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Vaccines
Special Issues
Immunization of Immunosuppressed Patients
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Immunization of Immunosuppressed Patients

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "COVID-19 Vaccines and Vaccination".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 1899

Special Issue Editors

Dr. Massimo Franchini

E-Mail Website
Guest Editor
Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, 46100 Mantua, Italy
Interests: coagulation; convalescent plasma therapy
Special Issues, Collections and Topics in MDPI journals
Dr. Daniele Focosi

E-Mail Website
Guest Editor
North-Western Tuscany Blood Bank, Pisa University Hospital, Pisa, Italy
Interests: virology; hematology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Mass vaccination campaigns have largely mitigated the healthcare burden of COVID-19, and booster vaccinations are being regularly updated. Nevertheless, vaccine response and efficacy remain suboptimal, mainly in those who need care the most, i.e., immunocompromised patients. In this Special Issue, we will analyze the effectiveness of different COVID-19 vaccine formulations across different cohorts of immunocompromised patients. Cohorts will range from oncohematological patients to solid organ transplant recipients to patients with autoimmune disorders. The Special Issue welcomes original research studies on novel vaccine approaches (e.g., mucosal delivery or novel adjuvants) and epidemiological studies or rigorous systematic reviews on vaccine efficacy in particular cohorts of immunocompromised patients.

We look forward to receiving your contributions.

Dr. Massimo Franchini
Dr. Daniele Focosi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19
  • vaccine efficacy
  • immunization

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Published Papers (3 papers)

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Research

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16 pages, 1123 KiB  
Article
Assessment of COVID-19 Vaccine Effectiveness Against SARS-CoV-2 Infection, Hospitalization and Death in Mexican Patients with Metabolic Syndrome from Northeast Mexico: A Multicenter Study
by Beatriz Silva Ramírez, Katia Peñuelas Urquides, Brenda Leticia Escobedo Guajardo, Viviana Leticia Mata Tijerina, Jorge Eleazar Cruz Luna, Roberto Corrales Pérez, Salvador Gómez García, Laura Adiene González Escalante and María Elena Camacho Moll
Vaccines 2025, 13(3), 244; https://doi.org/10.3390/vaccines13030244 - 27 Feb 2025
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Abstract
Background/Objectives: Metabolic syndrome (MetS) is a predisposing factor for severe COVID-19. The effectiveness of COVID-19 vaccines in patients with MetS has been poorly investigated. The aim of this study was to evaluate the effectiveness of COVID-19 vaccination before (BO) and after the Omicron [...] Read more.
Background/Objectives: Metabolic syndrome (MetS) is a predisposing factor for severe COVID-19. The effectiveness of COVID-19 vaccines in patients with MetS has been poorly investigated. The aim of this study was to evaluate the effectiveness of COVID-19 vaccination before (BO) and after the Omicron (AO) SARS-CoV-2 variant in patients with MetS. Methods: This retrospective observational study was carried out in a total of 3194 patients with MetS and a COVID-19 PCR or rapid antigen test. The main outcomes were vaccine effectiveness against infection, hospitalization and death resulting from COVID-19. Results: BO, only two doses of BNT162b2 were effective against infection, this effectiveness was lost AO. Also, with two doses, BNT162b2, ChAdOx1 and CoronaVac were effective against hospitalization BO; however, AO, only BNT162b2 and CoronaVac were effective. Regarding death as an outcome of COVID-19, two doses of BNT162b2 were effective BO, whereas AO, BNT162b2 and CoronaVac were 100% effective. BO the presentation of a sore throat increased after two doses of COVID-19 vaccine regardless of the type, and the presentation of dyspnea diminished after two doses of BNT162b2 and CoronaVac. Conclusions: The SARS-CoV-2 Omicron variant has impacted vaccines’ effectiveness against hospitalization and death in patients with MetS. A tailored vaccination scheme for patients with MetS should be implemented due to the varying effectiveness rates observed in our study. Full article
(This article belongs to the Special Issue Immunization of Immunosuppressed Patients)
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15 pages, 1514 KiB  
Article
Immunosuppressive Therapy Modifies Anti-Spike IgG Subclasses Distribution After Four Doses of mRNA Vaccination in a Cohort of Kidney Transplant Recipients
by Ignacio Juarez, Isabel Pérez-Flores, Arianne S. Aiffil Meneses, Ana Lopez-Gomez, Natividad Calvo Romero, Beatriz Rodríguez-Cubillo, María Angeles Moreno de la Higuera, Belén Peix-Jiménez, Raquel Gonzalez-Garcia, Beatriz Amorós-Pérez, Benigno Rivas-Pardo, Elvira Baos-Muñoz, Ana Arribi Vilela, Manuel Gómez Del Moral, Ana Isabel Sánchez-Fructuoso and Eduardo Martínez-Naves
Vaccines 2025, 13(2), 123; https://doi.org/10.3390/vaccines13020123 - 25 Jan 2025
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Abstract
Background: IgG4 is the least immunogenic subclass of IgG. Immunization with mRNA vaccines against SARS-CoV-2, unlike other vaccines, induces an increase in IgG4 against the spike protein in healthy populations. This study investigated whether immunosuppressive therapy affects the immune response, focusing on [...] Read more.
Background: IgG4 is the least immunogenic subclass of IgG. Immunization with mRNA vaccines against SARS-CoV-2, unlike other vaccines, induces an increase in IgG4 against the spike protein in healthy populations. This study investigated whether immunosuppressive therapy affects the immune response, focusing on IgG subclass changes, to four doses of mRNA vaccine in kidney transplant recipients (KTRs). Methods: This study includes 146 KTRs and 23 dialysis patients (DPs) who received three mRNA-1273 vaccine doses and a BNT162b2 booster. We evaluated anti-spike IgG titers and subclasses, T-CD4+ and T-CD8+ cellular responses, and serum neutralizing activity (SNA). Results: At the fourth dose, 75.8% of COVID-19 naïve KTRs developed humoral and cellular responses (vs. 95.7% in DPs). There was a correlation between anti-spike IgG titers/subclasses and SNA (p < 0.001). IgG subclass kinetics after the third/fourth dose differed between COVID-19 naïve KTRs and DPs. Immunosuppressive therapy influenced IgG subclasses: mTOR inhibitors (mTORi) positively influenced IgG1 and IgG3 (p < 0.05), while mycophenolic acid negatively affected IgG1, IgG3, and IgG4 (p < 0.05). SNA is correlated with breakthrough infections after four doses of vaccine in KTRs. mTORi was the only factor associated with SNA > 65% in naïve KTRs [4.29 (1.21–15.17), p = 0.024]. Conclusions: KTRs show weaker cellular and humoral immune responses to mRNA vaccines and a class shift towards non-inflammatory anti-S IgG4 upon booster doses. IgG subclasses show a positive correlation with SNA and are influenced by immunosuppression. Increased SNA after four doses of vaccine is protective against infection. mTORi may benefit non-responding KTRs. Full article
(This article belongs to the Special Issue Immunization of Immunosuppressed Patients)
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Review

