COVID-19 vaccination for patients with a compromised immune system

People whose immune system is compromised run a higher risk of complications if they contract COVID-19. Furthermore, we do not have enough evidence to show whether these people are sufficiently protected after being vaccinated. For this reason, the Netherlands Organisation for Health Research and Development, ZonMw, is facilitating eight studies focusing on the effectiveness of COVID-19 vaccines in these groups of patients. The findings of these studies will help patients, practitioners and policymakers to make the right decisions for the vaccination strategy.

A webinar series on COVID-19 vaccination in immunocompromised patients

During an international ZonMw webinar on 7 December 2021, researchers presented the first results from two studies: response to the corona vaccine in the case of kidney diseases and cancer. Did you miss it? Watch the webinar back.

Vaccinations for people with a compromised immune system

Vaccine research in healthy adults

To investigate the effectiveness of vaccines, manufacturers conduct their initial trials on healthy adults. This was also done during the development of the new vaccines to combat COVID-19. Specific risk groups were only included in these initial vaccination studies to a limited degree, such as people with certain diseases or disorders, obese people, those with Down’s syndrome, pregnant women and certain age groups.

Vaccination strategy: optimum protection for everyone

In combatting the pandemic, it is important that everyone is protected as well as possible against contracting COVID-19 after being vaccinated. We know that the vaccines are effective in healthy adults. Scientists all over the world are collecting additional information about the effectiveness of the vaccines in specific groups, for example in immune compromised patients.

Special attention to compromised immune systems

In addition to international studies, we are looking at a number of specific target groups in the Netherlands among which no research has been conducted, or where additional research is needed. These are people with a weakened immune system. We are specifically looking at:

  • patients with primary immunodeficiencies or immune disorders
  • cancer patients (solid tumours) undergoing chemotherapy and/or immunotherapy
  • patients with blood cancer
  • patients being treated with immunosuppressive medication (for rheumatism, IBD or MS)
  • kidney transplant patients and those undergoing dialysis
  • lung transplant patients
  • people with HIV
  • people with Down’s syndrome

Uniform methodology makes sharing knowledge simpler

It is important that the findings from these vaccine studies can be put into practice quickly. To enable knowledge sharing and overarching research, the studies in the Netherlands work on the basis of jointly agreed protocols and measurement methods. In addition, the interim results of these eight studies will be shared. The Dutch Ministry of Health, Welfare and Sport (VWS), the National Institute for Public Health and the Environment (RIVM) and the Health Council of the Netherlands are also involved  to either facilitate and/or assist in the implementation of study results.

Willy Spaan, the Chair of the Assessment Committee, and RIVM Coordinator Cécile van Els talk about this unique harmonisation of projects in which ZonMw has a coordinating role.

Total budget: 25 million euros

The Dutch Ministry of Health, Welfare and Sport (VWS) has made 25 million euros available for this part of the COVID-19 vaccine studies programme. Besides these eight studies, regarding patients with a compromised immune system, additional studies have an will be established to answer urgent questions.

Vaccine studies: part of broad coronavirus research

In conjunction with funding bodies, policymakers, researchers, patients, practitioners, data professionals and international partners, ZonMw is working on current and future ways of mobilising research and knowledge to contribute to solutions in the battle against the coronavirus and COVID-19 and their effects on society. The vaccine studies are part of this. Visit the project pages for more information on the projects.

Project number: 10430072010009
Dr I. Nijhof, Prof. M.D. Hazenberg,
Amsterdam UMC, in conjunction with affiliated hospitals: UMC Groningen, Erasmus UMC, LUMC

Patients with an underlying haematological disease have a high risk of suffering a more severe course of COVID-19. Despite this, they are often advised not to have the vaccination   because it is doubtful whether vaccination will provide sufficient protection. This study will investigate whether this is justifiable. The researchers expect to be able to identify patient groups who, contrary to expectations, do respond well to vaccination. They will also examine whether patients who are insufficiently protected after being vaccinated could be given added protection by having other members of their household vaccinated (ring vaccination).

Project number: 10430072010007
Dr Filip Eftimov, Prof. Marieke van Ham, Prof. Taco Kuijpers
Amsterdam UMC and Sanquin

It is currently not yet clear how long healthy people are protected against the SARS-CoV-2 virus following infection and/or vaccination. This uncertainty is even greater among people with an autoimmune disease, and in particular in patients treated with immunosuppressive medication. It remains to be seen whether the recently developed COVID-19 vaccines are as effective in patients taking immunosuppressive medication as in healthy people. This research focuses on the effectiveness of COVID-19 vaccination in this group of patients and, in addition, examines whether the specific immunity to SARS-CoV-2 wanes over time.

Project number: 10430072010003
Dr C.C. Van Leer Buter, Dr E. Verschuuren
UMC Groningen

COVID-19 is especially dangerous for patients that received a lung transplant and those that are on the waiting list for such a transplant. A virus infection like COVID-19 can lead to rejection of the transplanted lungs or to aa weakened lung function so that patients on the waiting list become ineligible for transplantation. However, it remains unclear whether COVID-19 vaccines are safe for these patients and if they work effectively. This research will investigate whether vaccination protects these patients against COVID-19.

Project number: 10430072010004
Prof. L. Bont
UMC Utrecht

To what extent   do the COVID-19 vaccines offer protection for people with Down’s syndrome?  The immune system in adults and children with Down syndrome functions less well. This puts them at a higher risk of complications from a COVID-19 infection. Therefore it is important to investigate whether they are protected by vaccination.

More information about this project

Project number: 10430072010002
Dr J.S.F. Sanders, Prof. R. Gansevoort
UMC Groningen

Vaccinations can be less effective in patients on dialysis and in kidney transplant patients and it remains to be seen whether the COVID-19 vaccine provides sufficient protection. During this project, the researchers intend to conduct four different studies to investigate the effectiveness and safety of COVID-19 vaccination in patients suffering from kidney disease.

More information about this project

Project number: 10430072010008
Prof. K. Brinkman
OLVG, West Location

The immune response after COVID-19 vaccination in people with HIV is currently unknown. Observations from previous studies with different vaccines suggest that the immune response may be reduced in these patients. This research will examine the short- and long-term immune response to vaccination in people living with HIV and will also map side-effects from the vaccines in this patient group.

Project number: 10430072010006
Dr V.A.S.H. Dalm
Erasmus MC

Patients with primary immunodeficiencies have an increased risk of infections and of becoming seriously ill or dying after contracting such infections. As such, they may also be more vulnerable to COVID-19 taking a more severe course. Protection against COVID-19 is therefore crucial for these patients. However, it is not known how safe and effective the COVID-19 vaccines are for this particular patient group. This study will investigate whether patients with a primary immunodeficiency are protected against COVID-19 after vaccination.

Project number: 10430072010005
Prof. E.G.E. de Vries
UMC Groningen, the Netherlands Cancer Institute (NKI) and the Antoni van Leeuwenhoek Hospital (AVL)

Patients with cancer who are undergoing immunotherapy and/or chemotherapy treatment are at a greater risk of suffering a more severe course of COVID-19. It is therefore important that these patients are optimally protected by vaccination. However, we do not know whether the COVID-19 vaccines are safe and effective for this group of patients, because immunotherapy and chemotherapy can affect the ability to develop a good immune response to vaccination. This research focuses on assessing the immune response and side-effects after COVID-19 vaccination in these patients.

More information about this project