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Effectiveness of heterologous and homologous COVID-19 vaccination among immunocompromised individuals: a systematic literature review and meta-analysis
Journal article   Open access   Peer reviewed

Effectiveness of heterologous and homologous COVID-19 vaccination among immunocompromised individuals: a systematic literature review and meta-analysis

Isabele Pardo, Aline Miho Maezato, Gustavo Yano Callado, Maria Celidonio Gutfreund, Mariana Kim Hsieh, Vivian Lin, Takaaki Kobayashi, Jorge L Salinas, Aruna Subramanian, Michael B Edmond, …
Antimicrobial stewardship & healthcare epidemiology : ASHE, Vol.4(1), e152
2024
DOI: 10.1017/ash.2024.369
PMCID: PMC11427957
PMID: 39346662
Appears in  UI Libraries Support Open Access
url
https://doi.org/10.1017/ash.2024.369View
Published (Version of record) Open Access

Abstract

We assessed the effectiveness of heterologous vaccination strategy in immunocompromised individuals regarding COVID-19 outcomes, comparing it to homologous approaches. Systematic literature review/meta-analysis. We searched PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science from January 1, 2020 to September 29, 2023. We included studies that evaluated the heterologous vaccination strategy on immunocompromised individuals through outcomes related to COVID-19 (levels of anti-SARS-CoV-2 spike protein IgG, neutralizing antibodies, symptomatic COVID-19 infection, hospitalization, and death) in comparison to homologous schemes. We also used random-effect models to produce pooled odds ratio estimates. Heterogeneity was investigated with I estimation. Eighteen studies met the inclusion criteria for this systematic review. Fourteen of them provided quantitative data for inclusion in the meta-analysis on vaccine response, being four of them also included in the vaccine effectiveness meta-analysis. The vaccination strategies (heterologous vs homologous) showed no difference in the odds of developing anti-SARS-CoV-2 spike protein IgG (odds ratio 1.12 [95% Cl: 0.73-1.72]). Heterologous schemes also showed no difference in the production of neutralizing antibodies (odds ratio 1.48 [95% Cl: 0.72-3.05]) nor vaccine effectiveness in comparison to homologous schemes (odds ratio 1.52 [95% CI: 0.66-3.53]). Alternative heterologous COVID-19 vaccinations have shown equivalent antibody response rates and vaccine effectiveness to homologous schemes, potentially aiding global disparity of vaccine distribution.
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