Immunogenicity against the BNT162b2 mRNA COVID-19 Vaccine in Rheumatic Disease Patients Receiving Immunosuppressive Therapy

Abstract

Objective To investigate the serum total antibody (immunoglobulin M and immunoglobulin G) titre against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein receptor-binding domain following BNT162b2 messenger ribonucleic acid (mRNA) coronavirus disease 2019 (COVID-19) vaccination in Japanese rheumatic disease patients undergoing immunosuppressive therapy. Methods The serum antibody titre against SARS-CoV-2 spike protein was analysed in 123 outpatients with rheumatic diseases at Kagawa University Hospital and 43 healthy volunteers who had received 2 doses of the BNT162b2 mRNA vaccine with at least 14 days elapsing since the second dose. Results The antibody titre in rheumatic disease patients was significantly lower than that in healthy subjects (p<0.0001). The antibody titres of the 41 patients who received biologics or Janus kinase inhibitors and the 47 patients who received conventional immunosuppressive agents were significantly lower than those of the 35 patients who did not receive immunosuppressive agents (p<0.0001 and p<0.0001, respectively). In addition, the mean antibody titre of the 43 patients on methotrexate was significantly lower than that of the 80 patients not on methotrexate (p=0.0017). Conclusion Immunogenicity to the BNT162b2 mRNA COVID-19 vaccine in rheumatic disease patients was found to be reduced under immunosuppressive treatment. In particular, methotrexate seems to be associated with a decreased antibody response.

Impaired humoral and cellular response to primary COVID‐19 vaccination in patients less than 2 years after allogeneic bone marrow transplant

“…Indeed, other large studies investigating antibody responses to COVID‐19 vaccines in HSCT recipients found that immunosuppressive therapy significantly decreased serological response to vaccine in HSCT recipients 15,18,29 . Furthermore, no patients in our cohort received mycophenolate mofetil or Janus kinase inhibitors, both of which have been shown to significantly reduce serological response to COVID‐19 vaccine 30,31 …”

“… 15 , 18 , 29 Furthermore, no patients in our cohort received mycophenolate mofetil or Janus kinase inhibitors, both of which have been shown to significantly reduce serological response to COVID‐19 vaccine. 30 , 31 …”

“…15,18,29 Furthermore, no patients in our cohort received mycophenolate mofetil or Janus kinase inhibitors, both of which have been shown to significantly reduce serological response to COVID-19 vaccine. 30,31 In the context of the new variant of concern, the Omicron variant, which has been shown to evade neutralisation by antibodies mounted to both ChAdOx1 vaccine and BNT162b2, 23 it is likely that measurement of the immune response by investigating anti-S antibodies alone is insufficient to demonstrate effective vaccine immunogenicity. While it is apparent that the vaccine-induced antibody response to the Omicron variant of SARS-CoV-2 is diminished, emerging evidence has demonstrated the conservation of T-cell responses to Omicron S. 23,32,33 Considering the reduced burden of infection with Omicron variant compared with subsequent variants of SARS-CoV-2 34 it is likely that T cells play an important role in protecting against severe disease and therefore represent an important marker of the immune response to SARS-CoV-2.…”

Immunogenicity of Vaccines Against SARS-CoV-2 In Patients With Rheumatic Diseases

“…K. Sugihara ИВРЗ (123) Pfizer МТ (35), ГИБП (29), Значимое снижение титров АТ и соавт. [36] Контроль ( 43) ГК (50) и др. у больных в целом (p<0,0001) и при лечении МТ (р=0,0017) E. Simader РА (53), mРНК МТ (55), ГИБП (51), Положительный АТ-ответ после первой и соавт.…”

Humoral immune response against BNT162b2 mRNA COVID-19 vaccine in patients with rheumatic disease undergoing immunosuppressive therapy: A Japanese monocentric study

“…Recently, we demonstrated and reported that immunogenicity to BNT162b2 is decreased in Japanese patients with RMDs under methotrexate treatment, similar to Western reports. [ 18 ] However, the differential effects of various rheumatic disease drugs, including methotrexate, on the immunogenicity of this vaccine have not yet been fully elucidated. Therefore, we compared the immunogenicity of the BNT162b2 vaccine in Japanese patients receiving various immunosuppressive drugs for RMDs with healthy controls.…”