Third dose corrects waning immunity to SARS-CoV-2 mRNA vaccines in immunocompromised patients with immune-mediated inflammatory diseases

Cheung, Michelle W; Dayam, Roya Monica; Law, Jaclyn C.; Goetgebuer, Rogier L; Chao, Gary; Finkelstein, Naomi; Stempak, Joanne M.; Pereira, Daniel; Croitoru, David; Acheampong, Lily; Rizwan, Saima; Lee, Jenny D; Ganatra, Darshini; Law, Ryan; Delgado-Brand, Melanie; Mailhot, Geneviève; Piguet, Vincent; Silverberg, Mark S.; Watts, Tania H.; Gingras, Anne‐Claude; Chandran, Vinod

doi:10.1136/rmdopen-2022-002622

Cited by 3 publications

(3 citation statements)

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“…In this prospective observational cohort study, we investigated the IM mune res P onse A fter C OVID-19 vaccination during maintenance T herapy in immune-mediated inflammatory diseases (IMPACT). The methods of the IMPACT study were previously reported in Refs (20, 21). In brief, we recruited adult participants, including healthy controls and patients diagnosed with one or more of the following IMIDs: inflammatory bowel disease, psoriasis, psoriatic arthritis, ankylosing spondylitis, rheumatoid arthritis, or hidradenitis suppurativa.…”

Section: Methodsmentioning

confidence: 99%

“…Statistics. Data from timepoints T1-T5 were previously reported (Dayam et al 2022, Cheung et al 2022) and reanalyzed here (Figures 1-6) using additional statistical approaches. Least-squares linear regression models controlled for age, BMI, sex and vaccine type (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

“…To further the knowledge of the impact of immunomodulatory drugs on the quality and magnitude of SARS-CoV-2 vaccine-induced immunity, we recently investigated the Im mune res P onse A fter C OVID-19 vaccination during maintenance T herapy in immune-mediated inflammatory diseases (IMPACT) by prospectively following a cohort of vaccinated IMID patients with inflammatory bowel disease, rheumatic or skin disease on immunosuppressive therapies compared to healthy controls (20, 21). We demonstrated that IMID patients exhibit greater waning of Ab and T cell responses to SARS-CoV-2 by 3-4 months post dose 2 compared to healthy controls (20).…”

Section: Introductionmentioning

confidence: 99%

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Third and fourth vaccine doses broaden and prolong immunity to SARS-CoV-2 in immunocompromised adult patients

Cheung

Dayam

Shapiro

et al. 2023

Preprint

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BackgroundPrevious studies have reported impaired humoral responses after SARS-CoV-2 mRNA vaccination in immunocompromised patients with immune-mediated inflammatory diseases (IMID), particularly those treated with anti-tumor necrosis factor (TNF) biologics. We previously reported that IMID patients exhibited greater waning of antibody and T cell responses compared to healthy controls after dose 2. Fewer data are available on the effects of third and fourth doses.MethodsThis observational cohort study collected plasma and peripheral blood mononuclear cells from healthy controls and untreated or treated IMID patients, pre-vaccination and after one to four doses of SARS-CoV-2 mRNA vaccine (BNT162b2 or mRNA-1273). SARS-CoV-2- specific antibody levels, neutralization, and T cell cytokine responses were measured against Wildtype (WT) and BA.1 and BA.5 variants of concern (VOCs).ResultsThird vaccine doses substantially restored and prolonged antibody and T cell responses in IMID patients and broadened responses against VOCs. Fourth dose effects were subtle but also prolonged antibody responses. However, IMID patients treated with anti-TNF, especially inflammatory bowel disease (IBD) patients, exhibited lower antibody responses even after the fourth dose. Although T cell IFNγ responses were maximal after one dose, IL-2 and IL-4 production increased with successive doses, and early production of these cytokines was predictive of neutralization responses at 3-4 months post-vaccination.ConclusionOur study demonstrates that third and fourth doses of the SARS-CoV-2 vaccine sustain and broaden immune responses to SARS-CoV-2, supporting the recommendation for three- and four-dose vaccination regimens in IMID patients.FundingCOVID-19 Immunity Task Force and Speck family donationConflict-of-Interest StatementsAnne-Claude Gingras has received research funds from a research contract with Providence Therapeutics Holdings, Inc., for other projects, participated in the COVID-19 Immunity Task Force (CITF) Immune Science and Testing working party, chaired the CIHR Institute of Genetics Advisory Board, and chairs the SAB of the National Research Council of Canada Human Health Therapeutics Board. Vinod Chandran has received research grants from AbbVie, Amgen, and Eli Lilly and has received honoraria for advisory board member roles from AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. His spouse is an employee of AstraZeneca. Vincent Piguet has no personal financial ties with any pharmaceutical company. He has received honoraria for speaker and/or advisory board member roles from AbbVie, Celgene, Janssen, Kyowa Kirin Co. Ltd, LEO Pharma, Novartis, Pfizer, Sanofi, UCB, and Union Therapeutics. In his role as Department Division Director of Dermatology at the University of Toronto, Dr. Piguet has received departmental support in the form of unrestricted educational grants from AbbVie, Bausch Health, Celgene, Janssen, LEO Pharma, Lilly, L’Oréal, NAOS, Novartis, Pfizer, Sandoz and Sanofi in the past 36 months. Vincent Piguet has received research grants from Sanofi, Abbvie and Novartis. Mark Silverberg has received research support, consulting fees and speaker honoraria from AbbVie, Janssen, Takeda, Pfizer, Gilead, and Amgen. All other authors have no conflicts to declare.Graphical Abstract

