tetano
Editor, Senior Moderator
Gastroenterology
. 2021 Sep 29;S0016-5085(21)03604-0.
doi: 10.1053/j.gastro.2021.09.055. Online ahead of print.
Serologic response to coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated inflammatory diseases: a systematic review and meta-analysis
Atsushi Sakuraba[SUP] 1 [/SUP], Alexander Luna[SUP] 2 [/SUP], Dejan Micic[SUP] 2 [/SUP]
Affiliations
Abstract
Background and aims: Patients with immune-mediated inflammatory diseases (IMIDs) have an increased risk of COVID-19, primarily attributed to the use of immunosuppressive drugs such as glucocorticoids, which may attenuate the response to vaccines. This meta-analysis aims to assess the serologic response to COVID-19 vaccination in patients with IMIDs.
Methods: Electronic databases were searched on August 1, 2021 for observational studies. Data including reference population, medications, vaccination, and proportion of patients achieving a serologic response were extracted.
Results: Twenty-five observational studies (5360 patients) were included for analyses. A majority of the studies used mRNA vaccines (BNT162b2, mRNA-1273) with a small number of studies including other types of vaccines (AZD1222, Coronavac, BBV152, Ad26.COV2.S). Serologic response after a single (6 studies) and two doses (17 studies) of mRNA vaccine were 73.2% (95% confidence interval [CI] 65.7-79.5) and 83.4% (95%CI 76.8-88.4), respectively. On meta-regression, anti-CD20 therapy was associated with lower response rates (P <0.001) and anti-TNF therapy also showed a trend toward lower response rates (P = 0.058). Patients with IMIDs were less likely to achieve a serologic response compared to controls after two doses of mRNA vaccine (6 studies; odds ratio 0.086, 95% CI 0.036-0.206, P < .001). There were not enough studies to assess response to the adenoviral or inactivated vaccines.
Conclusions: Our meta-analysis demonstrated that patients with IMIDs have a reduced response to mRNA COVID-19 vaccines. These results suggest that IMID patients receiving mRNA vaccines should complete the vaccine series without delay and support the strategy of providing a 3rd dose of the vaccine.
Keywords: immune-mediated inflammatory diseases; inflammatory bowel disease; outcomes; rheumatic disease; vaccine.
. 2021 Sep 29;S0016-5085(21)03604-0.
doi: 10.1053/j.gastro.2021.09.055. Online ahead of print.
Serologic response to coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated inflammatory diseases: a systematic review and meta-analysis
Atsushi Sakuraba[SUP] 1 [/SUP], Alexander Luna[SUP] 2 [/SUP], Dejan Micic[SUP] 2 [/SUP]
Affiliations
- PMID: 34599933
- DOI: 10.1053/j.gastro.2021.09.055
Abstract
Background and aims: Patients with immune-mediated inflammatory diseases (IMIDs) have an increased risk of COVID-19, primarily attributed to the use of immunosuppressive drugs such as glucocorticoids, which may attenuate the response to vaccines. This meta-analysis aims to assess the serologic response to COVID-19 vaccination in patients with IMIDs.
Methods: Electronic databases were searched on August 1, 2021 for observational studies. Data including reference population, medications, vaccination, and proportion of patients achieving a serologic response were extracted.
Results: Twenty-five observational studies (5360 patients) were included for analyses. A majority of the studies used mRNA vaccines (BNT162b2, mRNA-1273) with a small number of studies including other types of vaccines (AZD1222, Coronavac, BBV152, Ad26.COV2.S). Serologic response after a single (6 studies) and two doses (17 studies) of mRNA vaccine were 73.2% (95% confidence interval [CI] 65.7-79.5) and 83.4% (95%CI 76.8-88.4), respectively. On meta-regression, anti-CD20 therapy was associated with lower response rates (P <0.001) and anti-TNF therapy also showed a trend toward lower response rates (P = 0.058). Patients with IMIDs were less likely to achieve a serologic response compared to controls after two doses of mRNA vaccine (6 studies; odds ratio 0.086, 95% CI 0.036-0.206, P < .001). There were not enough studies to assess response to the adenoviral or inactivated vaccines.
Conclusions: Our meta-analysis demonstrated that patients with IMIDs have a reduced response to mRNA COVID-19 vaccines. These results suggest that IMID patients receiving mRNA vaccines should complete the vaccine series without delay and support the strategy of providing a 3rd dose of the vaccine.
Keywords: immune-mediated inflammatory diseases; inflammatory bowel disease; outcomes; rheumatic disease; vaccine.