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Attenuated response to fourth dose SARS-CoV-2 vaccination in patients with autoimmune disease: a case series
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  • Published on: 21 January 2022
    Attenuated response to fourth dose SARS-CoV-2 vaccination in patients with autoimmune disease: a case series: Correspondence
    • rujittika mungmunpuntipantip, medical scientist private academic consultant, Bangkok Thailand
    • Other Contributors:
      • viroj wiwanitkit, medicla professor

    Dear Editor, we read the article entitle “Attenuated response to fourth dose SARS-CoV-2 vaccination in patients with autoimmune disease: a case series [1]” with a great interest. The efficacy of COVID-19 vaccine among specific groups of vaccine recipients with underlying disease is a current important clinical issue. For many groups of patients, including to those with autoimmune diseases, the low immune response to standard vaccination is observed. Extra-dose vaccination is proposed. For the fourth dose of COVID-19 vaccine, it is currently a new idea. Few reports are published. The clinical evidence is required for supporting whether the fourth dose of vaccine will be useful or not and whether there will be any risk of too much vaccination [2]. This report is one of an early publication on this issue. A previous publication is on kidney transplant case. As expected, the high immune response after the fourth dose of vaccine is observed [3]. However, as also seen in the present report, there are various types of first, second and third dose vaccines that each subject in the series received and it might affect the final immune response after the fourth dose vaccine administration. Also, there is usually no confirmation to rule out a possible incidence of asymptomatic COVID-19 infection which might occur in the period between doses of COVID-19 vaccines. These important concerns should be addressed and control of those confounding factors is important if further clinical res...

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    Conflict of Interest:
    None declared.