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Scientific article
Open access
English

Type of mRNA COVID-19 vaccine and immunomodulatory treatment influence humoral immunogenicity in patients with inflammatory rheumatic diseases

Published inFrontiers in immunology, vol. 13, 1016927
Publication date2022-10-13
First online date2022-10-13
Abstract

Patients with inflammatory rheumatic diseases (IRD) are at increased risk for worse COVID-19 outcomes. Identifying whether mRNA vaccines differ in immunogenicity and examining the effects of immunomodulatory treatments may support COVID-19 vaccination strategies. We aimed to conduct a long-term, model-based comparison of the humoral immunogenicity following BNT162b2 and mRNA-1273 vaccination in a cohort of IRD patients. Patients from the Swiss IRD cohort (SCQM), who assented to mRNA COVID-19 vaccination were recruited between 3/2021-9/2021. Blood samples at baseline, 4, 12, and 24 weeks post second vaccine dose were tested for anti-SARS-CoV-2 spike IgG (anti-S1). We examined differences in antibody levels depending on the vaccine and treatment at baseline while adjusting for age, disease, and past SARS-CoV-2 infection. 565 IRD patients provided eligible samples. Among monotherapies, rituximab, abatacept, JAKi, and TNFi had the highest odds of reduced anti-S1 responses compared to no medication. Patients on specific combination therapies showed significantly lower antibody responses than those on monotherapy. Irrespective of the disease, treatment, and past SARS-CoV-2 infection, the odds of higher antibody levels at 4, 12, and 24 weeks post second vaccine dose were, respectively, 3.4, 3.8, and 3.8 times higher with mRNA-1273 versus BNT162b2 (p < 0.0001). With every year of age, the odds ratio of higher peak humoral immunogenicity following mRNA-1273 versus BNT162b2 increased by 5% (p < 0.001), indicating a particular benefit for elderly patients. Our results suggest that in IRD patients, two-dose vaccination with mRNA-1273 versus BNT162b2 results in higher anti-S1 levels, even more so in elderly patients.

eng
Keywords
  • BNT162b2
  • SARS-CoV-2
  • Anti-spike-IgG
  • Immunosuppression
  • MRNA-1273
  • Rheumatic disease
  • Vaccination
  • Waning immunity
  • Humans
  • Aged
  • COVID-19 Vaccines
  • COVID-19 / prevention & control
  • RNA, Messenger / genetics
  • BNT162 Vaccine
  • Viral Vaccines
  • SARS-CoV-2
  • Antibodies, Viral
  • Immunoglobulin G
  • Rheumatic Diseases / drug therapy
Citation (ISO format)
RAPTIS, Catherine E et al. Type of mRNA COVID-19 vaccine and immunomodulatory treatment influence humoral immunogenicity in patients with inflammatory rheumatic diseases. In: Frontiers in immunology, 2022, vol. 13, p. 1016927. doi: 10.3389/fimmu.2022.1016927
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Identifiers
ISSN of the journal1664-3224
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Creation01/10/2023 2:04:00 PM
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