TY - JOUR T1 - Humoral and T-cell responses to SARS-CoV-2 vaccination in patients receiving immunosuppression JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 1322 LP - 1329 DO - 10.1136/annrheumdis-2021-220626 VL - 80 IS - 10 AU - Maria Prendecki AU - Candice Clarke AU - Helena Edwards AU - Stacey McIntyre AU - Paige Mortimer AU - Sarah Gleeson AU - Paul Martin AU - Tina Thomson AU - Paul Randell AU - Anand Shah AU - Aran Singanayagam AU - Liz Lightstone AU - Alison Cox AU - Peter Kelleher AU - Michelle Willicombe AU - Stephen P McAdoo Y1 - 2021/10/01 UR - http://ard.bmj.com/content/80/10/1322.abstract N2 - Objective There is an urgent need to assess the impact of immunosuppressive therapies on the immunogenicity and efficacy of SARS-CoV-2 vaccination.Methods Serological and T-cell ELISpot assays were used to assess the response to first-dose and second-dose SARS-CoV-2 vaccine (with either BNT162b2 mRNA or ChAdOx1 nCoV-19 vaccines) in 140 participants receiving immunosuppression for autoimmune rheumatic and glomerular diseases.Results Following first-dose vaccine, 28.6% (34/119) of infection-naïve participants seroconverted and 26.0% (13/50) had detectable T-cell responses to SARS-CoV-2. Immune responses were augmented by second-dose vaccine, increasing seroconversion and T-cell response rates to 59.3% (54/91) and 82.6% (38/46), respectively. B-cell depletion at the time of vaccination was associated with failure to seroconvert, and tacrolimus therapy was associated with diminished T-cell responses. Reassuringly, only 8.7% of infection-naïve patients had neither antibody nor T-cell responses detected following second-dose vaccine. In patients with evidence of prior SARS-CoV-2 infection (19/140), all mounted high-titre antibody responses after first-dose vaccine, regardless of immunosuppressive therapy.Conclusion SARS-CoV-2 vaccines are immunogenic in patients receiving immunosuppression, when assessed by a combination of serology and cell-based assays, although the response is impaired compared with healthy individuals. B-cell depletion following rituximab impairs serological responses, but T-cell responses are preserved in this group. We suggest that repeat vaccine doses for serological non-responders should be investigated as means to induce more robust immunological response.Data are available upon reasonable request. ER -