Efficacy and safety of SARS-CoV-2 revaccination in non-responders with immune-mediated inflammatory disease. Issue 7 (24th November 2021)

• Record Type: Journal Article
• Authors: Simon, David; Tascilar, Koray; Fagni, Filippo; Schmidt, Katja; Krönke, Gerhard; Kleyer, Arnd; Ramming, Andreas; Schoenau, Verena; Bohr, Daniela; Knitza, Johannes; Harrer, Thomas; Manger, Karin; Manger, Bernhard; Schett, Georg
• Is Part Of: Annals of the rheumatic diseases. Volume 81:Issue 7(2022)
• Page Start: 1023
• Page End: 1027
• Publication Date: 2021-11-24
• Subjects: antirheumatic agents -- biological therapy -- COVID-19; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2021-221554
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objectives: To test whether patients with immune-mediated inflammatory disease (IMIDs), who did not respond to two doses of the SARS-CoV-2 vaccine, develop protective immunity, if a third vaccine dose is administered. Methods: Patients with IMID who failed to seroconvert after two doses of SARS-CoV-2 vaccine were subjected to a third vaccination with either mRNA or vector-based vaccines. Anti-SARS-CoV-2 IgG, neutralising activity and T cell responses were assessed at baseline and 3 weeks after revaccination and also evaluated seprarately in rituximab (RTX) and non-RTX exposed patients. Results: 66 non-responders were recruited, 33 treated with RTX, and 33 non-exposed to RTX. Overall, 49.2% patients seroconverted and 50.0% developed neutralising antibody activity. Seroconversion (78.8% vs 18.2%) and neutralising activity (80.0% vs 21.9%) was higher in non-RTX than RTX-treated patients with IMID, respectively. Humoral vaccination responses were not different among patients showing positive (59.3%) or negative (49.7%) T cell responses at baseline. Patients remaining on mRNA-based vaccines showed similar vaccination responses compared with those switching to vector-based vaccines. Conclusions: Overall, these data strongly argue in favor of a third vaccination in patients with IMID lacking response to standard vaccination irrespective of their B cell status.