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SARS-CoV-2-related disease (COVID-19) constitutes an ongoing challenge for public health. Vaccination campaigns have effectively reduced COVID-19-related morbidity and mortality, leading to less restrictive preventive measures. This has, however, led to worldwide absolute increasing rates of COVID-19 cases during the last months. Patients with multiorgan autoimmune disorders, including systemic lupus erythematosus (SLE) are at increased risk of morbidity due to SARS-CoV-2 infection and pandemic-related disruptions in public health services. Vaccination also constitutes a challenge for patients with SLE and other rheumatic disorders, who might develop dysfunctional immunisation responses due to disease-related and treatment-related factors. Poor humoral and cellular immunogenicity of current anti-SARS-COV-2 vaccines has been reported in patients with SLE and other immune-mediated diseases.1 2 However, less is known about the incidence and risk factors for breakthrough COVID-19 following vaccination.3 4
To address this issue, we analysed data from 452 patients with SLE (93% women) followed in seven Italian tertiary referral centres, who completed a primary vaccination cycle between January and November 2021. Data from patient history and status were collected during the last visit before and the first visit after the primary vaccination cycle. Postvaccination evaluations took place after a median (IQR) time of 3.9 (3.6–4.8) …
Handling editor Josef S Smolen
Contributors GAR, MG, TS, RC and LD designed the study. All authors contributed to data collection. GAR, MG, TS and LMA analysed the data. GAR drafted the manuscript. All authors contributed to the design of the study and to revise it critically for important intellectual content. All authors contributed to revising the manuscript and approved its final version.
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.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.