TY - JOUR
T1 - Transient Autoreactive PF4 and Antiphospholipid Antibodies in COVID-19 Vaccine Recipients
AU - Raadsen, Matthijs P.
AU - Visser, Chantal
AU - Lavell, A. H. Ayesha
AU - van de Munckhof, Anita A. G. A.
AU - Coutinho, Jonathan M.
AU - de Maat, Moniek P. M.
AU - GeurtsvanKessel, Corine H.
AU - Bomers, Marije K.
AU - Haagmans, Bart L.
AU - van Gorp, Eric C. M.
AU - Porcelijn, Leendert
AU - Kruip, Marieke J. H. A.
N1 - Funding Information: This study was supported by the Netherlands Organization for Health Research and Development (ZonMw, grant number 10430072110005 and 10430022010023). Publisher Copyright: © 2023 by the authors.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare autoimmune condition associated with recombinant adenovirus (rAV)-based COVID-19 vaccines. It is thought to arise from autoantibodies targeting platelet factor 4 (aPF4), triggered by vaccine-induced inflammation and the formation of neo-antigenic complexes between PF4 and the rAV vector. To investigate the specific induction of aPF4 by rAV-based vaccines, we examined sera from rAV vaccine recipients (AZD1222, AD26.COV2.S) and messenger RNA (mRNA) based (mRNA-1273, BNT162b2) COVID-19 vaccine recipients. We compared the antibody fold change (FC) for aPF4 and for antiphospholipid antibodies (aPL) of rAV to mRNA vaccine recipients. We combined two biobanks of Dutch healthcare workers and matched rAV-vaccinated individuals to mRNA-vaccinated controls, based on age, sex and prior history of COVID-19 (AZD1222: 37, Ad26.COV2.S: 35, mRNA-1273: 47, BNT162b2: 26). We found no significant differences in aPF4 FCs after the first (0.99 vs. 1.08, mean difference (MD) = −0.11 (95% CI −0.23 to 0.057)) and second doses of AZD1222 (0.99 vs. 1.10, MD = −0.11 (95% CI −0.31 to 0.10)) and after a single dose of Ad26.COV2.S compared to mRNA-based vaccines (1.01 vs. 0.99, MD = 0.026 (95% CI −0.13 to 0.18)). The mean FCs for the aPL in rAV-based vaccine recipients were similar to those in mRNA-based vaccines. No correlation was observed between post-vaccination aPF4 levels and vaccine type (mean aPF difference −0.070 (95% CI −0.14 to 0.002) mRNA vs. rAV). In summary, our study indicates that rAV and mRNA-based COVID-19 vaccines do not substantially elevate aPF4 levels in healthy individuals.
AB - Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare autoimmune condition associated with recombinant adenovirus (rAV)-based COVID-19 vaccines. It is thought to arise from autoantibodies targeting platelet factor 4 (aPF4), triggered by vaccine-induced inflammation and the formation of neo-antigenic complexes between PF4 and the rAV vector. To investigate the specific induction of aPF4 by rAV-based vaccines, we examined sera from rAV vaccine recipients (AZD1222, AD26.COV2.S) and messenger RNA (mRNA) based (mRNA-1273, BNT162b2) COVID-19 vaccine recipients. We compared the antibody fold change (FC) for aPF4 and for antiphospholipid antibodies (aPL) of rAV to mRNA vaccine recipients. We combined two biobanks of Dutch healthcare workers and matched rAV-vaccinated individuals to mRNA-vaccinated controls, based on age, sex and prior history of COVID-19 (AZD1222: 37, Ad26.COV2.S: 35, mRNA-1273: 47, BNT162b2: 26). We found no significant differences in aPF4 FCs after the first (0.99 vs. 1.08, mean difference (MD) = −0.11 (95% CI −0.23 to 0.057)) and second doses of AZD1222 (0.99 vs. 1.10, MD = −0.11 (95% CI −0.31 to 0.10)) and after a single dose of Ad26.COV2.S compared to mRNA-based vaccines (1.01 vs. 0.99, MD = 0.026 (95% CI −0.13 to 0.18)). The mean FCs for the aPL in rAV-based vaccine recipients were similar to those in mRNA-based vaccines. No correlation was observed between post-vaccination aPF4 levels and vaccine type (mean aPF difference −0.070 (95% CI −0.14 to 0.002) mRNA vs. rAV). In summary, our study indicates that rAV and mRNA-based COVID-19 vaccines do not substantially elevate aPF4 levels in healthy individuals.
KW - COVID-19 vaccines
KW - autoantibodies
KW - platelet factor 4
KW - thrombocytopenia
KW - thrombosis
UR - http://www.scopus.com/inward/record.url?scp=85180679695&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/vaccines11121851
DO - https://doi.org/10.3390/vaccines11121851
M3 - Article
C2 - 38140254
SN - 2076-393X
VL - 11
JO - Vaccines
JF - Vaccines
IS - 12
M1 - 1851
ER -