HYPOTHESES

1. Patients with chronic respiratory diseases will have a lower antibody response to
SARS-CoV-2 virus after vaccination and shorter durability of the response than
control subjects without chronic disorders.

2. Patients on corticosteroids and other immunomodulator medications for chronic
medical disorders will have a lower antibody response to SARS-CoV-2 after
vaccination and shorter durability of the response than subjects with chronic
disorders who are not being treated with corticosteroids and immunomodulator
medications.

SPECIFIC AIMS

1. Enroll up to 1,000 patients receiving a SARS-CoV-2 vaccination (initial or
subsequent vaccinations) in an observational study to determine vaccine antibody
response and durability.

1. Obtain blood samples to measure antibody assess the antibody, T cell and B cell
responses to SARS-CoV-2 vaccination before and every 3 months for 18 months
after the initial vaccination or subsequent vaccinations (boosters) .

2. Categorize patients by their age, gender, race, ethnicity, underlying chronic
disease, disease severity, medical therapy and comorbidities.

3. Assess the clinical effectiveness of the vaccine to prevent COVID-19
infections.

3. Determine the clinical features and gene expression of patients who are less
responsive (have lower antibody levels and shorter duration of antibody response) to
SARS-CoV-2 vaccinations.

STUDY DESIGN Patient population - up to 1,000.

Consisting of patients in the following groups:

1. Controls - who are NOT in any of the groups listed below.

2. Previous COVID infection

3. Asthma receiving immunomodulator medications

4. Asthma receiving chronic oral steroids

5. Asthma - NOT receiving immunomodulator medications or chronic oral steroids

6. Chronic Obstructive Pulmonary Disease (COPD)

7. Rheumatoid Arthritis receiving immunomodulator medications

8. Rheumatoid Arthritis NOT receiving immunomodulator medications

9. Interstitial lung disease

10. Cancer patients receiving chemotherapy

11. Bronchiectasis

12. Cystic fibrosis