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  • Disease activity and humoral response in patients with inflammatory rheumatic diseases after two doses of the Pfizer mRNA vaccine against SARS-CoV-2

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Epidemiology
Disease activity and humoral response in patients with inflammatory rheumatic diseases after two doses of the Pfizer mRNA vaccine against SARS-CoV-2
  1. Yolanda Braun-Moscovici1,2,
  2. Marielle Kaplan2,3,
  3. Maya Braun4,
  4. Doron Markovits1,2,
  5. Samy Giryes1,2,
  6. Kohava Toledano1,2,
  7. Yonit Tavor1,2,
  8. Katya Dolnikov1,2,
  9. Alexandra Balbir-Gurman1,2
  1. 1 B. Shine Department of Rheumatology, Rambam Health Care Campus, Haifa, Israel
  2. 2 The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
  3. 3 Biochemistry Laboratory, Rambam Health Care Campus, Haifa, Israel
  4. 4 Bioinformatics, The Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
  1. Correspondence to Dr Yolanda Braun-Moscovici, B. Shine Department of Rheumatology, Rambam Health Care Campus, Haifa 31096, Israel; y_braun{at}rambam.health.gov.il

Abstract

Background The registration trials of messenger RNA (mRNA) vaccines against SARS-CoV-2 did not address patients with inflammatory rheumatic diseases (IRD).

Objective To assess the humoral response after two doses of mRNA vaccine against SARS-CoV-2, in patients with IRD treated with immunomodulating drugs and the impact on IRD activity.

Methods Consecutive patients treated at the rheumatology institute, who received their first SARS-CoV-2 (Pfizer) vaccine, were recruited to the study, at their routine visit. They were reassessed 4–6 weeks after receiving the second dose of vaccine, and blood samples were obtained for serology. IRD activity assessment and the vaccine side effects were documented during both visits. IgG antibodies (Abs) against SARS-CoV-2 were detected using the SARS-CoV-2 IgG II Quant (Abbott) assay.

Results Two hundred and sixty-four patients with stable disease, (mean(SD) age 57.6 (13.18) years, disease duration 11.06 (7.42) years), were recruited. The immunomodulatory therapy was not modified before or after the vaccination. After the second vaccination, 227 patients (86%) mounted IgG Ab against SARS-CoV-2 (mean (SD) 5830.8 (8937) AU/mL) and 37 patients (14%) did not, 22/37 were treated with B cell-depleting agents. The reported side effects of the vaccine were minor. The rheumatic disease remained stable in all patients.

Conclusions The vast majority of patients with IRD developed a significant humoral response following the administration of the second dose of the Pfizer mRNA vaccine against SARS-CoV-2 virus. Only minor side effects were reported and no apparent impact on IRD activity was noted.

  • COVID-19
  • autoimmune diseases
  • vaccination
  • antirheumatic agents
  • biological therapy

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article. Data are under embargo by local authorities if not included into the manuscript.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/annrheumdis-2021-220503

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article. Data are under embargo by local authorities if not included into the manuscript.

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors Study design: YB-M, AB-G. Sample collection: YB-M, DM, SG, KT, YT, KD, AB-G. Experiments and data analysis: YB-M, MK, MB, AB-G. Tables and figure: YB-M, MB. Data interpretation: YB-M, MK. Writing of the manuscript: YB-M, AB-G. Critical proofreading of the manuscript: all authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.