Messenger RNA vaccines and neutralizing anti-severe acute respiratory syndrome coronavirus 2 antibodies in patients with immunodeficiency.

We would like to share our ideas on the article entitled “Detection of neutralizing anti–severe acute respiratory syndrome coronavirus 2 antibodies in patients with common variable immunodeficiency after immunization with messenger RNA vaccines.” Romano et al concluded that “CVID patients must be included in COVID-19 vaccination programs because of the ability of mRNA vaccines to safely induce production of neutralizing antibodies in this category of patients.” Given that Romano et al noted that the production of neutralizing antibodies did not mean protection, it is, therefore, necessary to have further studies for confirmation on the advantage of vaccines. Whether the messenger RNA (mRNA) can result in unwanted immunologic problems in a common variable immunodeficiency (CVID) case is also another important question. An association between CVID and autoimmunity was proposed. , There are many reports on the possible association between mRNA COVID-19 vaccine and autoimmunity generation. A careful risk and benefit evaluation is needed for making any recommendation on using the mRNA COVID-19 vaccine among CVID cases.