Immune Response to COVID-19 Vaccination in Frail Patients

Abstract

Objective This study sought to examine the immune response to COVID-19 vaccination in frail patients and the associated role of inflammatory factors in immune response to COVID-19 vaccination. Methods A prospective cohort study design was used to assess the effects of the COVID-19 vaccine in non-frail and frail elderly individuals following a frailty assessment. The immune response between the two elderly populations were compared using Poisson regression modeling. A nested case-control study in an elderly population was also performed, differentiating the case group from the control group based on COVID-19 vaccine efficacy. A logistic regression analysis was employed to examine the correlation between frailty-related inflammatory factors and COVID-19 vaccine efficacy. Results A total of 920 individuals participated in the study, with 598 (65%) belonging to the non-frail group and 322 (35%) to the frail group. The frail group exhibited a lower seropositivity rate than the non-frail group after adjusting for age, amount of vaccination shots, and vaccination type using modified Poisson regression (RR = 0.929, 95% CI: 0.891 − 0.968; P < 0.05). The Logistic regression analysis revealed that the positive group had lower levels of CXCL10 (OR = 0.951; CI: 0.907 − 0.997; P < 0.05) after correcting for covariate weakening. Conclusion The present findings indicate that frailty may have a negative impact on COVID-19 vaccine efficacy. The concentration of CXCL10 may affect COVID-19 vaccine efficacy by altering the inflammatory levels in elderly frail patients.