Impaired Immunogenicity to COVID-19 Vaccines in Autoimmune Systemic Diseases - High Prevalence of Non-Response in Different Patients’ Subgroups

Abstract

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Effect of mycophenolate mofetil dose on antibody response following initial SARS-CoV-2 vaccination in patients with systemic sclerosis

“…In conclusion, 30 (30%) of 100 patients with systemic sclerosis who were tested for anti-SARS-CoV-2 IgG did not show evidence of an antibody response following initial SARS-CoV-2 vaccination. Consistent with previous findings, 2 , 6 , 7 use of mycophenolate mofetil or rituximab was associated with negative antibody response. To our knowledge, this is the first report to investigate the effects of mycophenolate mofetil dose on anti-SARS-CoV-2 IgG antibody response in patients with systemic sclerosis, with patients on high-dose mycophenolate mofetil the least likely to have detectable antibodies.…”

Absent or suboptimal response to booster dose of COVID-19 vaccine in patients with autoimmune systemic diseases

“…The seroconversion induced by multiple doses of COVID-19 vaccine was evaluated after the first vaccination, after 6 months, and after the booster dose administration. Following the initial demonstration of impaired immunogenicity induced by the first vaccination cycle [ 15 ], the present study highlights a dramatic drop in serum NAb levels at 6 months along with the positive peak triggered by the booster dose of vaccine. Nevertheless, NAb titers remained on average lower compared to the general population even after the booster vaccine, while a relevant proportion of patients showed absent or suboptimal response.…”

“…At the beginning, a series of 478 ASD patients were analyzed as regards the humoral immunogenicity of COVID-19 vaccine [ 15 ]; over one quarter (27.9%) of individuals developed valuable levels of serum NAb within the first month after the vaccination cycle (first step). During the present study (second step), we evaluated the NAb titers in 344 ASD patients after the first 6-month follow-up period; a marked increase of the absent/suboptimal responder rate (from 27.9% to 41.85%) was recorded.…”

“…Our prospective, observational study evaluated the immunogenicity and safety of COVID-19 vaccines, as well as the possible role of ongoing immune-modifier treatments in a series of well-defined ASD population, collecting data from 21 Italian referral centers. In a previous report, we analyzed the vaccine immunogenicity in 478 ASD patients during the first 2–4 weeks after the first cycle of vaccination [ 15 ]. Here, we examined 244 patients who received the vaccine booster by detecting serum NAb before (time 2) and after (time 3) the booster dose administered after at least 6 months from the first vaccination cycle ( Fig.…”

Association between immunosuppressants and antibody responses to SARS-CoV-2 vaccines in patients with autoimmune liver diseases

“…However, a series of case reports suggest that mRNA-based vaccines may induce autoimmune liver disease [8][9][10][11][12][13][14][15][16]. This has caused concern among hepatologists as well as patients with autoimmune liver disease (AILD) [17,18].…”