Anti-SARS-CoV-2 immunogenicity decay and incident cases six months after Sinovac-CoronaVac inactivated vaccine in autoimmune rheumatic diseases patients: phase 4 prospective trial

Abstract

We provide novel data on anti-SARS-CoV-2 immunogenicity decay and incident cases six months after the 2nd dose of Sinovac-CoronaVac inactivated vaccine(D210) in 828 autoimmune rheumatic diseases(ARD) patients compared with 223 age/sex-balanced control group(CG). From D69 to D210, anti-S1/S2IgG positivity and GMT reduced 23.8% and 38% in ARD(p<0.001/p<0.001) and 20% and 51% in CG(p<0.001/p<0.001). From D69 to D210 NAb positivity and activity declined 41% and 54% in ARD(p<0.001/p<0.001) and 39.7% and 47% in CG(p<0.001/p<0.001). Multivariate logistic regression analysis showed that male(OR=0.56;95%CI0.40-0.79;p<0.001), prednisone(OR=0.56; 95%CI0.41-0.76;p<0.001), anti-TNF(OR=0.66;95%CI0.45-0.96;p=0.031), abatacept(OR=0.29; 95%CI0.15-0.56;p<0.001) and rituximab(OR=0.32;95%CI0.11-0.90;p=0.031) use were associated with a substantial reduction on IgG response at D210 in ARD patients. A decrease of COVID-19 cases(from 27.5 to 8.1/100 person-years;p<0.001) occurred during the study despite the Delta variant spread. In conclusion, after 6-months of Sinovac-CoronaVac 2nd dose, immunogenicity of ARD patients was markedly reduced, particularly in males and those under prednisone/biological therapies, without a concomitant rise in COVID-19 cases(NCT04754698).

Physical activity and antibody persistence 6 months after the second dose of CoronaVac in immunocompromised patients

“…Now, we extended this notion by showing that being physically active is also associated with greater persistent immune response 6 months after vaccination, evidenced by higher rates of seroconversion and neutralizing antibodies. Considering that the prevalence of seropositivity in response to CoronaVac decreased to 17% following 6 months in general population and 23.8% in immunocompromised patients, 2 the 50% greater odds of IgG and NAb positivity rates observed herein in active vs. inactive ARD patients appears to be clinically meaningful. The associations observed also suggest that physical activity status may be more influential on antibody persistence than classical factors related to vaccine immunogenicity, such as older age and use of immunosuppressants.…”

“…Vaccine‐induced antibody titers and effectiveness against symptomatic COVID‐19 have been shown to wane over time. For instance, individuals who received a two‐dose schedule of CoronaVac (Sinovac's inactivated vaccine)—a WHO‐approved vaccine that is effective in preventing severe cases of COVID‐19 and is increasing the global supply through COVAX—exhibited a decline in neutralizing antibodies (NAb) seropositivity 6 months after full‐course of vaccination in the general population 1 and in patients with autoimmune rheumatic disease (ARD) 2 …”

“…For instance, individuals who received a two-dose schedule of CoronaVac (Sinovac's inactivated vaccine)-a WHO-approved vaccine that is effective in preventing severe cases of COVID-19 and is increasing the global supply through COVAX-exhibited a decline in neutralizing antibodies (NAb) seropositivity 6 months after full-course of vaccination in the general population 1 and in patients with autoimmune rheumatic disease (ARD). 2 In a global scenario with inequity of vaccines and heterogeneous responses to vaccination, it is key to gathering knowledge on potential risk factors associated with poor persistence of immunity to develop strategies to enhance immunogenicity durability, as well as to prioritize individuals to receive booster doses. In this context, a physically active lifestyle emerges as a potential candidate.…”

Physical Activity Associates with Greater Antibody Persistence through 6 Months after the Second Dose of CoronaVac in Patients with Autoimmune Rheumatic Diseases

“…Considering that the prevalence of seropositivity in response to CoronaVac decreased to 17% following 6 months in general population 14 and 23.8% in immunocompromised patients, 7 the 50% greater odds of IgG and NAb positivity rates observed herein in active vs. inactive ARD patients appears to be clinically meaningful. The associations observed also suggest that physical activity status may be more in uential on antibody persistence than classical factors related to vaccine immunogenicity, such as older age and use of immunosuppressants.…”

“…6 Of note, the same pattern of immunity waning was observed for autoimmune rheumatic disease (ARD) patients vaccinated with CoronaVac, without a concomitant increase in cases or hospitalization, despite the Delta variant spread. 7 In a global scenario with shortage and inequity of vaccines, and heterogeneous responses to vaccination, it is key to gathering knowledge on potential risk factors associated with poor persistence of immunity in order to develop strategies to enhance immunogenicity durability, as well as to prioritize individuals to receive a booster dose. In this regard, there is evidence suggesting that physical activity may act as an adjuvant to vaccines.…”