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16 pages, 256 KiB  
Review
COVID-19 Vaccination in Patients with Hematological Malignances
by Massimo Franchini, Fabrizio Maggi and Daniele Focosi
Vaccines 2025, 13(5), 465; https://doi.org/10.3390/vaccines13050465 - 25 Apr 2025
Viewed by 111
Abstract
Patients with hematologic malignancies (HM) represent a population particularly vulnerable to infections due to their cancer-related immune deficiency and the immunosuppressive treatment they are administered. Accordingly, a high hospitalization and mortality rate has been consistently reported in such a frail population during the [...] Read more.
Patients with hematologic malignancies (HM) represent a population particularly vulnerable to infections due to their cancer-related immune deficiency and the immunosuppressive treatment they are administered. Accordingly, a high hospitalization and mortality rate has been consistently reported in such a frail population during the first COVID-19 pandemic waves. After a brief description of the clinical impact of SARS-CoV-2 infection in patients with blood cancers, this narrative review is focused on the protective effect of COVID-19 vaccines in patients with HM. All in all, the results from the literature analysis indicate that booster shots in fully vaccinated HM patients are significantly able to increase seroconversion rates, which represent the best surrogate of vaccine efficacy. Despite these encouraging data, concerns still remain regarding the lower immune responses to COVID-19 vaccines, even to booster doses, in severely immunosuppressed HM patients, such as those receiving anti-CD20 monoclonal antibody therapies and hematopoietic stem cell transplants. Full article
(This article belongs to the Special Issue Immunization of Immunosuppressed Patients)
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