Biological modifications of the immune response to COVID-19 vaccine in patients treated with anti-CD20 agents and immune-checkpoint inhibitors

Investigating the impact of immune-modulating therapies on mRNA vaccine efficacy remains vital, transcending the immediate context of the COVID-19 pandemic. This study focuses on the differential immune responses to COVID-19 mRNA booster vaccines among healthy volunteers, cancer patients undergoing treatment with immune-checkpoint inhibitors (ICIs), and those treated with the anti-CD20 antibody rituximab. Utilizing RNA sequencing, serology, and interferon-γ release assessment, we charted the temporal dynamics of the immune response in such cohorts. Our findings indicate that ICIs maintain an immune profile similar to that of healthy individuals, whereas treatment with rituximab leads to the impairment of type I interferon response and the upregulation of transcripts pertaining to regulatory T cells, with a global dysregulation of both humoral and cellular immunity. This research deepens our understanding of the sophisticated interplay within the immune system in health and disease states, potentially informing therapeutic strategies across a spectrum of immunological conditions. ### Competing Interest Statement The authors have declared no competing interest.