Study Shows Vaccination Decision in IEI Patients Must Be Individualized

Inborn errors of immunity (IEI) increase morbidity and mortality risks, particularly from respiratory tract infections. Hence, vaccination becomes pivotal for IEI patients. 

A study examined the vaccination and respiratory tract infection rates in a diverse IEI patient cohort undergoing immune globulin replacement therapy (IGRT) at a tertiary care center. Data on vaccinations and respiratory infections were extracted from medical records. The study included 33 patients (mean age= 37.7 ± 11.4 years; 17 male). The most common clinical phenotype in the cohort was primary antibody deficiencies (90.9 percent). Only two patients had a genetic diagnosis, both of whom were brothers diagnosed with Wiskott-Aldrich syndrome (WAS). Almost half (48.5 percent) of patients had bronchiectasis and 81.8 percent were on prophylactic antibiotics. All patients with IEI included in the study were regularly receiving IGRT. 

The vaccination rate of patients against respiratory tract infections was 42.4 percent, 57.6 percent and 78.8 percent for influenza, pneumococcus and COVID-19, respectively. Only one patient (7.1 percent) who received the influenza vaccine developed an upper respiratory tract infection. However, viral panel analysis could not be performed as the patient did not present to the hospital. The COVID-19 vaccination rate was notably higher than that of other vaccines, likely due to increased awareness during the pandemic, aided by public advisories and media influence. 

The researchers observed higher vaccination rates for the COVID-19 vaccine compared to other vaccines (influenza and pneumococcal vaccines). Although the researchers acknowledged the potential impact of social and governmental influence in increasing vaccination rates, they concluded that it is crucial to acknowledge that vaccination decisions in IEI patients must be individualized.