Human subjects

Eleven healthy adult subjects (mean age ± standard deviation, 40.8 years ±6.7, 6 males and 5 females) who were going to receive COVID-19 mRNA vaccine were recruited between December 2020 and May 2021. Healthy individuals were those who were not taking immunosuppressive drugs and did not have a disease potentially affecting the immune system including infection, cancer, asthma, immunodeficiency, autoimmunity and diabetes.³ Healthy subjects received the first and second doses of COVID-19 mRNA vaccine (Moderna vaccine, n = 8 and Pfizer-BioNTech vaccine, n = 3). Twelve patients with PADs (mean age ± standard deviation, 45.1 years ±22.5, 3 males and 9 females) were recruited from Yale Immunodeficiency clinics (Supplementary Table S1 for detailed clinical characteristics). These patients include 4 patients with CVID, 3 patients with IgG deficiency, 1 patient with selective antibody deficiency, and 3 patients with IgG subclass 2 deficiency. Patients with PADs were divided into two groups including CVID and other PADs including the latter three conditions as previously done.⁹ Patients with PADs received the first and second doses of COVID-19 mRNA vaccine (Moderna vaccine, n = 6 and Pfizer-BioNTech vaccine, n = 6). After obtaining informed consent, peripheral blood samples were obtained at three time points: prior to vaccination and 3–4 weeks after the first and second doses of the Pfizer-BioNTech or Moderna COVID-19 mRNA vaccine. None of the study subjects had SARS-CoV-2 infection at the three time points of blood sampling as determined by serum anti-nucleocapsid IgG antibody ELISA.