Effects of the second dose of COVID-19 vaccines in patients with autoimmune rheumatic diseases with hybrid immunity

Menon, Aparna R; Cherian, Somy; Paul, Aby; Kumar, Kripesh; Ahmed, Sakir; Mehta, Pankti; Musthafa, Shaik; Gayathri, B; Benny, Libin; Shenoy, Padmanabha

doi:10.1007/s00296-022-05265-3

Cited by 2 publications

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“…Our recent study had shown that the neutralization potential of serum against Omicron in vitro was reduced in those having hybrid immunity after receiving the second dose of the vaccine [ 16 ]. However, this did not translate to reduce protection against the Omicron variant in vivo in a very large cohort followed up through the Omicron wave in India.…”

Section: Discussionmentioning

confidence: 99%

“…Breakthrough infections were observed in 7.4% of the cohort and were associated with poor humoral response to vaccines. Data regarding the effectiveness of primary immunization, boosters, and hybrid immunity against the Omicron variant in patients with AIRDs are scarce with in vitro studies suggesting poor vaccine-induced immune response against the Omicron variant [ 15 , 16 ]. The duration of protection offered by vaccination or past infection in this subgroup of patients is also questionable.…”

Section: Introductionmentioning

confidence: 99%

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Correlates of breakthrough Omicron (B.1.1.529) infections in a prospective cohort of vaccinated patients with rheumatic diseases

Benny¹,

Mehta

Ahmed

et al. 2023

Rheumatol Int

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Background Data on the effectiveness of SARS-CoV-2 vaccines and the durability of protection against the prevalent Omicron variant are scarce, especially in patients with autoimmune rheumatic diseases (AIRDs). Hence, we prospectively studied Omicron breakthrough infections in patients with AIRDs and attempted to isolate associated risk factors. Methods Patients with AIRDs who had completed primary vaccination with either AZD1222 or BBV152 vaccines were included and prospectively followed up from January 2022 onwards for the development of breakthrough Omicron infections. The time interval from the last event [2nd dose of vaccination (V) or past COVID-19 infection (I) whichever was later] to Omicron infection was recorded. Patients were divided based on the events and their order of occurrence into V + V, V + I, I + V, V + I + V, and V + V + I groups. The incidence of breakthrough infections and their predictors were studied with a focus on the vaccine type and hybrid (H) immunity (vaccinated individuals with a history of COVID-19 infection). Results We included 907 patients with AIRDs (53.5 ± 11.7 years and a male-to-female ratio of 1:5.1), and the majority of patients had received AZD1222 (755, 83.2%). Breakthrough infections were observed in 158 of 907(17.4%) of which 97 (10.4%) were confirmed by RT-PCR. Breakthrough infections were significantly greater in the V versus the H group (15.7% and 3.5%, log-rank test, p = < 0.01). Among the hybrid group, the order of infection and vaccination had no bearing on the risk of breakthrough infections. On multivariate analysis, breakthrough infections were significantly lesser in the H versus the V group [HR: 0.2(0.1–0.4); p = 0.01]. Conclusion The risk of breakthrough Omicron infections in fully vaccinated patients with AIRDs was 17.4% with a significantly lower risk in patients with hybrid immunity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%