How to Manage COVID-19 Vaccination in Immune-Mediated Inflammatory Diseases: An Expert Opinion by IMIDs Study Group

Ferretti, Francesca; Cannatelli, Rosanna; Benucci, Maurizio; Carmagnola, S.; Clementi, Emilio; Dilillo, Dario; Fiorina, Paolo; Galli, Massimo; Gallieni, Maurizio; Genovese, Giovanni; Giorgi, Valeria; Invernizzi, Alessandro; Maconi, Giovanni; Maier, Jeanette A. M.; Marzano, Angelo Valerio; Morpurgo, Paola S.; Nebuloni, Manuela; Radovanovic, Dejan; Riva, Agostino; Rizzardini, Giuliano; Sabiu, Gianmarco; Santus, Pierachille; Staurenghi, Giovanni; Zuccotti, Gianvincenzo; Sarzi-Puttini, P.; Ardizzone, Sandro

doi:10.3389/fimmu.2021.656362

Cited by 31 publications

(40 citation statements)

References 120 publications

(136 reference statements)

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“…A recent opinion paper on COVID-19 vaccination in immune-mediated diseases concluded that ocular (immune-mediated) side effects were very unlikely to happen, which should, however, not prevent us to be vigilant [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Reactivation of Vogt-Koyanagi-Harada disease under control for more than 6 years, following anti-SARS-CoV-2 vaccination

Papasavvas¹,

Herbort²

2021

J Ophthal Inflamm Infect

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Background/purpose Vogt-Koyanagi-Harada (VKH) disease is a primary stromal choroiditis with bilateral granulomatous panuveitis. If initial-onset VKH is treated early and relentlessly the disease can be controlled and even “cured” in a substantial number of cases. We are reporting on a patient treated early and in a sustained fashion who was inflammation free for seven years but who presented a reactivation 6 weeks after the second dose of anti-SARS-CoV-2 vaccination. Case report A 43-year-old woman presented with severe initial-onset VKH disease which was brought under control using steroidal and non-steroidal Immunosuppression (mycophenolic acid and cyclosporine) with additional infliximab infusions because of the persistence of subclinical choroiditis identified on ICGA. Under infliximab alone disease had been inflammation free with no subclinical disease and absence of sunset glow fundus for 6 years. However, following anti-SARS-CoV-2 vaccination, severe resurgence of the disease occurred with exudative retinal detachments. Disease was rapidly brought again under control with oral prednisone (1 mg/kg) therapy and a new loading scheme of infliximab therapy. Conclusion VKH disease results from an autoimmune process directed against melanocyte associated antigens which can be controlled when early and sustained immunosuppressive treatment is introduced. It seems that anti-SARS-CoV-2 vaccination can be at the origin of reactivation of long-time controlled disease.

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Section: Discussionmentioning

confidence: 99%

Reactivation of Vogt-Koyanagi-Harada disease under control for more than 6 years, following anti-SARS-CoV-2 vaccination

Papasavvas¹,

Herbort²

2021

J Ophthal Inflamm Infect

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“…В целом отсутствие синтеза нейтрализующих антител имело место у каждого 10-го пациента (9,5%), o n l i n e fi r s t Таблица 3. Рекомендации по терапии и вакцинации пациентов с ревматическими заболеваниями в период пандемии COVID-19 [90][91][92][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107][108] Продолжение таблицы 3 o n l i n e fi r s t страдающего ИВРЗ, и у каждого 100-го (0,5%) в группе контроля. Наконец совсем недавно было показано, что базовое лечение МТ ассоциируется с неадекватным синтезом анти-SARS-CoV-2 (у 62,2% пациентов) и отсутствием вирусспецифической активации CD8 + -Т-клеток [169].…”

Section: Discussionunclassified

Coronavirus Disease 2019 (COVID-19) and Immune-mediated Rheumatic Diseases. Recommendations of the Association of Rheumatologists of Russia

Насонов

Лила

Мазуров

et al. 2021

Naučno-praktičeskaâ revmatologiâ

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In mid-2021, the SARS-CoV-2 (Severe Acute Respiratory coronavirus 2) infection, which caused the coronavirus disease (COVID-19) pandemic, affected more than 157 million people in all regions of the world and led to more than 3.2 million deaths. It is assumed that elderly age, uncontrolled inflammation, anti-inflammatory therapy, comorbid pathology, genetic and other factors can potentially lead to an increase in “sensitivity” to viral and bacterial infections, including SARS-CoV-2. The new version of the recommendations of the Association of Rheumatologists of Russia formulates the main provisions concerning the tactics of managing patients with Immune-mediated Rheumatic Diseases during the ongoing COVID-19 pandemic.

