![]() Each partner site contributes demographic, medication, laboratory, diagnosis, and vital status data to the central data repository, and the data are harmonized into the Observational Medical Outcomes Partnership data model (eMethods 3 and eAppendix in Supplement 1). The design, data collection, sampling approach, and data harmonization methods used by the N3C have been described previously24,25 and are summarized in eMethods 1 to 5 in Supplement 1. ![]() The N3C developed a secure and centralized electronic medical record (EMR)''based repository of COVID-19 clinical data, including testing, diagnoses, and vaccination data, submitted by partner health care organizations (predominantly academic medical centers) across the US. The National COVID Cohort Collaborative (N3C) is a partnership that is supported and overseen by the National Center for Advancing Translational Sciences of the National Institutes of Health. Patients with cancer, especially those with hematologic cancers who are undergoing bone marrow transplantation (BMT) with ensuing long-lasting T-cell deficiency, also have suboptimal immune response to vaccination.16,17 Marked immune deficiency, noted by lower CD4 cell counts, often indicates antibody responses to vaccines among persons living with HIV.12,13 Common immunosuppressant medications (eg, calcineurin inhibitors or mycophenolic acid) to prevent allograft rejection among SOT recipients affect the immune response to vaccination.14,15 Furthermore, treatment regimens (eg, monoclonal antibody therapies, corticosteroids, or methotrexate) for autoimmune diseases (ie, multiple sclerosis and rheumatoid arthritis ) might interfere with the immunogenicity of vaccines and the development of an adequate immune response. A recent study observed that persons with immune dysfunction, including those living with HIV or receiving immunosuppressant medications (ie, recipients of solid organ transplant ), have a higher risk for developing severe COVID-19 outcomes.11 Whether a weakened immune system might prevent these individuals from responding to SARS-CoV-2 vaccination has not been examined in a large-scale real-world setting.
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