulating, studies focused on the special circumstances of immunocompromised patients are needed to inform prevention and treatment approaches.Copyright & COPY; 2023 The Author(s). Published by Elsevier Ltd.This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

The COVID-19 pandemic has had a disproportionate impact on immunocompromised patients, who are at increased risk for impaired vaccine responses, severe disease, prolonged hospitalizations, and deaths. People with deficiencies in lymphocyte number or function, such as transplant recipients and those with hematologic malignancies, are particularly at risk. Their impaired immune responses to vaccination and infection leave them more vulnerable to high viral loads and severe complications of COVID-19, which can in turn lead to disease progression, development of immune escape variants, and transmission of infection.