Dermal priming in enhancing vaccine immunogenicity
Research type
Research Study
Full title
Understanding the impact of local dermal priming in enhancing vaccine immunogenicity in patients receiving B cell depleting immunosuppression
IRAS ID
362426
Contact name
Rona Smith
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundation Trust and University of Cambridge
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Immunosuppressed patients, particularly those receiving drugs like rituximab, which targets a specific cell in the immune system - the B cell - are at an increased risk of severe infections, including Covid-19 and influenza (flu) as well as other vaccine-preventable illnesses. One critical function of B cells is to produce antibodies, which protect against these infections. Therefore, despite being recommended at least annually, usual vaccination approaches often fail to elicit adequate antibody responses in patients receiving rituximab, resulting in sub-optimal protection, leaving patients at risk of contracting infections.
Imiquimod is a cream, which is applied to the skin, and is an approved treatment for various skin conditions, including warts (which can be caused by some viruses) and some types of skin cancer. It works by enhancing the activity of components of the immune system other than B cells, including the innate immune system (the body’s first line of defence), which in turn activates T cells (another important cell that makes up the immune system). This approach can help to clear viral infections. These other immune cell types may also compensate for reduced B-cell function in patients who have received rituximab, and may boost the effect of a vaccine leading to improved antibody responses and potentially better protection against infections.
This small study is primarily to understand how imiquimod and Covid-19 vaccines work together in patients who have received rituximab. It will specifically address the question of whether imiquimod can still stimulate the innate immune system, even in the absence of B cells. And if it does, does this lead to higher antibody levels following Covid-19 vaccination. If there is a potential signal of effect, the best outcome measure will be selected and taken forward into a larger study to confirm clinical effectiveness of using imiquimod as an agent to boost vaccine responses.
REC name
East of England - Cambridge Central Research Ethics Committee
REC reference
25/EE/0229
Date of REC Opinion
19 Nov 2025
REC opinion
Further Information Favourable Opinion