1. Strong response after fourth dose of mRNA COVID-19 vaccine in autoimmune rheumatic diseases patients with poor response to inactivated vaccine
- Author
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Nadia E Aikawa, Leonard V K Kupa, Clovis A Silva, Carla G S Saad, Sandra G Pasoto, Emily F N Yuki, Solange R G Fusco, Samuel K Shinjo, Danieli C O Andrade, Percival D Sampaio-Barros, Rosa M R Pereira, Anna C S Chasin, Andrea Y Shimabuco, Ana P Luppino-Assad, Elaine P Leon, Marta H Lopes, Leila Antonangelo, Ana C Medeiros-Ribeiro, and Eloisa Bonfa
- Subjects
Rheumatology ,Pharmacology (medical) - Abstract
Objectives To assess immunogenicity of a heterologous fourth dose of an mRNA (BNT162b2) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in autoimmune rheumatic diseases (ARD) patients with poor/non-response to inactivated vaccine (Sinovac-CoronaVac). Methods A total of 164 ARD patients who were coronavirus disease 2019 (COVID-19) poor/non-responders (negative anti-SARS-CoV-2 S1/S2 IgG and/or neutralizing antibodies—NAb) to the third dose of Sinovac-CoronaVac received an additional heterologous dose of mRNA (BNT162b2) 3 months after last dose. IgG and NAb were evaluated before and after the fourth dose. Results Significant increases were observed after the fourth dose in IgG (66.4 vs 95.1%, P Conclusions This is the largest study to provide evidence of a remarkable humoral response after the fourth dose of heterologous mRNA SARS-CoV-2 vaccination in ARD patients with poor/non-response to the third dose of an inactivated vaccine. We further identified that treatment, particularly rituximab and prednisone, impaired antibody response to this additional dose. Trial registration ClinicalTrials.gov, https://clinicaltrials.gov, CoronavRheum #NCT04754698.
- Published
- 2022
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