Impaired Humoral Immunity with Concomitant Preserved T Cell Reactivity in IBD Patients on Treatment with Infliximab 6 Month after Vaccination with the SARS-CoV-2 mRNA Vaccine BNT162b2: A Pilot Study

Vollenberg, Richard; Tepasse, Phil‐Robin; Lorentzen, Eva; Nowacki, Tobias M.

doi:10.3390/jpm12050694

Cited by 8 publications

(7 citation statements)

References 55 publications

(68 reference statements)

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“…Removal of the combination-treated anti-TNF patients from this analysis did not affect the differences observed. This finding is in line with literature reporting an effect of anti-TNF therapy on SARS-CoV-2 vaccine response in IBD patients (10,24,(30)(31)(32), but not in other IMID patients without an IBD diagnosis (33,34). The mechanisms underlying the differential effect of anti-TNF therapy on vaccine-induced immunity based on disease indication are unclear but may be attributed to higher doses or a higher proportion receiving drugs intravenously in the IBD group compared to the non-IBD IMID patients, although this remains to be determined.…”

Section: Discussionsupporting

confidence: 92%

Third and fourth vaccine doses broaden and prolong immunity to SARS-CoV-2 in immunocompromised adult patients

Cheung

Dayam

Shapiro

et al. 2023

Preprint

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BackgroundPrevious studies have reported impaired humoral responses after SARS-CoV-2 mRNA vaccination in immunocompromised patients with immune-mediated inflammatory diseases (IMID), particularly those treated with anti-tumor necrosis factor (TNF) biologics. We previously reported that IMID patients exhibited greater waning of antibody and T cell responses compared to healthy controls after dose 2. Fewer data are available on the effects of third and fourth doses.MethodsThis observational cohort study collected plasma and peripheral blood mononuclear cells from healthy controls and untreated or treated IMID patients, pre-vaccination and after one to four doses of SARS-CoV-2 mRNA vaccine (BNT162b2 or mRNA-1273). SARS-CoV-2- specific antibody levels, neutralization, and T cell cytokine responses were measured against Wildtype (WT) and BA.1 and BA.5 variants of concern (VOCs).ResultsThird vaccine doses substantially restored and prolonged antibody and T cell responses in IMID patients and broadened responses against VOCs. Fourth dose effects were subtle but also prolonged antibody responses. However, IMID patients treated with anti-TNF, especially inflammatory bowel disease (IBD) patients, exhibited lower antibody responses even after the fourth dose. Although T cell IFNγ responses were maximal after one dose, IL-2 and IL-4 production increased with successive doses, and early production of these cytokines was predictive of neutralization responses at 3-4 months post-vaccination.ConclusionOur study demonstrates that third and fourth doses of the SARS-CoV-2 vaccine sustain and broaden immune responses to SARS-CoV-2, supporting the recommendation for three- and four-dose vaccination regimens in IMID patients.FundingCOVID-19 Immunity Task Force and Speck family donationConflict-of-Interest StatementsAnne-Claude Gingras has received research funds from a research contract with Providence Therapeutics Holdings, Inc., for other projects, participated in the COVID-19 Immunity Task Force (CITF) Immune Science and Testing working party, chaired the CIHR Institute of Genetics Advisory Board, and chairs the SAB of the National Research Council of Canada Human Health Therapeutics Board. Vinod Chandran has received research grants from AbbVie, Amgen, and Eli Lilly and has received honoraria for advisory board member roles from AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. His spouse is an employee of AstraZeneca. Vincent Piguet has no personal financial ties with any pharmaceutical company. He has received honoraria for speaker and/or advisory board member roles from AbbVie, Celgene, Janssen, Kyowa Kirin Co. Ltd, LEO Pharma, Novartis, Pfizer, Sanofi, UCB, and Union Therapeutics. In his role as Department Division Director of Dermatology at the University of Toronto, Dr. Piguet has received departmental support in the form of unrestricted educational grants from AbbVie, Bausch Health, Celgene, Janssen, LEO Pharma, Lilly, L’Oréal, NAOS, Novartis, Pfizer, Sandoz and Sanofi in the past 36 months. Vincent Piguet has received research grants from Sanofi, Abbvie and Novartis. Mark Silverberg has received research support, consulting fees and speaker honoraria from AbbVie, Janssen, Takeda, Pfizer, Gilead, and Amgen. All other authors have no conflicts to declare.Graphical Abstract

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Section: Discussionsupporting

confidence: 92%

Third and fourth vaccine doses broaden and prolong immunity to SARS-CoV-2 in immunocompromised adult patients

Cheung

Dayam

Shapiro

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…These drugs are reported to interfere with the activity of COVID-19 vaccines [ 49 , 50 ]. Additionally, alterations in humoral immunity are reported six months following COVID-19 vaccination among patients with inflammatory bowel disease who receive anti-TNF (infliximab, adalimumab) therapy [ 51 ]. Therefore, we might expect that high prevaccination level of stress might disrupt immune regulation, resulting in increased flux of immune cells and accelerated release of cytokines, chemokines, and reactive oxygen species at injection site, eventually leading to more local pain, redness, and swelling and probably more other adverse effects (e.g., generalized muscle ache) [ 52 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

Emotional Reaction to the First Dose of COVID-19 Vaccine: Postvaccination Decline in Anxiety and Stress among Anxious Individuals and Increase among Individuals with Normal Prevaccination Anxiety Levels

