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Inborn errors of immunity (IEI) represent a heterogeneous group of disorders characterized by impaired function of the immune system. Patients with IEI can have variable responses to vaccinations, depending on the nature and extent of the defect. Studies performed during the recent COVID-19 pandemic have brought unique insight into vaccine immunogenicity in individuals with IEI, knowledge that can be extended to the growing number of patients with secondary immunodeficiency arising from malignancy, organ transplantation, autoimmune conditions, and their treatments. In this review, we describe vaccine immunogenicity in IEI alongside their equivalent secondary immunodeficiencies and discuss what lessons can be learned about immunization strategies more broadly.<\/jats:p>","DOI":"10.1093\/cei\/uxaf059","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T11:24:36Z","timestamp":1756725876000},"source":"Crossref","is-referenced-by-count":1,"title":["Learning from inborn errors of immunity and secondary immune deficiencies about vaccine immunogenicity, efficacy, and safety"],"prefix":"10.1093","volume":"219","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9408-3774","authenticated-orcid":false,"given":"Nicholas E","family":"Peters","sequence":"first","affiliation":[{"name":"Clinical Immunology Service, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5345-2156","authenticated-orcid":false,"given":"Adrian M","family":"Shields","sequence":"additional","affiliation":[{"name":"Clinical Immunology Service, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7954-3267","authenticated-orcid":false,"given":"Sophie","family":"Hambleton","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University , Newcastle upon Tyne ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex G","family":"Richter","sequence":"additional","affiliation":[{"name":"Clinical Immunology Service, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"2026031913315161300_CIT0001","doi-asserted-by":"publisher","first-page":"2307","DOI":"10.1016\/S0140-6736(24)00850-X","article-title":"Contribution of vaccination to improved survival and health: modelling 50 years of the expanded programme on immunization","volume":"403","author":"Shattock","year":"2024","journal-title":"Lancet"},{"key":"2026031913315161300_CIT0002","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1038\/s41577-020-00479-7","article-title":"A guide to vaccinology: from basic principles to new developments","volume":"21","author":"Pollard","year":"2021","journal-title":"Nat Rev Immunol"},{"key":"2026031913315161300_CIT0003","doi-asserted-by":"crossref","DOI":"10.70962\/jhi.20250002","article-title":"The 2024 update of IUIS phenotypic classification of human inborn errors of immunity","volume":"1","author":"Bousfiha","year":"2025","journal-title":"J Hum Immunity"},{"key":"2026031913315161300_CIT0004","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1007\/s10875-019-00642-3","article-title":"Life-threatening infections due to live-attenuated vaccines: early manifestations of inborn errors of immunity","volume":"39","author":"Poyhonen","year":"2019","journal-title":"J Clin Immunol"},{"key":"2026031913315161300_CIT0005","doi-asserted-by":"publisher","first-page":"2491","DOI":"10.1080\/21645515.2019.1593082","article-title":"A review of complement sources used in serum bactericidal assays for evaluating immune responses to meningococcal ACWY conjugate vaccines","volume":"15","author":"Findlow","year":"2019","journal-title":"Hum Vaccin Immunother"},{"key":"2026031913315161300_CIT0006","doi-asserted-by":"crossref","DOI":"10.3791\/59400","article-title":"Opsonophagocytic killing assay to assess immunological responses against bacterial pathogens","author":"Paschall","year":"2019, 59400","journal-title":"J Vis Exp"},{"key":"2026031913315161300_CIT0007","doi-asserted-by":"publisher","first-page":"554","DOI":"10.3390\/vaccines12050554","article-title":"SARS-CoV-2 neutralization assays used in clinical trials: a narrative review","volume":"12","author":"Sun","year":"2024","journal-title":"Vaccines (Basel)"},{"key":"2026031913315161300_CIT0008","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/s0022-1759(02)00499-4","article-title":"Identification of an antigen-specific B cell population","volume":"272","author":"Newman","year":"2003","journal-title":"J Immunol Methods"},{"key":"2026031913315161300_CIT0009","doi-asserted-by":"publisher","first-page":"S128","DOI":"10.21037\/atm.2019.05.76","article-title":"Progress in interferon-gamma release assay development and applications: an unfolding story of translational research","volume":"7","author":"Lalvani","year":"2019","journal-title":"Ann Transl Med"},{"key":"2026031913315161300_CIT0010","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1056\/NEJM200104053441406","article-title":"Complement. 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