SARS-CoV-2 breakthrough infections among vaccinated individuals with rheumatic disease: results from the COVID-19 Global Rheumatology Alliance provider registry
Jean W. Liew,Milena A. Gianfrancesco,Carly Harrison,Zara Izadi,Stephanie Rush,Saskia Lawson-Tovey,Lindsay Jacobsohn,Clairissa Ja,Kimme L. Hyrich,Laure Gossec,Anja Strangfeld,Loreto Carmona,Martin Schäfer,Elsa Frãzao-Mateus,Inita Bulina,Frances Stafford,Abdurrahman Tufan,Christine Graver,Gözde Kübra Yardımcı,J. Zepa,Samar Al Emadi,C. Cook,F. Abutiban,Dfiza Dey,Genevieve Katigbak,Lauren Kaufman,E. Kowalski,Marco Ulises Martínez-Martínez,N. Patel,Greta Reyes-Cordero,Evelyn O. Salido,Ellison Smith,David Snow,Jeffrey A. Sparks,Leanna Wise,Suleman Bhana,M. Gore-Massy,Rebecca Grainger,Jonathan S. Hausmann,Emily Sirotich,Paul Sufka,Zachary S. Wallace,Pedro Machado,Philip Robinson,Jinoos Yazdany +44 more
TLDR
While COVID-19 vaccination prevents severe infections, poor immunogenicity in immunocompromised people threatens vaccine effectiveness and further risk mitigation strategies are likely needed to protect this selected high-risk population.Abstract:
Objective While COVID-19 vaccination prevents severe infections, poor immunogenicity in immunocompromised people threatens vaccine effectiveness. We analysed the clinical characteristics of patients with rheumatic disease who developed breakthrough COVID-19 after vaccination against SARS-CoV-2. Methods We included people partially or fully vaccinated against SARS-CoV-2 who developed COVID-19 between 5 January and 30 September 2021 and were reported to the Global Rheumatology Alliance registry. Breakthrough infections were defined as occurring ≥14 days after completion of the vaccination series, specifically 14 days after the second dose in a two-dose series or 14 days after a single-dose vaccine. We analysed patients’ demographic and clinical characteristics and COVID-19 symptoms and outcomes. Results SARS-CoV-2 infection was reported in 197 partially or fully vaccinated people with rheumatic disease (mean age 54 years, 77% female, 56% white). The majority (n=140/197, 71%) received messenger RNA vaccines. Among the fully vaccinated (n=87), infection occurred a mean of 112 (±60) days after the second vaccine dose. Among those fully vaccinated and hospitalised (n=22, age range 36–83 years), nine had used B cell-depleting therapy (BCDT), with six as monotherapy, at the time of vaccination. Three were on mycophenolate. The majority (n=14/22, 64%) were not taking systemic glucocorticoids. Eight patients had pre-existing lung disease and five patients died. Conclusion More than half of fully vaccinated individuals with breakthrough infections requiring hospitalisation were on BCDT or mycophenolate. Further risk mitigation strategies are likely needed to protect this selected high-risk population.read more
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Immunogenicity, breakthrough infection, and underlying disease flare after SARS-CoV-2 vaccination among individuals with systemic autoimmune rheumatic diseases
TL;DR: The phase III clinical trials for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines did not include those who are immunosuppressed as discussed by the authors .
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Factors associated with COVID-19 breakthrough infection among vaccinated patients with rheumatic diseases: A cohort study
N. Patel,Xiaosong Wang,Xiaoqing Fu,Yumeko Kawano,C. Cook,Kathleen M M Vanni,Grace Qian,Emily P Banasiak,E. Kowalski,Yuqing Zhang,Jeffrey A. Sparks,Zachary S. Wallace +11 more
TL;DR: Among patients with rheumatic diseases, multiple immunomodulators were associated with increased risk of breakthrough infection in SARS-CoV-2 vaccines as mentioned in this paper , which highlights the need for additional mitigation strategies in this vulnerable population.
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SARS-CoV-2 breakthrough infections in patients with immune-mediated inflammatory diseases during the omicron dominant period
Laura Boekel,Yaëlle R Besten,Femke Hooijberg,Rosa Wartena,Maurice Steenhuis,Erik H Vogelzang,Maureen Leeuw,Sadaf Atiqi,Sander W. Tas,Willem F. Lems,S. Marieke van Ham,Filip Eftimov,Eileen W Stalman,Luuk Wieske,Taco W. Kuijpers,Alexandre E. Voskuyl,Ronald F van Vollenhoven,Martijn Gerritsen,Charlotte L M Krieckaert,Theo Rispens,Maarten Boers,Michael T. Nurmohamed,Gertjan Wolbink +22 more
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