# An Overview of the Strategies to Boost SARS-CoV-2-Specific Immunity in People with Inborn Errors of Immunity

## TL;DR

This paper reviews strategies to improve immune responses against SARS-CoV-2 in people with inborn immune system disorders.

## Contribution

The paper provides a comprehensive review of vaccine and antibody-based strategies for boosting immunity in individuals with inborn errors of immunity.

## Key findings

- Vaccine responses in IEI patients are uncertain and may not protect against new variants.
- Immunoglobulin replacement therapy and monoclonal antibodies offer passive immunity for IEI patients.
- More research is needed to define protective immunity and optimize treatments for IEI individuals.

## Abstract

The SARS-CoV-2 pandemic has heightened concerns about immunological protection, especially for individuals with inborn errors of immunity (IEI). While COVID-19 vaccines elicit strong immune responses in healthy individuals, their effectiveness in IEI patients remains unclear, particularly against new viral variants and vaccine formulations. This uncertainty has led to anxiety, prolonged self-isolation, and repeated vaccinations with uncertain benefits among IEI patients. Despite some level of immune response from vaccination, the definition of protective immunity in IEI individuals is still unknown. Given their susceptibility to severe COVID-19, strategies such as immunoglobulin replacement therapy (IgRT) and monoclonal antibodies have been employed to provide passive immunity, and protection against both current and emerging variants. This review examines the efficacy of COVID-19 vaccines and antibody-based therapies in IEI patients, their capacity to recognize viral variants, and the necessary advances required for the ongoing protection of people with IEIs.