Absent or suboptimal response to booster dose of COVID-19 vaccine in patients with autoimmune systemic diseases

Ferri, Clodoveo; Gragnani, Laura; Raimondo, Vincenzo; Visentini, Marcella; Giuggioli, Dilia; Lorini, Serena; Foti, Rosario; Cacciapaglia, Fabio; Caminiti, Maurizio; Olivo, Domenico; Cuomo, Giovanna; Pellegrini, Roberta; Pigatto, Erika; Urraro, Teresa; Naclerio, Caterina; Tavoni, Antonio; Puccetti, Lorenzo; Cavazzana, Ilaria; Ruscitti, Piero; Vadacca, Marta; Gualana, Francesca La; Cozzi, Franco; Spinella, Amelia; Visalli, Elisa; Bosco, Ylenia Dal; Amato, Giorgio; Masini, Francesco; Mariano, Giuseppa Pagano; Brittelli, Raffaele; Aiello, Vincenzo; Scorpiniti, Daniela; Rechichi, Giovanni; Varcasia, Giuseppe; Monti, Monica; Elia, Giusy; Franceschini, Franco; Casato, Milvia; Ursini, F.; Giacomelli, Roberto; Fallahi, Poupak; Santini, Stefano Angelo; Iannone, Florenzo; Salvarani, Carlo; Zignego, Anna Linda; Antonelli, Alessandro

doi:10.1016/j.jaut.2022.102866

Cited by 15 publications

(24 citation statements)

References 36 publications

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“…Our data is in line with the study by Le Moine et al., who showed a significant increase in SARS-CoV-2 spike-specific antibody levels 6 months after primary vaccination after the booster dose in patients with RA compared with RA patients who did not receive a booster dose ( 31 ). A similar increase, in IgG-neutralizing antibody levels, was shown after the booster dose in the study by Ferri et al., lower in AIIRD patients than in healthy controls ( 32 ). The study by Benucci et al.…”

Section: Discussionsupporting

confidence: 76%

“…Unfortunately, despite the commencement of widespread COVID-19 vaccination with booster doses in many countries around the world, data on the effectiveness of COVID-19 vaccine booster doses in patients with AIIRD is scarce (27,28). There are only a few studies describing the immunogenicity of a booster dose in AIIRD patients (29)(30)(31)(32)(33), but no study evaluating individual immunomodulatory drugs' effect on cellular response to booster dose in AIIRD patients. The aim of our study was therefore to assess the immunogenicity of a booster dose of COVID-19 vaccination on humoral and cellular levels in inflammatory arthritis (IA) cohort treated with immunomodulatory drugs.…”

Section: Introductionmentioning

confidence: 99%

“…Inflammatory arthritis group characteristics. IgG-neutralizing antibody levels, was shown after the booster dose in the study byFerri et al, lower in AIIRD patients than in healthy controls(32). The study byBenucci et al showed increased antibody levels after the COVID-19 vaccine booster dose in RA patients but lowered humoral response after ABT and RTX(29).…”

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confidence: 96%

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Humoral and cellular immunogenicity of COVID-19 booster dose vaccination in inflammatory arthritis patients

Wroński

Jaszczyk²,

Roszkowski³

et al. 2022

Front. Immunol.

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IntroductionPrevious studies have shown a reduction in the effectiveness of primary COVID-19 vaccination in patients with rheumatic diseases. However, limited data is available regarding the effectiveness of the COVID-19 vaccine booster dose, especially on cellular response. The study aimed to assess the humoral and cellular immunogenicity of a booster dose in patients with inflammatory arthritis (IA).Patients and methods49 IA and 47 age and sex-matched healthy controls (HC) were included in a prospective cohort study. Both groups completed primary COVID-19 vaccination and after more than 180 days received a BNT162b2 booster shot. Humoral responses (level of IgG antibodies) and cellular responses (IFN-γ production) were assessed before and after 4 weeks from the booster dose of the vaccine.ResultsAfter the booster dose, all participants showed an increased humoral response, although significantly reduced antibody levels were observed in IA patients compared to HC (p=0.004). The cellular response was significantly lower both before (p<0.001) and after (p<0.001) the booster dose in IA patients as compared to HC. Among the immunomodulatory drugs, only biological and targeted synthetic drugs lowered the humoral response after booster vaccination. However, the cellular response was decreased after all immunomodulatory drugs except IL-17 inhibitors and sulfasalazine.ConclusionOur data indicate that patients with rheumatic diseases present lower humoral and cellular responses after the COVID-19 booster vaccine in comparison to HC. This may translate into a recommendation for subsequent booster doses of the COVID-19 vaccine for rheumatic patients.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

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Humoral and cellular immunogenicity of COVID-19 booster dose vaccination in inflammatory arthritis patients

Wroński

Jaszczyk²,

Roszkowski³

et al. 2022

Front. Immunol.

