Personalized, precise and predictive vaccinology's holy grail is to anticipate immune response for every individual, depending on their genetic background and all other factors that may impact vaccine immunogenicity, efficacy, and safety.
The high expense of comprehensive genomic and immune-profiling tests, however, prohibits their routine use and this disproportionally affects underserved populations.
A new paper reports preliminary results of an ongoing study of COVID-19 vaccination in geographic neighborhoods and online health support groups. Due to innovative recruitment and monitoring strategies, the study has the largest representation of active "oldest old" - individuals aged 80 or older - than all other trials with diverse age groups.
Despite widespread belief of a biphasic pattern for the frequency of systemic adverse events post-vaccination (VAEs), the paper reports statistically significant differences in the incidence of VAEs for both younger and 80+ populations when compared to those in the 60-69 and 70-79 age brackets. The subtypes of adverse events in younger and older populations are different. This short paper groups post-vaccination events in three types: "No or minimal VAEs", and short- or long-term reactions that significantly impacted activities of daily living.
The paper suggests genetic origin for some adverse reactions. Scientists have only just begun to look into genetics of less common VAEs. HLA-A∗03:01 (contributing to low risk of severe COVID-19) was recently found to be associated with increased risk of stronger side effects (including fever and chills) from Pfizer-BioNTech COVID-19 vaccination. In another recent study, HLA-DQB1*06 alleles were found to protect from breakthrough infection during the ancestral SARS-CoV-2 virus and subsequent Alpha-variant waves compared with non-carriers. Hopefully, more studies will follow.
