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Twenty were vaccinated while receiving chemotherapy. Twenty received the BNT162b2 mRNA vaccine. Spike reactive antibodies (S\u2010IgG) and\/or T\u2010cells (SRT) were detected in 16 of 20 (80%) vaccinated patients; 13 (65%) and 9 (45%) were positive for S\u2010IgG and SRT, respectively. Six (30%) showed both spike reactive B and T\u2010cell responses. Eleven of the 13 with S\u2010IgG positivity were negative for anti\u2010Nucleocapsid IgG, an antibody profile consistent with a vaccine induced immune response. All 13S\u2010IgG+ patients showed neutralizing antibodies. SRT included CD4+ (7) and CD8+ (6) T\u2010cells; both CD4+ and CD8+ SRT were seen in 4. SRT were multifunctional (producing multiple cytokines) in most patients (8 of 9); 4 showed SRT with triple cytokine and B\u2010cell co\u2010stimulatory responses, indicating a multimodal adaptive immune response. Immune responses were seen among patients vaccinated in the settings of lymphopenia (6 of 12) intensive chemotherapy (3 of 4), and Peg allergy (6 of 8). Sequencing revealed public CD4+ and CD8+ TCR sequences reactive to epitopes across the spike protein. In conclusion, COVID\u201019 vaccination induced B and\/or T\u2010cell responses in a majority of children and young adults undergoing ALL chemotherapy.<\/jats:p>","DOI":"10.1002\/ijc.35096","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T04:14:18Z","timestamp":1721016858000},"page":"2190-2200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["<scp>COVID<\/scp>\n                    \u201019 vaccinated children, adolescents, and young adults with acute lymphoblastic leukemia show spike reactive antibodies and multifunctional T\u2010cells"],"prefix":"10.1002","volume":"155","author":[{"given":"Rebecca S.","family":"Parker","sequence":"first","affiliation":[{"name":"Children's Center for Cancer and Blood Disease Children's Hospital Los Angeles  California Los Angeles 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