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“…As we recently reported, although a percentage of non-responder ASD patients seroconverted after the booster dose, a subgroup of subjects with absent or suboptimal NAb titer persist [ 32 ]. This observation concerning the humoral response to COVID-19 vaccine is in line with the results described in the present analysis, as 31% of patients has a deficient humoral response after the booster dose.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, while the humoral response seems to be linked to the use of DMT [ 6 , 32 ], 50% of ASD patients with impaired cellular response did not receive such treatments.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 vaccine immunogenicity in 16 patients with autoimmune systemic diseases. Lack of both humoral and cellular response to booster dose and ongoing disease modifying therapies

Gragnani

Visentini²,

Lorini³

et al. 2022

Journal of Translational Autoimmunity

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Analysis of mRNA COVID-19 Vaccine Uptake Among Immunocompromised Individuals in a Large US Health System

et al. 2023

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ImportanceImmunocompromised individuals are at increased risk for severe outcomes due to SARS-CoV-2 infection. Given the varying and complex nature of COVID-19 vaccination recommendations, it is important to understand COVID-19 vaccine uptake in this vulnerable population.ObjectiveTo assess mRNA COVID-19 vaccine uptake and factors associated with uptake among immunocompromised individuals from December 14, 2020, through August 6, 2022.Design, Setting, and ParticipantsThis cohort study was conducted with patients of Kaiser Permanente Southern California (KPSC), an integrated health care system in the US. The study included patients aged 18 years or older who were immunocompromised (individuals with an immunocompromising condition or patients who received immunosuppressive medications in the year prior to December 14, 2020) and still met criteria for being immunocompromised 1 year later.ExposuresAge, sex, self-identified race and ethnicity, prior positive COVID-19 test result, immunocompromising condition, immunomodulating medication, comorbidities, health care utilization, and neighborhood median income.Main Outcomes and MeasuresOutcomes were the number of doses of mRNA COVID-19 vaccine received and the factors associated with receipt of at least 4 doses, estimated by hazard ratios (HRs) and 95% Wald CIs via Cox proportional hazards regression. Statistical analyses were conducted between August 9 and 23, 2022.ResultsOverall, 42 697 immunocompromised individuals met the study eligibility criteria. Among these, 18 789 (44.0%) were aged 65 years or older; 20 061 (47.0%) were women and 22 635 (53.0%) were men. With regard to race and ethnicity, 4295 participants (10.1%) identified as Asian or Pacific Islander, 5174 (12.1%) as Black, 14 289 (33.5%) as Hispanic, and 17 902 (41.9%) as White. As of the end of the study period and after accounting for participant censoring due to death or disenrollment from the KPSC health plan, 78.0% of immunocompromised individuals had received a third dose of mRNA COVID-19 vaccine. Only 41.0% had received a fourth dose, which corresponds to a primary series and a monovalent booster dose for immunocompromised individuals. Uptake of a fifth dose was only 0.9% following the US Centers for Disease Control and Prevention (CDC) recommendation to receive a second monovalent booster (ie, fifth dose). Adults aged 65 years or older (HR, 3.95 [95% CI, 3.70-4.22]) were more likely to receive at least 4 doses compared with those aged 18 to 44 years or 45 to 64 years (2.52 [2.36-2.69]). Hispanic and non-Hispanic Black adults (HR, 0.77 [95% CI, 0.74-0.80] and 0.82 [0.78-0.87], respectively, compared with non-Hispanic White adults), individuals with prior documented SARS-CoV-2 infection (0.71 [0.62-0.81] compared with those without), and individuals receiving high-dose corticosteroids (0.88 [0.81-0.95] compared with those who were not) were less likely to receive at least 4 doses.Conclusions and RelevanceThese findings suggest that adherence to CDC mRNA monovalent COVID-19 booster dose recommendations among immunocompromised individuals was low. Given the increased risk for severe COVID-19 in this vulnerable population and the well-established additional protection afforded by booster doses, targeted and tailored efforts to ensure that immunocompromised individuals remain up to date with COVID-19 booster dose recommendations are warranted.

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Absent or suboptimal response to booster dose of COVID-19 vaccine in patients with autoimmune systemic diseases

Cited by 15 publications

References 36 publications

Humoral and cellular immunogenicity of COVID-19 booster dose vaccination in inflammatory arthritis patients

Humoral and cellular immunogenicity of COVID-19 booster dose vaccination in inflammatory arthritis patients

COVID-19 vaccine immunogenicity in 16 patients with autoimmune systemic diseases. Lack of both humoral and cellular response to booster dose and ongoing disease modifying therapies

Analysis of mRNA COVID-19 Vaccine Uptake Among Immunocompromised Individuals in a Large US Health System

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