Effectiveness and durability of the mRNA vaccine-induced SARS-CoV-2-specific humoral and cellular immunity in severe asthma patients on biological therapy

The COVID-19 vaccines effectively elicit humoral and cellular immunity against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a healthy population. This immunity decreases several months after the vaccination. However, the efficacy of the vaccine-induced immunity and its durability in patients with severe asthma on biological therapy is unknown. In this study, we evaluated the effectiveness and durability of the mRNA vaccine-induced SARS-CoV-2-specific humoral and cellular immunity in severe asthma patients on biological therapy. The study included 37 patients with severe asthma treated with anti-IgE (omalizumab, n=18), anti-IL5 (mepolizumab, n=14; reslizumab, n=4), or anti-IL5R (benralizumab, n=1) biological therapy. All patients were vaccinated with two doses of BNT162b2 mRNA vaccine (Comirnaty) at a 6-week period between the doses. We found that the COVID-19 vaccination elicited SARS-CoV-2-specific humoral and cellular immunity, which significantly declined 6 months after the second dose of the vaccine. The type of biological treatment did not affect the vaccine-elicited immunity. However, the patients’ age negatively impacted the vaccine-induced humoral response. On the other hand, no such age-related impact was observed on the vaccine-elicited cellular immunity. Our findings showed that biological therapy of patients with severe asthma does not compromise the effectiveness and durability of the COVID-19 vaccine-induced immunity.