02 April 2024

Scientists described the state of the immune system in a German man after 217 vaccinations against covidae

German scientists described an exceptional case of hypervaccination: an elderly man received 217 doses of covid vaccination. Analysis of his immunologic profile showed that his adaptive immunity responses were not significantly different from those of people who had received three doses of the vaccine. The case report is published in The Lancet Infectious Diseases.

The instructions for most existing covida vaccines recommend two doses of the drug administered 21 to 28 days apart. Notably, the pattern of revaccination against covid is not fully understood. The World Health Organization recommends administering additional doses only to high- and medium-risk groups - the elderly, people with weakened immunity and comorbidities. The interval between vaccinations should be 6 to 12 months.

A team of doctors led by Kilian Schober from the University of Erlangen-Nuremberg described the case of a 62-year-old man from Magdeburg who intentionally and for personal reasons received 217 vaccinations against SARS-CoV-2 over a period of 29 months. This hypervaccination was performed outside the context of a clinical trial and contrary to national vaccination recommendations. Evidence of 130 vaccinations over nine months was collected by the Magdeburg State Attorney, who initiated a fraud investigation into the case, but criminal charges were not ultimately filed.

Throughout the hypervaccination period, the patient did not report any vaccine-related side effects. Notably, he had never had a history of covirus, as indicated by repeated negative rapid tests, PCR tests, and serologic blood tests. Levels of immunoglobulin G (IgG) class antibodies to SARS-CoV-2 were compared with those of a control group of 29 vaccinees who received three doses of mRNA vaccine. The patient's anti-spike IgG levels were highest on day 214 of vaccination and on the third day after 215 vaccination, but the pharmacokinetics of antibody reduction were consistent with those of the control group. The 217th vaccination also led to a moderate increase in anti-spike IgG levels. There was also an IgG to IgG4 switch in the patient: on day 189 after the 215 vaccination, their levels were elevated in absolute amounts, but not in relative amounts, compared to control individuals on day 189 after their third vaccination.

In contrast to the control group participants, physicians detected anti-spike IgG in the patient's saliva. In addition, the serum's ability to neutralize the virus was 5.4-fold and 11.5-fold higher compared to the vaccinated control group for wild-type and Omicron B1.1.529 spike protein, respectively. The study patient also had a slightly elevated level of spike-specific B-lymphocytes without a high degree of clonal expansion or frequency of somatic hypermutations.

CD8+ T cells specific for the immunodominant spike-specific HLA-A*01/LTD epitope were approximately six times more frequent than in controls. The phenotype of T cells was skewed toward effector memory T cells in absolute and relative numbers. Single-cell RNA sequencing of LTD-specific T cells confirmed a more differentiated T-cell phenotype and revealed a higher degree of clonal expansion compared with vaccinated controls. The patient's CD8+ T cells showed a higher sensitivity to peptides than the controls.

Thus, this clinical case demonstrates that SARS-CoV-2 hypervaccination did not lead to adverse events and increased spike-specific antibodies and T cells. However, it had no significant effect on the quality of adaptive immune responses. In part, this supports the view that revaccination is not necessary in healthy adults.

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