Immunogenicity and safety of the CoronaVac and BNT162b2 Covid-19 vaccine in patients with inflammatory rheumatic diseases and healthy adults: comparison of different vaccines

Abstract

Objectives To determine the seroconversion (SC) rate after CoronaVac and BNT162b2 vaccines in adults with inflammatory rheumatic disease (IRD). Methods Patients who were followed up with IRD and who received two doses of either CoronaVac or BNT162b2 vaccines were included in this prospective observational single-center study. Subjects with two doses of CoronaVac or BNT162b2 without known IRD were included in the healthy controls. The blood samples were taken at a minimum of two and a maximum of 12 weeks after the second dose of vaccine. Results A total of 81 patients with IRD (61 CoronaVac, 20 BNT162b2) and 100 healthy controls (70 CoronaVac, 30 BNT162b2) were included. The SC rate was slightly lower among patients with IRD versus controls (84 vs 97%, p = 0.002). The SC rate was 100% in all participants who received BNT162b2 both in the patient and control group. The IgG antibody level after CoronaVac in the patient group was significantly lower than both the BNT162b2 ( p = 0.031) and the healthy group ( p < 0.001). Among patients with IRD, those on rituximab (RTX) (12/81,14.8%) had significantly less SC rate (5/12, 41.7%). The median neutralizing antibody titers were significantly higher in patients with BNT162b2 compared with CoronaVac (1.97 vs. 16.34, p < 0.001). Conclusions This study showed that all patients with BNT162b2 vaccine developed immunogenicity in patients with IRD, while there was a decreased antibody response with CoronaVac vaccine compared to that of BNT162b2. In particular, RTX significantly reduces the SC rate.

Immunogenicity and safety of the BBIBP‐CorV vaccine in patients with autoimmune inflammatory rheumatic diseases undergoing immunosuppressive therapy in a monocentric cohort

“…Despite numerous studies regarding short‐term immunogenicity and safety of Sinovac‐CoronaVac inactivated vaccine in patients with AIIRD, 11,15 we could not find any reports pointing to the efficiency and adverse events of other inactivated vaccines in these patients. In line with the immunogenicity of the inactivated vaccines, Sinovac‐CoronaVac vaccine provides a suitable immunogenicity in patients with AIIRD, although postvaccination level of anti‐SARS‐CoV‐2 IgG antibody is significantly lower than the mRNA COVID‐19 vaccines 15 .…”

“…13 On the contrary, there are some evidence showing mRNA COVID-19 vaccines (BNT162b2 and mRNA-1273) failed to provide an effective response against SARS-CoV-2 infection in patients with AIIRD and the level of serum IgGneutralizing antibody was significantly lower in patients with AIIRD than healthy subjects. 14 Despite numerous studies regarding short-term immunogenicity and safety of Sinovac-CoronaVac inactivated vaccine in patients with AIIRD, 11,15 we could not find any reports pointing to the efficiency and adverse events of other inactivated vaccines in these patients. In line with the immunogenicity of the inactivated vaccines, Sinovac-CoronaVac vaccine provides a suitable immunogenicity in patients with AIIRD, although postvaccination level of anti-SARS-CoV-2 IgG antibody is significantly lower than the mRNA COVID-19 vaccines.…”

“…Although some reports have pointed that mRNA SARS‐CoV‐2 vaccines failed to induce an acceptable immune responses in patients with rheumatic diseases under immunotherapies, 27 our findings are consistent with previous studies showing inactivated CoronaVac and SARS‐CoV‐2 mRNA vaccines are immunogenic in the majority of patients with AIIRD 10 . In this regard, there is a decreased antibody response in the AIIRD patients compared to the healthy control group 2,10,11 . Previous studies have shown that CoronaVac vaccine, with an acceptable safety profile, can lead to the development of antibodies in patients with chronic inflammatory conditions, although the seroconversion rate was slightly lower in the patients received inactivated vaccine than those vaccinated with the BNT162b2 mRNA vaccine 11 .…”

“…In line with this notion, most studies pointing to the efficiency and side effects of COVID‐19 vaccination are the mRNA vaccines, such as BNT162b2, mRNA‐1273, and ChAdOx1 nCoV‐19 vaccines 7–10 . Previous studies have indicated that mRNA COVID‐19 vaccines had an acceptable safety and immunogenicity in the majority of patients with AIIRD 10,11 . However, some immunosuppressive drugs, such as glucocorticoids, rituximab, mycophenolate mofetil, and abatacept, can significantly reduce mRNA vaccine‐induced immunogenicity 10,12 .…”

Effectiveness of BBIBP-CorV vaccine in preventing SARS-CoV2 infection and severe outcomes in people living with multiple sclerosis: A population-based study

“…Our result supports the growing evidence that rituximab may impair the vaccine-induced immune response in MS patients ( Apostolidis et al, 2021 ; Ciampi et al, 2022 ; Etemadifar et al, 2022 ; Tallantyre et al, 2022 ). Studies on rituximab-treated patients with other autoimmune disorders such as inflammatory rheumatic diseases and musculoskeletal diseases showed impaired immune responses after SARS-CoV-2 vaccination ( Batıbay et al, 2022 ; Furer et al, 2021 ; Kroon et al, 2022 ; Moor et al, 2021 ; Zheng et al, 2022 ). However, some found suitable immunity after vaccination among rituximab-treated patients ( Takai et al, 2022 ).…”