Antibody response to a single dose of SARS-CoV-2 mRNA vaccine in patients with rheumatic and musculoskeletal diseases

Abstract

Antibody response to a single dose of SARS-CoV-2 mRNA vaccine in patients with rheumatic and musculoskeletal diseases The immune response to SARS-CoV-2 messenger RNA (mRNA) vaccines in patients with rheumatic and musculoskeletal diseases (RMD) is undefined because these individuals were largely excluded from phase I-III studies. To better understand the immune response to vaccination in this patient population, we studied the antibody response in patients with RMD who completed the first dose of SARS-CoV-2 mRNA vaccination. Participants with RMD across the USA were recruited to participate in this prospective cohort via social media. Those with prior SARS-CoV-2 were excluded. We collected demographics, RMD diagnoses and immunomodulatory regimens and tested for SARS-CoV-2 antibodies at baseline and prior to the second vaccine dose. Antibody testing was conducted on the semiquantitative Roche Elecsys anti-SARS-CoV-2 S enzyme immunoassay (EIA) which tests for antibodies against the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein. 1 We evaluated the association between demographic/clinical characteristics and positive antibody response using Fisher's exact test and Wilcoxon rank-sum test. We studied 123 participants who received their first SARS-CoV-2 vaccination dose between

Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in adult patients with autoimmune inflammatory rheumatic diseases and in the general population: a multicentre study

“…These findings confirm the results reported by Geisen et al , where considerable immunogenicity was induced by anti-SARS-CoV-2 mRNA vaccines in a small group of patients with chronic inflammatory diseases. 4 The mean level of the anti-spike S1/S2 IgG neutralising antibodies measured 2–6 weeks after the second vaccine dose was significantly lower in patients with AIIRD compared with controls in all age groups, consistent with the response to a single dose of mRNA vaccines in patients with rheumatic disease reported by Boyarsky et al , 5 raising concerns about the long-term protection of the vaccine in patients with AIIRD.…”

Immunogenicity and safety of an inactivated virus vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases

“…Similarly, most patients (91%) with several immune-mediated in ammatory diseases (n = 84), including only 16 with systemic ARD, developed detectable neutralizing activity in a retrospective study with BNT162b2 mRNA SARS-CoV-2 vaccine immunogenicity 16 . Reinforcing this nding, a report with small representation of various ARD without a control group, also observed that anti-RBD antibodies response to the mRNA vaccines was present in 74% of the patients, with distinct patterns according to age and therapeutic regimen 17 . Importantly, immunocompromised patients encompasses a group that have intrinsic factors of high risk for infectious diseases due to disease immune dysregulation itself and current therapy, in addition to high frequencies of comorbidities associated with coronavirus severity [18][19][20] and therefore, they may ful ll criteria for prioritization in the context of limited vaccine supply 21 .…”

“…With this rigid protocol, our ndings evidenced a lower CoronaVac immunogenicity in ARD patients, although within the immunologic response standards (SC rates and GMT) established by European Medicine Agency (EMA) and Food and Drugs Administration (FDA) recommendations for Emergency Use Authorization of pandemic vaccines, such as in uenza 33,34 . The 70% SC rate was comparable to the obtained against the pandemic in uenza A H1N1 inactivated vaccine (approximately 63%), 35 but lower than the reported for SARS-CoV-2 mRNA vaccine in a very small ARD population, 17 and in a study with patients predominantly under cytokine inhibitors therapy and with small representation of systemic diseases 16 . We further demonstrated a signi cant increase in immune response parameters after the second dose, reinforcing the importance to observe the full vaccination schedule for optimal vaccine effect.…”

“…Age-matching with the CG was essential as seroconversion against CoronaVac may be lower in the older population 10 . This condition was not met by previous studies evaluating SARS-CoV-2 vaccination in ARD patients precluding a de nitive conclusion about their ndings [15][16][17] . The lack of assessment of vaccine T-cell responses was a limitation of the present study 30,31 .…”

Correspondence on ‘EULAR December 2020 viewpoints on SARS-CoV-2 vaccination in patients with RMDs’

“…Based on the long-time experience with other non-live vaccines, the COVID-19 Task Force of the European League Against Rheumatisms (EULAR) first delivered a preliminary set of information in December 2020. 1 Overall, it is expected that the safety and immunogenicity of COVID-19 vaccines for most of the DMARDs will be comparable with that registered for the general population, [2][3][4] so that postponing vaccination pending more information appears unjustified. A number of independent surveys have however alarmingly reported that, among patients with RMD, potential acceptance of COVID-19 vaccines may not exceed 60%, without apparent differences in relation to specific diseases, comorbidities and type of medication.…”