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

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Correspondence
Correspondence on ‘Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort’
  1. Giuseppe A Ramirez1,2,
  2. Emanuel Della-Torre1,2,
  3. Luca Moroni1,2,
  4. Mona-Rita Yacoub1,2,
  5. Lorenzo Dagna1,2
  6. On behalf of the OSR-COVAX study group
    1. 1 Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milano, Italy
    2. 2 Immunology, Università Vita Salute San Raffaele, Milano, Italy
    1. Correspondence to Dr Giuseppe A Ramirez, Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy; ramirez.giuseppealvise{at}hsr.it

    https://doi.org/10.1136/annrheumdis-2021-220539

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      We read with interest the recent report by Geisen et al,1 who describe the immunogenicity and safety profile of two mRNA-based anti-SARS-CoV-2 vaccines in a cohort of 26 patients with chronic arthritides, psoriasis and other inflammatory diseases, compared with 42 healthy controls. The majority of subjects were health professionals, which makes the 14-day post-vaccinal observations provided by the authors particularly informative for high-risk settings, such as hospitals. Extensive data about the impact of anti-SARS-CoV-2 vaccines in patients with immune-mediated disorders are eagerly awaited, since people living with these diseases were excluded from registration trials,2–4 despite constituting a risk group for severe SARS-CoV-2-realated disease (COVID-19)5–7 and, potentially, for adverse immune-mediated post-vaccinal events.8–11

      To contribute in filling this knowledge gap, we studied 55 consecutive patients (54 health professionals) with rheumatic diseases and primary immunodeficiencies, for a median (IQR) of 66 (42–75) days from the first and 45 (20–52) days from the second dose of the BNT162b2 vaccine2 (detailed methods: online supplemental material 1). Thirty-eight patients (69%) had one or more comorbidities, including allergy in 22 cases (table 1).

      Supplemental material

      [annrheumdis-2021-220539supp001.pdf]

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      Table 1

      Clinical features of the study cohort

      At time of vaccination, 42/55 patients had been in remission for 20 (5–29) months. The median disease duration was 11 (5–18) years. Fifty-one patients (93%) were taking one or more immunosuppressive/immunomodulating drugs beside other treatments (online supplemental tables 1 and 2).

      Supplemental material

      [annrheumdis-2021-220539supp002.pdf]

      Supplemental material

      [annrheumdis-2021-220539supp003.pdf]

      No patient had evidence of …

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      Footnotes

      • GAR, ED-T and LM contributed equally.

      • Collaborators The OSR-COVAX study group: Elena M Baldissera; Enrica P Bozzolo; Nicola Boffini; Giulia Di Colo; Corrado Campochiaro; Adriana Cariddi; Giacomo De Luca; Matteo Bellone; Silvia Sartorelli; Angelo A Manfredi; Giulio Cavalli; Alessandro Tomelleri; Chiara Asperti; Gaia Mancuso; Nicola Farina; Ambra Mascheri; Nicoletta Saporiti.

      • Contributors GAR, ED-T, LM, M-RY, LD designed the study. GAR, ED-T, LM collected clinical data. GAR analysed the data. All authors contributed to the critical analysis of the results and to revise the manuscript draft. All authors approved the final version of the article and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work will appropriately be investigated and resolved.

      • 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; internally 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.