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“…The best criterion, therefore, to evaluate the priority level of access to COVID-19 vaccine in these patients is the clinical one [ 124 ]: in patients with AIAIDs under heavy immunosuppressive therapy and a history of serious and recurrent infections, the immunology specialist will determine the priority level, in keeping with the Raccomandazioni ad interim sui gruppi target della vaccinazione anti-SARS-CoV-2/COVID-19 (GURI 24.3.2021), elaborated by the Italian Ministry of Health. It is necessary to emphasize that vulnerable patients with markedly dysfunctional immune systems may act as an incubator for SARS-CoV-2 variants.…”

Section: Should Patients With Aiaids Pids and Sids Be Prioritized In The Access To Vaccines?mentioning

confidence: 99%

“…There is no general agreement regarding priority criteria for anti-COVID vaccine access for patients with AIAIDs, PIDs, and SIDs, because there is no consensus on their actual risk of infection or developing a more serious disease. The best criterion to evaluate the priority level of access to COVID-19 vaccine in these patients is the clinical one [ 124 ]: in patients with AIAIDs under heavy immunosuppressive therapy and a history of serious and recurrent infections, the immunology specialist should determine the priority level, in keeping with the Raccomandazioni ad interim sui gruppi target della vaccinazione anti-SARS-CoV-2/COVID-19 (GURI 24.3.2021), elaborated by the Italian Ministry of Health. Clinical criteria should guide the management of patients with PIDs and SIDs as well.…”

Section: Recommendationsmentioning

confidence: 99%

Anti-COVID-19 Vaccination in Patients with Autoimmune-Autoinflammatory Disorders and Primary/Secondary Immunodeficiencies: The Position of the Task Force on Behalf of the Italian Immunological Societies

et al. 2021

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The Coronavirus disease 2019 (COVID-19) pandemic has represented an unprecedented challenge for humankind from health, economic, and social viewpoints. In February 2020, Italy was the first western country to be deeply hit by the pandemic and suffered the highest case/fatality rate among western countries. Brand new anti-COVID-19 vaccines have been developed and made available in <1-year from the viral sequence publication. Patients with compromised immune systems, such as autoimmune-autoinflammatory disorders (AIAIDs), primary (PIDs) and secondary (SIDs) immunodeficiencies, have received careful attention for a long time regarding their capacity to safely respond to traditional vaccines. The Italian Immunological Societies, therefore, have promptly faced the issues of safety, immunogenicity, and efficacy/effectiveness of the innovative COVID-19 vaccines, as well as priority to vaccine access, in patients with AIADs, PIDs, and SIDs, by organizing an ad-hoc Task Force. Patients with AIADs, PIDs, and SIDs: (1) Do not present contraindications to COVID-19 vaccines if a mRNA vaccine is used and administered in a stabilized disease phase without active infection. (2) Should usually not discontinue immunosuppressive therapy, which may be modulated depending on the patient’s clinical condition. (3) When eligible, should have a priority access to vaccination. In fact, immunizing these patients may have relevant social/health consequences, since these patients, if infected, may develop chronic infection, which prolongs viral spread and facilitates the emergence of viral variants.

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How to Manage COVID-19 Vaccination in Immune-Mediated Inflammatory Diseases: An Expert Opinion by IMIDs Study Group

Cited by 31 publications

References 120 publications

Reactivation of Vogt-Koyanagi-Harada disease under control for more than 6 years, following anti-SARS-CoV-2 vaccination

Reactivation of Vogt-Koyanagi-Harada disease under control for more than 6 years, following anti-SARS-CoV-2 vaccination

Coronavirus Disease 2019 (COVID-19) and Immune-mediated Rheumatic Diseases. Recommendations of the Association of Rheumatologists of Russia

Anti-COVID-19 Vaccination in Patients with Autoimmune-Autoinflammatory Disorders and Primary/Secondary Immunodeficiencies: The Position of the Task Force on Behalf of the Italian Immunological Societies

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