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Letter
Inactivated vaccines may not provide adequate protection in immunosuppressed patients with rheumatic diseases
  1. Padmanabha Shenoy1,
  2. Sakir Ahmed2,
  3. Aby Paul1,
  4. Somy Cherian1,
  5. Anuroopa Vijayan1,
  6. Sageer AS Babu1,
  7. Aswathy Sukumaran1
  1. 1Center For Arthritis and Rheumatism Excellence, Sree Sudheendra Medical Mission, Kochi, Kerala, India
  2. 2Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
  1. Correspondence to Dr Padmanabha Shenoy, Center For Arthritis and Rheumatism Excellence, Sree Sudheendra Medical Mission, Kochi, Kerala, India; drdpshenoy{at}gmail.com

https://doi.org/10.1136/annrheumdis-2021-221496

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    Patients with autoimmune rheumatic diseases (AIRDs) are vulnerable to COVID-19 due to the presence of multiple comorbidities.1 Moreover, patients on immunosuppressants have blunted responses to vaccination as compared with healthy people.2 3 Persistence of the virus in such people may lead to the selection of more virulent mutants of SARS-CoV-2.4 It is crucial that they are prioritised for the best possible vaccine. India has crossed 650 million vaccinations with predominantly two vaccines: the adenoviral vector-borne AZD1222 (ChAdOx1 nCoV-19) and the indigenous whole-virion β-propiolactone-inactivated BBV152. In our cohort of around 1500 patients with AIRD who are being followed up to assess the immunogenicity of COVID-19 vaccines, we identified 475 patients who have completed two doses of either vaccine. Serum was collected on median 30th (range 28–35) day after the second dose of vaccine with informed consent after ethics clearance. Titres of IgG antibodies to spike protein were estimated with the Elecsys kit (Roche, Switzerland). To check the neutralisation potential of the sera, age, sex and disease matched 80 BBV152 and 85 AZD1222 recipients …

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors PS and SA conceptualised and drafted the paper. All authors approved the final version.

    • Funding This study was funded by the Indian Rheumatology Association.

    • 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.