For a study, researchers sought to examine the impact of diagnosis, therapy, and modified vaccination schedules on the magnitude and duration of the SARS-CoV-2 vaccination response in individuals with immune-mediated inflammatory disorders. Between December 15, 2020, and December 1, 2021, a large prospective cohort of healthy controls and individuals with immune-mediated inflammatory disorders (attending or admitted to affiliated centers) had their IgG antibody response to SARS-CoV-2 vaccination monitored over time. Participants in the cohort study who had been diagnosed with an immune-mediated inflammatory disease and those who had not were included in the analysis. A questionnaire was used to gather both demographic and disease-specific information. The immune system’s reaction was studied and compared between different therapy and disease groups and the use of booster shots. Antibody response to SARS-CoV-2 was evaluated by enzyme-linked immunosorbent assay (ELISA) and assessed in optical density ratio units, with age and sex adjustments made using mixed-effects models. Marginal mean antibody titers and marginal risks of poor response (optical density ratio <1.1) were determined for each week from week 8 following the first vaccination to week 40 using these models. At each time point, healthy controls had higher mean antibody titers than those with immune-mediated inflammatory diseases, with a peak antibody response that was more than twice as strong as that of those with immune-mediated inflammatory diseases (mean optical density ratio 12.48; 95% CI 11.50-13.53). In patients with immune-mediated inflammatory disorders, those on B-cell inhibitors had a worse response to vaccination than those on T-cell inhibitors (highest mean difference from healthy controls, 11.68%; 10.17% to 13.29%). Antibody responses varied little among immune-mediated inflammatory disorders on average. The mean antibody titers of participants with immune-mediated inflammatory disorders who received a third dose of vaccine 40 weeks after the initial immunization were greater than those of healthy controls who had two doses of vaccine (mean didifference,.34; 0.01-2.69). SARS-CoV-2 vaccination results in a weaker and shorter-lived humoral immune response in those with immunological-mediated inflammatory disorders, putting them at risk of infection. In order to better protect those with immune-mediated inflammatory illnesses, vaccination schedules may need to be adjusted to include either earlier booster doses or more frequent re-doses, or both.
Source: thelancet.com/journals/lanrhe/article/PIIS2665-9913(22)00191-6/fulltext