Al‐Amer

Malak

Burqan

et al. 2022

JPM

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Although vaccination has been adopted by the WHO to limit worldwide transmission of COVID-19, people’s worries about COVID-19 vaccines may suppress their desire for vaccination despite vaccine availability. This study aimed to investigate anxiety and stress symptoms among 250 Jordanians (mean age = 43.18 ± 6.34 years, 72% females) who received their first vaccine dose. The respondents completed the anxiety and stress subscales of the Depression Anxiety and Stress scale 21 (DASS-21) before and after vaccination. The respondents expressed more moderate–severe levels of stress before than after vaccination (20.8% and 13.2%, respectively). Meanwhile, 37.2% and 45.2% of the respondents expressed moderate–severe anxiety before and after vaccination, respectively. Wilcoxon signed-rank test revealed that the drop in the level of stress from before- (median (IQR) = 5 (1–8)) to after vaccination (median (IQR) = 3 (1–7)) was statistically significant (z = −3.81, p = 0.001, r = 0.17) while the increase in anxiety was not. Anxiety significantly dropped postvaccination among individuals experiencing mild to severe anxiety before vaccination. Similarly, stress and anxiety significantly increased among individuals expressing normal anxiety before vaccination (z = −3.57 and −8.24, p values = 0.001, r = 0.16 and 0.37, respectively). Age positively correlated with postvaccination anxiety among respondents with mild prevaccination anxiety, and it negatively correlated with the prevaccination level of stress in the normal-anxiety group. Gender, marital status, respondents’ level of education, and history of COVID-19 infection had no significant correlation with anxiety or stress at either point of measurement. Overcoming their hesitancy to receive COVID-19 vaccines, individuals with normal levels of anxiety experienced a rise in their distress symptoms following immunization. On the contrary, vaccination seemed to desensitize anxious individuals. Policymakers need to formulate a population-specific plan to increase vaccine preparedness and promote psychological well-being over all during the pandemic.

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“…These drugs are reported to interfere with the activity of COVID-19 vaccines [44,45]. Additionally, alterations in humoral immunity are reported six months following COVID-19 vaccination among patients with inflammatory bowel disease on anti-TNF (infliximab, adalimumab) therapy [46]. Therefore, we might expect that high pre vaccination level of stress might disrupt immune regulation, resulting in increased flux of immune cells and accelerated release of cytokines, chemokines, and reactive oxygen species at injection site, eventually leading to more local pain, redness, and swelling and probably more other adverse effects (e.g., generalized muscle ache) [47,48].…”

Section: Discussionmentioning

confidence: 99%

Emotional Reaction to the First Dose of COVID-19 Vaccine: Post Vaccination Decline in Anxiety and Stress Among Anxious Individuals and Increase Among Individuals with Normal Anxiety Levels Pre Vaccination

Al‐Amer¹,

Malak²,

Burqan³

et al. 2022

Preprint

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Although vaccinating the world is adopted by the WHO to limit COVID-19 transmission, people’s worries about vaccines may suppress their desire for vaccination despite vaccine availability. This study aimed to evaluate the levels of stress and anxiety among 250 Jordanians who received their first vaccine dose at a local community health center. The respondents completed the stress and anxiety subscales of the Depression Anxiety and Stress scale 21 (DASS-21) pre- and post-vaccination. The respondents expressed more moderate-severe levels of stress pre than post vaccination (20.8% and 13.2%, respectively). Meanwhile, 37.2% and 45.2% of the respondents expressed moderate-severe anxiety pre and post vaccination, respectively. Wilcoxon signed-rank test revealed that the drop in the level of stress from pre (median (IQR) = 5 (1-8)) to post vaccination (median (IQR) = 3 (1-7)) was statistically significant (z = -3.81, p = 0.001, r = 0.17) while the increase in anxiety was not. Anxiety median significantly dropped among individuals experiencing mild to severe anxiety pre vaccination. Similarly, stress and anxiety significantly increased among individuals expressing normal anxiety pre vaccination (z = -3.57 and -8.24, p values = 0.001, r = 0.16 and 0.37, respectively). Age positively correlated with post vaccination anxiety among respondents with mild pre vaccination anxiety, and it negatively correlated with pre vaccination level of stress in the normal anxiety group. Gender, marital status, respondents’ level of education, and history of COVID-19 infection had no significant correlation with anxiety or stress at either point of measurement. Overcoming their hesitancy to receive COVID-19 vaccine, individuals with normal levels of anxiety experienced a rise in their distress symptoms following immunization. On the contrary, vaccination seemed to desensitize anxious individuals. Policymakers need to formulate a population-specific plan to increase vaccine preparedness and promote psychological well-being over all during the pandemic.

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Impaired Humoral Immunity with Concomitant Preserved T Cell Reactivity in IBD Patients on Treatment with Infliximab 6 Month after Vaccination with the SARS-CoV-2 mRNA Vaccine BNT162b2: A Pilot Study

Cited by 8 publications

References 55 publications

Third and fourth vaccine doses broaden and prolong immunity to SARS-CoV-2 in immunocompromised adult patients

Third and fourth vaccine doses broaden and prolong immunity to SARS-CoV-2 in immunocompromised adult patients

Emotional Reaction to the First Dose of COVID-19 Vaccine: Postvaccination Decline in Anxiety and Stress among Anxious Individuals and Increase among Individuals with Normal Prevaccination Anxiety Levels

Emotional Reaction to the First Dose of COVID-19 Vaccine: Post Vaccination Decline in Anxiety and Stress Among Anxious Individuals and Increase Among Individuals with Normal Anxiety Levels Pre Vaccination

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