Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort

• Published in: Annals of the rheumatic diseases Vol. 80; no. 10; pp. 1306 - 1311
• Main Authors: Geisen, Ulf M, Berner, Dennis K, Tran, Florian, Sümbül, Melike, Vullriede, Lena, Ciripoi, Maria, Reid, Hayley M, Schaffarzyk, Annika, Longardt, Ann C, Franzenburg, Jeanette, Hoff, Paula, Schirmer, Jan H, Zeuner, Rainald, Friedrichs, Anette, Steinbach, Andrea, Knies, Christine, Markewitz, Robert DH, Morrison, Peter J, Gerdes, Sascha, Schreiber, Stefan, Hoyer, Bimba F
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and European League Against Rheumatism 01.10.2021; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Adult; Age; Aged; Aged, 80 and over; Antibodies; Antibodies, Neutralizing - immunology; Antibodies, Viral - immunology; arthritis; Cohort Studies; Coronaviruses; COVID-19; COVID-19 - prevention & control; COVID-19 vaccines; COVID-19 Vaccines - immunology; Disease; Drug dosages; Enzyme-linked immunosorbent assay; Epidemiology; Female; Humans; Immunization; Immunocompromised Host - immunology; Immunogenicity; Immunogenicity, Vaccine - immunology; Immunoglobulin G; Immunosuppressive agents; Immunosuppressive Agents - therapeutic use; Infections; Inflammation; Inflammation - drug therapy; Inflammation - immunology; Inflammatory diseases; Lupus; Male; Medical personnel; Middle Aged; mRNA; mRNA Vaccines; Pandemics; Patients; Psoriasis; Rheumatic Diseases - drug therapy; Rheumatic Diseases - immunology; rheumatoid; Rheumatoid arthritis; Safety; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Side effects; Statistical analysis; Steroids; tumor necrosis factor inhibitors; vaccination; Vaccines, Synthetic - immunology; COVID-19; arthritis; tumor necrosis factor inhibitors; rheumatoid; vaccination
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2021-220272

IntroductionIn light of the SARS-CoV-2 pandemic, protecting vulnerable groups has become a high priority. Persons at risk of severe disease, for example, those receiving immunosuppressive therapies for chronic inflammatory cdiseases (CIDs), are prioritised for vaccination. However, data concerning generation of protective antibody titres in immunosuppressed patients are scarce. Additionally, mRNA vaccines represent a new vaccine technology leading to increased insecurity especially in patients with CID.ObjectiveHere we present for the first time, data on the efficacy and safety of anti-SARS-CoV-2 mRNA vaccines in a cohort of immunosuppressed patients as compared with healthy controls.Methods42 healthy controls and 26 patients with CID were included in this study (mean age 37.5 vs 50.5 years). Immunisations were performed according to national guidelines with mRNA vaccines. Antibody titres were assessed by ELISA before initial vaccination and 7 days after secondary vaccination. Disease activity and side effects were assessed prior to and 7 days after both vaccinations.ResultsAnti-SARS-CoV-2 antibodies as well as neutralising activity could be detected in all study participants. IgG titres were significantly lower in patients as compared with controls (2053 binding antibody units (BAU)/mL ±1218 vs 2685±1102). Side effects were comparable in both groups. No severe adverse effects were observed, and no patients experienced a disease flare.ConclusionWe show that SARS-CoV-2 mRNA vaccines lead to development of antibodies in immunosuppressed patients without considerable side effects or induction of disease flares. Despite the small size of this cohort, we were able to demonstrate the efficiency and safety of mRNA vaccines in our cohort.