Pharma Focus Asia

Baseline Characteristics of SARS-CoV-2 Vaccine Non-responders in a Large Population-based Sample

Ashraf Yaseen, Stacia M. DeSantis, Rachit Sabharwal, Yashar Talebi, Michael D. Swartz, Shiming Zhang, Luis Leon Novelo, Cesar L. Pinzon-Gomez, Sarah E. Messiah, Melissa Valerio-Shewmaker, Harold W. Kohl III, Jessica Ross, David Lakey, Jennifer A. Shuford, Stephen J. Pont, Eric Boerwinkle.


Studies indicate that individuals with chronic conditions and specific baseline characteristics may not mount a robust humoral antibody response to SARS-CoV-2 vaccines. In this paper, we used data from the Texas Coronavirus Antibody REsponse Survey (Texas CARES), a longitudinal state-wide seroprevalence program that has enrolled more than 90,000 participants, to evaluate the role of chronic diseases as the potential risk factors of non-response to SARS-CoV-2 vaccines in a large epidemiologic cohort.


Individuals with certain malignancies, organ transplant recipients, and immune-compromised individuals could mount either an incomplete or sub-optimal antibody response to “primary series vaccination”, or PSV. PSV in the United States is defined as receiving two mRNA vaccines (Moderna or Pfizer) or one non-mRNA vaccine (Johnson & Johnson or Novavax). Agha M et al. found that 46% of hematologic malignancy patients did not produce antibodies following SARS-CoV-2 mRNA vaccination and were therefore vaccine non-responders.

Materials and Methods:

Since October 2020, the Texas Coronavirus Antibody REsponse Survey (Texas CARES) program has enrolled more than 90,000 participants ages 5-to-90 years old in a state-wide antibody prevalence surveillance program to inform stakeholders about the human antibody response to SARS-CoV-2 and its vaccines, the longevity of immune response, and how this response varies in a demographically diverse state-wide population.


The majority of the results from this population-level survey align with recent literature indicating that those with cancer and pre-existing immune compromising comorbidities have higher odds of vaccine non-response than those without such conditions. Our results show that immunocompromised participants were 15.43 times more likely to have no response to a vaccine versus those who were not immunocompromised.


The authors would like to thank the participants for sharing their time and insights.

Citation: Yaseen A, DeSantis SM, Sabharwal R, Talebi Y, Swartz MD, Zhang S, et al. (2024) Baseline characteristics of SARS-CoV-2 vaccine non-responders in a large population-based sample. PLoS ONE 19(5): e0303420.

Editor: Olatunji Matthew Kolawole, University of Ilorin, NIGERIA

Received: December 8, 2023; Accepted: April 25, 2024; Published: May 13, 2024.

Copyright: © 2024 Yaseen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Data cannot be shared publicly because the data contain potentially identifying or sensitive participants’ information. Data are available from the Texas Department of State Health Services Institutional Review Board (contact via [email protected]) for researchers who meet the criteria for access to confidential data. De-identified datasets can be made available upon reasonable request and within a reasonable time in accordance with the general spirit of colleagueship within the scientific community and with policies adopted by UTHealth Houston and the Texas Department of State Health Services. Please submit data requests to [email protected]. Texas CARES investigators are committed to data sharing. Granular results and user-specified data summaries are currently publicly available on the Texas CARES portal ( Upon project completion, de-identified secondary data and detailed documentation will be made publicly available through the same portal as open-access data sources after de-identification and collapsing cells to protect individuals representing rare events or conditions.

Funding: Project funded by Texas Department of State Health Services (Grant #HHS000866600001).

Competing interests: The authors have declared that no competing interests exist.


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