Vaccine responses in immunocompromised patients:

Healthcare systems worldwide are dealing with increasing number of patients with impaired immune response due to several factors: HIV has become chronic disease due to advances in diagnostics and treatment, many patients take immunosuppressive medications to control inflammatory or autoimmune conditions. Also, chemotherapy for oncological diseases involves weakening of the immune system. These patients are often at increased risk of infections, some of which may be preventable by vaccination. However, immune response and protection acquired by vaccination may be impaired on these patients.

At SGVI, we are interested in studying the immune response to vaccinations in groups of immunocompromised patients, especially in People Living with HIV (PLWH). We have several on-going studies focusing on vaccine immunogenicity in immunocompromised patients at SGVI:

Current studies:

  • Propositive:

This is a phase IV, open label, interventional clinical trial sponsored by SGUL and funded by GSK to study safety and immunogenicity of two meningitis vaccines: MenACWY (Menveo®) and 4CMenB (Bexsero®) in adult patients with HIV infection.

  • Propositive Follow-up:

The second phase study after Propositive, sponsored by SGUL and funded by GSK, investigating long-term immunogenicity of MenACWY (Menveo®) and 4CMenB (Bexsero®) in the cohort of adult patients with HIV infection recruited to the Propositive study.

  • COVID-19 vaccines and HIV (David to fill in)

Future studies:

Project Team

Adult Clinical Research Fellow

Alberto San Francisco Ramos

Adult Clinical Research Fellow

David Smith

Paediatric Research Nurse

Shehnaz Athaide

Co-Director

Dr Catherine Cosgrove

Adult Clinical Research Fellow

Alberto San Francisco Ramos

Alberto is an Infectious Diseases and Microbiology Specialist Registrar with an interest in Global Health and Emerging Infectious Diseases. Alberto joined SGVI as part of a research placement in September 2020 and is currently working as an Adult clinical research fellow in several COVID-19 vaccine trials. He is the lead fellow for the COM-COV and COM-COV2 studies looking at heterologous COVID-19 vaccine schedules.

Alberto is also involved in studying vaccine responses in immunocompromised patients. He is investigating immune responses to meningococcal vaccinations (MenACWY and MenB) in HIV+ patients (ProPositive and Propositive follow-up trials), as well as the immunogenicity of COVID-19 vaccination in Tuberous Sclerosis Complex patients taking mTor inhibitor therapy.

Safety and Efficacy of NVX-CoV2373 Covid-19 Vaccine. N Engl J Med. 2021 Jun 30. doi: https://doi.org/10.1056/NEJMoa2107659.

Heterologous prime-boost COVID-19 vaccination: initial reactogenicity data. The Lancet Volume 397, Isuue 10289, P2043-2046, May 29, 2021. Part of Com-COV Study group. https://doi.org/10.1016/S0140-6736(21)01115-6

Efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine against SARS-CoV-2 variant of concern 202012/01 (B.1.1.7): an exploratory analysis of a randomised controlled trial. The Lancet Volume 397, Issue 10282, 10–16 April 2021, Pages 1351-1362. Part of Oxford Vaccine Group. https://doi.org/10.1016/S0140-6736(21)00628-0

Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine: a pooled analysis of four randomised trials. Lancet. 2021 6-12 March; 397(10277): 881–891. Part of Oxford Vaccine Group. https://doi.org/10.1016/S0140-6736(21)00432-3

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet 2020 Dec 8;S0140-6736(20)32661-1. Part of Oxford Vaccine Group. https://doi.org/10.1016/S0140-6736(20)32661-1

Adult Clinical Research Fellow

David Smith

David is an Infectious Diseases trainee currently undertaking a research placement. Having published work on Vitamin D in latent TB patients and its association with progression to active disease David is now working on a pilot study to increase the sensitivity of TB culture and detect persistent sub-populations of Mycobacteria within patient samples. This pilot data will inform the design of future large clinical trials of these techniques. David has also been working on a number of COVID-19 vaccine trials including leading on the COV001/002 and Valneva trials, and have published editorials on important topics in COVID-19. David previously completed laboratory research on respiratory virus’s effects on the ubiquitin intracellular pathways as part of an intercalated degree at Oxford University.

Smith, D., & Gill, D. (2021). Antivirals against SARS-CoV-2 by autumn?. BMJ, 373, n1215. doi:10.1136/bmj.n1215

Burgess, S., Smith, D., Kenyon, J. C., & Gill, D. (2020). Lightening the viral load to lessen covid-19 severity.. BMJ, 371, m4763. doi:10.1136/bmj.m4763

Patterson, B., Smith, D., Telford, A., Tana, A., Johnstone, D., Davidson, R., & Martineau, A. R. (2020). Vitamin D deficiency predicts latent TB reactivation independent of preventive therapy: a longitudinal study.. Int J Tuberc Lung Dis, 24(9), 916-921. doi:10.5588/ijtld.19.0605

Paediatric Research Nurse

Shehnaz Athaide

I have been working in Vaccine Institute as an Adult Clinical Research Nurse since April 2019 till date. My work mainly focuses on collecting data for our current Adult research studies, recruiting participants, conducting clinical appointments, taking study related clinical samples, processing them and recording data on a secure system. I enjoy my work while being a part of vaccine research team at St. Georges University of London and NHS trust.

Co-Director

Dr Catherine Cosgrove