Interferon-gamma release assay testing to assess COVID-19 vaccination response in a SARS-CoV-2 seronegative patient on rituximab: a case report

Highlights

• A robust T cell response to SARS-CoV-2 vaccination can occur even in patients with impaired humoral immunity.

• A delay in immunosuppression may be unnecessary prior to SARS-CoV-2 vaccination.

• The known efficacy of SARS-CoV-2 vaccination in immunocompromised patients remains limited.

Abstract

We describe the case of a 44-year-old female patient on rituximab for the treatment of multiple sclerosis with undetectable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG specific antibodies 18 days after the second dose of SARS-CoV-2 vaccine. Interferon-gamma release assay testing for SARS-CoV-2 was positive on day 19, demonstrating a robust T cell-mediated response despite the lack of an antibody-mediated response.