COVID-19 vaccination effective when coadministered with flu, pneumonia shots
Although anti-spike IgG concentrations were reduced in patients who got multiple vaccines at the same time, neutralization activity of the COVID-19 vaccine remained the same, indicating that patients received functional immune protection, a Danish study found.
Coadministering COVID-19 mRNA, influenza, and pneumococcal (PPSV23) vaccines is feasible and safe, without significantly impairing neutralizing antibody responses, a study concluded.
Researchers looked at data on 3,104 patients from the Danish National Cohort Study of Effectiveness and Safety of SARS-CoV-2 Vaccines (ENFORCE), a nonrandomized study evaluating the immunological response, safety, and durability of COVID-19 vaccination (median age, 70 years; 54% women). The study participants received a fourth dose of an mRNA COVID-19 vaccine alone or with an influenza vaccine, with or without PPSV23, from January to December 2022. Researchers measured SARS-CoV-2 anti-spike and anti-receptor binding domain IgG concentrations and neutralization activity before and one month after vaccination. Results were published by Clinical Infectious Diseases on Aug. 18.
In the COVID-19, COVID-19 plus influenza, and COVID-19 plus influenza and PPSV23 group, anti-spike IgG geometric mean fold rises (GMFR) were 1.95, 1.56, and 1.42, respectively. For neutralization activity, values were 8.99, 12.42, and 8.23, respectively. The adjusted odds ratio (OR) of at least a doubling of anti-spike IgG GMFR was 0.64 for COVID-19 plus flu and 0.43 for all three shots, compared to COVID-19 alone; for neutralization activity, the ORs were 0.96 and 0.97, respectively. The odds for anti-receptor binding domain GMFRs followed similar patterns. Systemic adverse events were more common in the group that got all three vaccines at once (adjusted OR, 2.04; P<0.001), though no serious events were reported.
The study authors concluded that neutralization activity remained unaffected, indicating maintained functional immune protection despite the observed reductions in IgG concentrations following coadministration.
“However, systemic adverse events were more frequent in the coadministration groups, particularly with PPSV23, which may impact patient acceptability,” they wrote. “These findings provide valuable real-world evidence supporting vaccine coadministrating strategies, particularly for high-risk populations.”