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Third and fourth vaccine doses broaden and prolong immunity to SARS-CoV-2 in immunocompromised adult patients

Cheung

Dayam

Shapiro

et al. 2023

Preprint

Self Cite

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Impact of COVID-19 on Patients With Psoriasis or Psoriatic Arthritis

Mease,

Nash,

Grieb

et al. 2023

J Rheumatol

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Given the impact of the coronavirus disease 2019 (COVID-19) on patients with psoriatic disease (PsD), a session was devoted at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2022 annual meeting to discussing the current understanding of the risk of severe COVID-19 in patients with PsD. The effects of PsD and its treatment on prevention and treatment of COVID-19 with vaccinations, antiviral drugs, and monoclonal antibodies were discussed. The session concluded with a presentation on the perspectives of patient research partners about their experiences with COVID-19.

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Third and Fourth Vaccine Doses Broaden and Prolong Immunity to SARS-CoV-2 in Adult Patients with Immune-Mediated Inflammatory Diseases

Cheung

Dayam

Shapiro

et al. 2023

The Journal of Immunology

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Previous studies have reported impaired humoral responses after SARS-CoV-2 mRNA vaccination in patients with immune-mediated inflammatory diseases (IMIDs), particularly those treated with anti-TNF biologics. We previously reported that IMID patients diagnosed with inflammatory bowel disease, psoriasis, psoriatic arthritis, ankylosing spondylitis, or rheumatoid arthritis exhibited greater waning of Ab and T cell responses than healthy control subjects after SARS-CoV-2 vaccine dose 2. Fewer data are available on the effects of third and fourth doses. This observational cohort study collected plasma and PBMCs from healthy control subjects and untreated or treated patients with IMIDs prevaccination and after one to four doses of SARS-CoV-2 mRNA vaccine (BNT162b2 or mRNA-1273). SARS-CoV-2–specific Ab levels, neutralization, and T cell cytokine release were measured against wild-type and Omicron BA.1 and BA.5 variants of concern. Third vaccine doses substantially restored and prolonged Ab and T cell responses in patients with IMIDs and broadened responses against variants of concern. Fourth-dose effects were subtle but also prolonged Ab responses. However, patients with IMIDs treated with anti-TNF, especially patients with inflammatory bowel disease, exhibited lower Ab responses even after the fourth dose. Although T cell IFN-γ responses were maximal after one dose, IL-2 and IL-4 production increased with successive doses, and early production of these cytokines was predictive of neutralization responses at 3–4 mo postvaccination. Our study demonstrates that third and fourth doses of the SARS-CoV-2 mRNA vaccines sustain and broaden immune responses to SARS-CoV-2, supporting the recommendation for three- and four-dose vaccination regimens in patients with IMIDs.

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Third dose corrects waning immunity to SARS-CoV-2 mRNA vaccines in immunocompromised patients with immune-mediated inflammatory diseases

Cited by 3 publications

References 6 publications

Third and fourth vaccine doses broaden and prolong immunity to SARS-CoV-2 in immunocompromised adult patients

Third and fourth vaccine doses broaden and prolong immunity to SARS-CoV-2 in immunocompromised adult patients

Impact of COVID-19 on Patients With Psoriasis or Psoriatic Arthritis

Third and Fourth Vaccine Doses Broaden and Prolong Immunity to SARS-CoV-2 in Adult Patients with Immune-Mediated Inflammatory Diseases

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