Antibody response to inactivated COVID-19 vaccine (CoronaVac) in immune-mediated diseases: a controlled study among hospital workers and elderly

• Published in: Rheumatology international Vol. 41; no. 8; pp. 1429 - 1440
• Main Authors: Seyahi, Emire, Bakhdiyarli, Guldaran, Oztas, Mert, Kuskucu, Mert Ahmet, Tok, Yesim, Sut, Necdet, Ozcifci, Guzin, Ozcaglayan, Ali, Balkan, Ilker Inanc, Saltoglu, Nese, Tabak, Fehmi, Hamuryudan, Vedat
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2021; Springer Nature B.V
• Subjects: Adult; Age; Age Factors; Aged; Antibodies; Antibodies, Viral - blood; Biomarkers - blood; Case-Control Studies; Coronaviruses; COVID-19 vaccines; COVID-19 Vaccines - administration & dosage; Cross-Sectional Studies; Female; Humans; Immune System Diseases - blood; Immune System Diseases - diagnosis; Immune System Diseases - immunology; Immunity, Humoral; Immunization Schedule; Immunocompromised Host; Immunogenicity, Vaccine; Immunoglobulin G - blood; Immunotherapy; Male; Mass Vaccination; Medicine; Medicine & Public Health; Middle Aged; Monoclonal antibodies; Observational Research; Older people; Personnel, Hospital; Rheumatology; Time Factors; Turkey; Vaccines, Inactivated - administration & dosage; Young Adult; Turkey; COVID-19; Antibody to S1 spike protein; Hospital workers; Vaccination; CoronaVac; Elderly; Inflammatory diseases; Seroprevalence
• ISSN: 0172-8172; 1437-160X; 1437-160X
• DOI: 10.1007/s00296-021-04910-7

Objective To assess antibody response to inactivated COVID-19 vaccine in patients with immune-mediated diseases (IMD) among hospital workers and people aged 65 and older. Methods In this cross-sectional study, we studied 82 hospital workers with IMD (mean age: 42.2 ± 10.0 years) and 300 (mean age: 41.7 ± 9.9 years) controls. Among + 65 aged population, we studied 22 (mean age: 71.4 ± 4.5 years) patients and 47 controls (mean age: 70.9 ± 4.8 years). All study subjects had a negative history for COVID-19. Sera were obtained after at least 21 days following the second vaccination. Anti-spike IgG antibody titers were measured quantitatively using a commercially available immunoassay method. Results Patients with IMD were significantly less likely to have detectable antibodies than healthy controls both among the hospital workers (92.7% vs 99.7%, p  < 0.001) and elderly population (77.3% vs 97.9%, p  = 0.011). Among patients with IMD, those using immunosuppressive or immune-modulating drugs (64/75, 85.3%) were significantly less likely to have detectable antibodies compared to those off treatment (29/29, 100%) ( p  = 0.029). Additionally, a negative association between age and the antibody titer categories among patients ( r  = − 0.352; p  < 0.001) and controls ( r  = − 0.258; p  < 0.001) were demonstrated. Conclusions Among hospital workers, the vast majority of patients with IMD and immunocompetent controls developed a significant humoral response following the administration of the second dose of inactivated COVID-19 vaccine. This was also true for the elderly population, albeit with lower antibody titers. Immunosuppressive use, particularly rituximab significantly reduced antibody titers. Antibody titers were significantly lower among those aged ≥ 60 years both in patient and control populations. Whether these individuals should get a booster dose warrants further studies.