免疫功能受损患者（ICPs）患有较高的发生严重COVID-19形式的风险，且较普通人群承受更大的并发症和死亡负担。然而，最近的研究表明，不同ICPs在SARS-CoV-2 mRNA疫苗的抗体反应中可能存在高度变异。本研究采用协作的单中心前瞻性队列研究，评估了四组ICPs（癌症（n = 232）：造血干细胞移植（HSCT；n = 126）患者；与HIV感染者（PLWH；n = 131）及肺移植（LT；n = 39）患者）在日内瓦大学医院接受2次和3次mRNA疫苗后对SARS-CoV-2刺突蛋白抗体滴度进行了评估；以及健康个体（n = 49）。首次接种疫苗后，健康个体（2417 IU/mL [95% CI：2327-2500]）、PLWH组（2024 IU/mL [95% CI:1854-2209]）和癌症患者（840 IU/mL [95% CI: 625-1129]）观察到最高的抗S抗体几何平均滴度（IU/mL），而HSCT和LT组的患者抗体反应较弱（198 IU/mL [95% CI: 108-361]和7.3 IU/mL [95% CI: 2.5-22]）。强化剂量在1个月后对PLWH（2500 IU/mL）和癌症患者（2386 IU/mL [95% CI: 2182-2500]）产生了较高的抗体反应，对HSCT患者产生了中等的反应（521 IU/mL [95% CI: 306-885]），对LT受体则产生了较差的反应（84 IU/mL [95% CI: 18-389]）。移植或化疗中使用的免疫抑制药物与疫苗反应的差异相关。研究结果确认了不同ICPs在mRNA疫苗后的体液反应的异质性，并强调了为这些不同群体制定个性化建议的必要性。

Immunocompromised patients (ICPs) have a higher risk of developing severe forms of COVID-19 and experience a higher burden of complications and mortality than the general population. However, recent studies have suggested that the antibody response to SARS-CoV-2 mRNA vaccines could be highly variable among different ICPs. Using a collaborative, monocentric, prospective cohort study, we assessed anti-SARS-CoV-2 spike protein antibody titers following two and three doses of mRNA vaccines in four groups of ICPs (cancer [n = 232]: hematopoietic stem cell transplant [HSCT; n = 126] patients; people living with HIV [PLWH; n = 131]; and lung transplant [LT; n = 39] recipients) treated at Geneva University Hospitals; and healthy individuals (n = 49). After primo-vaccination, the highest anti-S antibody geometric mean titer (IU/mL) was observed in healthy individuals (2417 IU/mL [95% CI: 2327-2500]), the PLWH group (2024 IU/mL [95% CI:1854-2209]) and patients with cancer (840 IU/mL [95% CI: 625-1129]), whereas patients in the HSCT and LT groups had weaker antibody responses (198 IU/mL [95% CI: 108-361] and 7.3 IU/mL [95% CI: 2.5-22]). The booster dose conferred a high antibody response after 1 month in both PLWH (2500 IU/mL) and cancer patients (2386 IU/mL [95% CI: 2182-2500]), a moderate response in HSCT patients (521 IU/mL [95% CI: 306-885]) and a poor response in LT recipients (84 IU/mL [95% CI: 18-389]). Contemporary treatment with immunosuppressive drugs used in transplantation or chemotherapy was associated with a poor response to vaccination. Our findings confirmed the heterogeneity of the humoral response after mRNA vaccines among different ICPs and the need for personalized recommendations for each of these different groups.