Immunogenicity of BNT162b2 mRNA COVID-19 Vaccine in Patients with Cardiovascular Disease

• Published in: Journal of clinical medicine Vol. 10; no. 23; p. 5498
• Main Authors: Naruse, Hiroyuki, Ito, Hiroyasu, Izawa, Hideo, Sarai, Masayoshi, Ishii, Junnichi, Sakaguchi, Eirin, Murakami, Reiko, Ando, Tatsuya, Fujigaki, Hidetsugu, Saito, Kuniaki
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 24.11.2021; MDPI
• Subjects: Acute coronary syndromes; Antibodies; Blood pressure; Cardiac arrhythmia; Cardiomyopathy; Cardiovascular disease; Clinical medicine; Coronary vessels; coronavirus disease 2019 (COVID-19); Coronaviruses; COVID-19 vaccines; Diabetes; Diabetic retinopathy; Generalized linear models; Heart; Hypertension; immunogenicity; Infections; Serology; Severe acute respiratory syndrome coronavirus 2; Transplants & implants; vaccine; Variables; Vein & artery diseases; Japan
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm10235498

Concern has been raised about the effectiveness of the coronavirus disease 2019 (COVID-19) vaccine in the population of patients with various comorbidities such as heart disease. We investigated the humoral response to the BNT162b2 mRNA COVID-19 vaccine in patients with cardiovascular disease (CVD). We measured IgG against severe acute respiratory syndrome coronavirus 2 spike receptor-binding domain (RBD-IgG) in 85 CVD patients and 179 healthcare workers (HCWs). Blood samples were collected from patients and HCWs three times: (1) before the first dose of vaccination, (2) two weeks after the first dose of vaccination, and (3) two weeks after the second dose of vaccination. Patients with CVD showed a significantly inferior serological response to the BNT162b2 mRNA COVID-19 vaccine at 14 days after the prime dose compared to HCWs (21% vs. 95%, p < 0.001). Median RBD-IgG titers of patients with CVD at 14 days after the second dose were significantly lower than those of HCWs (137.2 U/mL (80.6–200.4 U/mL) vs. 176.2 U/mL (123.9–260.0 U/mL), p < 0.001). In multivariable analyses, CVD is significantly associated with seropositivity after first vaccination and RBD-IgG titers after second vaccination. CVD patients may have a poor humoral response to the BNT162b2 mRNA COVID-19 vaccine, need to be closely monitored, and require earlier revaccination to ensure stronger immunity and protection against infection.