Comparative Study of Immunogenicity and reactogenicity of ChAdOx1 vaccine in patients with autoimmune inflammatory rheumatic diseases and healthy controls
Keywords:
COVID-19, SARS-CoV-2 vaccine, Immunogenicity, Reactogenicity, Autoimmune inflammatory rheumatic diseases (AIRDs)Abstract
The data are limited on vaccine responses in patients with autoimmune inflammatory rheumatic disease (AIRD), especially for the adenoviral vector ChAdOx1 vaccine. This single-center prospective cohort study evaluated the immunogenicity and safety of ChAdOx1 vaccine in patients with AIRD at Chulabhorn Hospital, Thailand. Thirty-five patients with AIRDs were enrolled between June 9 and July 1, 2021. The immune response and reactogenicity data of 70 healthcare workers (age- and sex-frequency matched) were used as a control group. All participants were vaccinated with two doses of ChAdOx1 vaccine with a 3-month interval. Antibodies against the receptor-binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein were assessed prevaccination, 3 months after the first dose, and 1 month after the second dose. Disease activity and reactogenicity were assessed before and 7 days after both vaccinations.
The geometric mean concentration of SARS-CoV-2 antibodies at 3 months after the first vaccination was significantly lower in patients than that in healthy controls (21.82 vs 66.01 BAU/mL, P = 0.002), although there was an insignificant decrease in antibody response in patients with AIRDs compared with that in healthy controls at 1 month after the second vaccination (647.05 vs 814.08 BAU/mL, P = 0.484). Vaccines were mostly well tolerated with mild adverse reactions, and no patients experienced a disease flare. The antibody responses of patients with AIRDs did not significantly differ from those of healthy controls but did tend to be lower. Most vaccinations were well-tolerated without postvaccination disease flares.
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