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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’
  1. Larissa Valor-Méndez1,
  2. Koray Tascilar1,
  3. David Simon1,
  4. Joerg Distler1,
  5. Arnd Kleyer2,
  6. Georg Schett2,
  7. Juergen Rech1
  1. 1 Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
  2. 2 Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
  1. Correspondence to Dr Larissa Valor-Méndez, Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany; larissa.valormendez{at}

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We read with interest the work by Geisen and colleagues1 on the efficacy and safety of anti-SARS-CoV-2 mRNA vaccine in patients with rheumatic diseases. While substantial data on the efficacy and safety of SARS-CoV-2 vaccination have been created during the last months, it is currently unclear whether the vaccination is efficacious and safe in patients with autoinflammatory diseases (AIDs). These patients present with exacerbated innate immune responses associated with enhanced production of interleukin (IL)-1.2

Testing the immune response to SARS-CoV-2 vaccination in patients with AIDs is of interest, as IL-1 has been involved in the pathogenesis of COVID-19; thus, IL-1 expression is massively increased in patients with severe COVID-19.3–5 Furthermore, COVID-19 has shown to trigger an increased inflammatory disease activity in patients with AIDs.6 7 In addition, IL-1 inhibition has been applied in the treatment of COVID-19 and while initial uncontrolled studies revealed promising results,8 a randomised controlled trial showed no improvement of COVID-19 on IL-1 blockade.9 While current data suggest the immune response to SARS-CoV-2 vaccination may be reduced in certain diseases, such as rheumatoid arthritis,10 and certain treatments such as methotrexate,11 such data cannot be applied to AID or to IL-1 inhibitors as the underlying pathophysiology is fundamentally different. Hence, we aimed to investigate SARS-CoV-2 vaccination …

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  • Collaborators Silke Winkler.

  • Contributors JR conceived the original idea. JR, KT and LV-M designed the study and wrote the manuscript. All authors provided critical feedback and helped shape the research and analysis, and contributed to the final version of the manuscript.

  • Funding This study was supported by the Schreiber Foundation and the German Research Council (CRC1181 and FOR2886 Mascara).

  • 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.