COVID-19 vaccine effectiveness against omicron (B.1.1.529) variant infection and hospitalisation in patients taking immunosuppressive medications: a retrospective cohort study

Risk, Malcolm; Hayek, Salim S.; Schiopu, Elena; Yuan, Liyang; Shen, Chen; Shi, Xu; Freed, Gary L.; Zhao, Lili

doi:10.1016/s2665-9913(22)00216-8

Cited by 44 publications

(36 citation statements)

References 32 publications

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“…COVID-19 VE against Omicron infection and hospitalization in patients taking immunosuppressive medications have been assessed in a retrospective cohort study led in the United-States, including 5609 patients receiving immunosuppressants [ 74 ]. In this population, three doses of BNT162b2 had a VE of 50% (95% CI [31–64]; p < 0.0001) and three doses of mRNA-1273 had a VE of 60% (95% CI [42–73]; p < 0.0001) against Omicron infection.…”

Section: Resultsmentioning

confidence: 99%

COVID-19 Vaccines against Omicron Variant: Real-World Data on Effectiveness

Kherabi

Launay

Ngũyen

2022

Viruses

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The efficacy of vaccines against coronavirus disease 2019 (COVID-19) has now been well established in phase III clinical trials. However, clinical studies based on real-world data remain critical to assess vaccines effectiveness (VE), especially in specific populations and against variants of concern (VOC). This review presents the principles and methods of VE studies and the main available results on VE of COVID-19 vaccines at the time of Omicron circulation. References for this narrative review were identified through searches of PubMed database up to 13 September 2022. The results of phase III clinical trials have been globally confirmed by VE in real-life studies, including in the elderly. Emergence of VOC Omicron emphasized the importance of booster doses to maintain a high level of protection against severe forms. There are still numerous challenges regarding booster(s) and duration of immunity, particularly in specific subpopulations, and regarding the need for adapted vaccines.

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Section: Resultsmentioning

confidence: 99%

COVID-19 Vaccines against Omicron Variant: Real-World Data on Effectiveness

Kherabi

Launay

Ngũyen

2022

Viruses

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“…[4][5][6] Poorer outcomes have been observed consistently in multiple, rigorous, large datasets of varied origin and context, suggesting that COVID-19 remains a risk that disproportionately impacts patients who are immunosuppressed. Importantly, though, the study by Risk and colleagues 3 shows that, even in the era of the omicron variant, preventive therapy still mitigates this risk: patients who received three doses of either available mRNA vaccine derived significant benefit over those who received two doses (50% [95% CI 31 to 64] vaccine effectiveness against SARS-CoV-2 infection for three doses of the BNT162b2 vaccine; p<0•0001; vs 13% [-19 to 39] for two doses; p=0•43; compared with those who were unvaccinated). However, protection against hospitalisation due to COVID-19 was similar between patients who received three doses and those who received two doses (87% [95% CI 74 to 93] vaccine effectiveness with three doses of either mRNA vaccine vs 85% [62 to 94] with two doses; both p<0•0001; compared with patients who were unvaccinated).…”

Section: Preventive Medicine In Rheumatology: Covid-19 and Its Lesson...mentioning

confidence: 95%

“…In The Lancet Rheumatology , Malcolm Risk and colleagues 3 report the findings of their study of COVID-19 vaccine effectiveness in patients on immunosuppressants during the omicron (B.1.1.529 variant)-dominant wave of the pandemic. Among 168 414 patients from the US state of Michigan during the first omicron peak (December, 2021, to March, 2022), the 5609 patients who were taking immunosuppressive mediations had increased risk of adverse outcomes compared with those who were not immunosuppressed.…”

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confidence: 99%

“…COVID-19 has led to continuing waves of preventive medicine challenges, the necessity of which has been emphasised by Risk and colleagues' study. 3 To deliver our optimal approach to preventive medicine, despite necessary constant changes and society's fading sense of urgency, we must build better systems, which can serve our patients' broader preventive medicine needs now and in the future.…”

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confidence: 99%

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Preventive medicine in rheumatology: COVID-19 and its lessons for better health outcomes

Liew¹,

Robinson²

2022

The Lancet Rheumatology

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“…Immune responses were not studied. Additionally, Risk et al’s analysis of Michigan Medicine data ( n = 168,414) indicated that three doses of BNT162b2 or mRNA-1273 vaccine was strongly protective against COVID-19-related hospitalisation in both individuals receiving immune-modifying therapy (vaccine effectiveness 87%, 95% CI 74–93) and those who were immunocompetent (92%, 95% CI 87–95) [ 53 ]. Further large-scale clinical effectiveness data from populations receiving immune-modifying therapies are awaited.…”

Section: Other Factors That May Impact the Immune Response To The Cov...mentioning

confidence: 99%

The Impact of Immune-Modifying Treatments for Skin Diseases on the Immune Response to COVID-19 Vaccines: a Narrative Review

Liew

Tree²,

Smith³

2022

Curr Derm Rep

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Purpose of Review SARS-CoV-2 has had a devastating global effect, with vaccinations being paramount in the public health strategy against COVID-19. Vaccinations have uncoupled infection from adverse COVID-19 outcomes worldwide. While immune-modifying therapies are effective for the management of skin diseases such as psoriasis and atopic dermatitis, these medications also impair protective immune responses. There has been longstanding uncertainty and concern over the impact of immune-modifying therapies on the effectiveness of vaccines; for example, it is well recognised that methotrexate impairs humoral responses to both influenza and pneumococcal vaccines. This narrative review aims to discuss the evidence to date on the impact of immune-modifying therapies on the immune response to COVID-19 vaccines, with a focus on the first two vaccine doses. Recent Findings Individuals receiving immune-modifying therapy are more likely to have attenuated humoral responses to a single dose of COVID-19 vaccine compared to healthy controls; however, this may be improved by a complete course of vaccination. B cell targeted biologics such as rituximab markedly impair the humoral response to both the first and second COVID-19 vaccination. There remains a paucity of data on cellular immune responses, with the few available studies indicating lower responses to two vaccine doses in individuals receiving immune-modifying therapies compared to healthy controls, which may impact the durability of immune responses. Summary Inadequate humoral immune responses to a single dose of vaccine in the context of immune-modifying therapy are improved by a complete course of vaccination. Individuals receiving immune-modifying treatments should be encouraged to take up a complete vaccine course to mitigate their risk against COVID-19. Research in large patient populations on the longevity/kinetics of the complex humoral and cellular response to subsequent vaccine doses, including against newer variants of concern, is warranted, in addition to data on immune correlates of vaccine clinical effectiveness.

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COVID-19 vaccine effectiveness against omicron (B.1.1.529) variant infection and hospitalisation in patients taking immunosuppressive medications: a retrospective cohort study

Cited by 44 publications

References 32 publications

COVID-19 Vaccines against Omicron Variant: Real-World Data on Effectiveness

COVID-19 Vaccines against Omicron Variant: Real-World Data on Effectiveness

Preventive medicine in rheumatology: COVID-19 and its lessons for better health outcomes

The Impact of Immune-Modifying Treatments for Skin Diseases on the Immune Response to COVID-19 Vaccines: a Narrative Review

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