Hybrid immunity versus vaccine-induced immunity against SARS CoV2 in Patients with Autoimmune Rheumatic Diseases

Abstract

Introduction: Single-dose COVID-19 vaccines in healthy individuals with past COVID-19 infections seem to provide better immunity than double doses in COVID-19 unexposed individuals. However, it is not known whether the same is true for patients with autoimmune rheumatic diseases (AIRD) who are on immunosuppressants. Methods: We identified 30 patients with AIRD who took a single dose of the ChAdOx1 vaccine post-COVID-19 infection. Age, sex and disease similar patients were enrolled in to three groups of 30 each who had (1) past infection with COVID-19 but no vaccine, (2) a single dose of ChAdOx1 and (3) double doses of ChAdOx1. Sera were collected from each patient approximately 30 days after last vaccine dose or since the onset of COVID19 symptoms (in the unvaccinated group). Antibodies to spike protein were estimated and virus neutralization potential of sera was tested. Results: Baseline characteristics including drug usage was similar betweenthe groups. Seroconversion occurred in 25(83%), 23(77%), 27(90%), and 30(100%) in natural infection, single-dose vaccine, double dose vaccine, and infection and single dose vaccine groups respectively. Mean antibody titres (10076.8 SD 8998) in the last group were at least 6-100x higher than in the other 3 groups. Also, the infection +vaccine group had the highest neutralization potential of 83.37 % as compared to 45.4% in the fully vaccinated group. Conclusion: The hybrid immunity with a single dose of the vector-based vaccine post-infection seems to be superior to double dosage of the vaccine in patients with AIRD. A universal vaccination strategy involving a single dose of vaccine for all individuals with previous COVID-19 infection seems to be effective in these patients also.

Previous COVID-19 Infection and Antibody Levels After Vaccination

“…In another study on BNT162b2, the authors reported similar IgG antibody levels and ACE2 antibody-binding inhibition responses between individuals with prior COVID-19 infection after a single dose and individuals without prior infection after two doses of vaccine ( 34 ). An interesting study that also reported conclusions similar to those reported here was conducted in individuals with autoimmune rheumatic diseases who were taking immunosuppressants ( 35 ). The study showed that one dose of ChAdOx1 in individuals with a previous infection was also superior to two doses in this subset of immunocompromised patients.…”

Previous COVID-19 infection and antibody levels after vaccination

“…In another study on BNT162b2, the authors reported similar IgG antibody levels and ACE2 antibody binding inhibition responses from a single dose in individuals with prior COVID-19 infection compared to levels measured after two doses of vaccine in individuals without prior infection (Ebinger et al, 2021). An interesting study that also reported similar conclusions to those reported here was conducted on autoimmune rheumatic diseases (AIRD) who are on immunosuppressants (Shenoy et al, 2021). The study showed that one dose of ChAdOx1 with a previous infection was also superior compared to two doses in this subset of immunocompromised patients.…”

Rule Based Mamdani Fuzzy Inference System to Analyze Efficacy of COVID19 Vaccines

“…Participants aged 18 to 44 had a substantially greater effectiveness rate than those aged 45 and over. Participants having a lower immunity rate [18] and a history of chronic illness also had a lower effectiveness rate. Authors in [11] presented collective research from three randomized controlled trials conducted in the UK and Brazil on Pfizer and Covishield.…”