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Humoral and cellular immunogenicity, effectiveness and safety of COVID-19 mRNA vaccination in patients with pediatric rheumatic diseases: A prospective cohort study

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Názov: Humoral and cellular immunogenicity, effectiveness and safety of COVID-19 mRNA vaccination in patients with pediatric rheumatic diseases: A prospective cohort study
Autori: Mohamad Hamad Saied, Joeri W. van Straalen, Sytze de Roock, Frans M. Verduyn Lunel, Jelle de Wit, Lia G.H. de Rond, Erika Van Nieuwenhove, Bas J. Vastert, Joris M. van Montfrans, Annet van Royen-Kerkhof, Gerrie C.J. de Joode-Smink, Joost F. Swart, Nico M. Wulffraat, Marc H.A. Jansen
Prispievatelia: Immuno/reuma onderzoek 7 (Swart), Infection & Immunity, Immuno/reuma onderzoek 1 (Vastert), Child Health, MMB Medische Staf, Immuno/reuma patientenzorg, CTI Van Loosdregt, Immunologie/Reumatologie, Cluster B, Geneeskunde, Immuno/reuma ERN, Open Repository DS7.6 Demo
Zdroj: Vaccine. 42:1145-1153
Informácie o vydavateľovi: Elsevier BV, 2024.
Rok vydania: 2024
Predmety: Pediatric rheumatic diseases, Vaccine safety, COVID-19 Vaccines, Epidemiology, Antibodies, Viral, 03 medical and health sciences, Immunogenicity, Vaccine, 0302 clinical medicine, Rheumatic Diseases, Journal Article, Humans, COVID-19 mRNA vaccines, Prospective Studies, RNA, Messenger, Child, Humoral immunogenicity, General Veterinary, General Immunology and Microbiology, SARS-CoV-2, Vaccination, Cellular immunogenicity, Public Health, Environmental and Occupational Health, COVID-19, Juvenile idiopathic arthritis, Arthritis, Juvenile, 3. Good health, Infectious Diseases, Molecular Medicine, Cohort study, Vaccine effectivity
Popis: To evaluate immunogenicity, effectiveness and safety of COVID-19 vaccination in patients with pediatric autoimmune inflammatory rheumatic disease (pedAIIRD).A prospective cohort study was performed at the pediatric rheumatology department of the Wilhelmina Children's Hospital in Utrecht, the Netherlands. Vaccination dates, COVID-19 cases and vaccine-related adverse events (AEs) were registered for all pedAIIRD patients during regular clinic visits from March 2021 - August 2022. SARS-CoV-2 IgG antibody levels and T-cell responses were measured from serum samples after vaccination, and clinical and drug therapy data were collected from electronic medical records. Rate of COVID-19 disease was compared between vaccinated and unvaccinated patients in a time-varying Cox regression analysis.A total of 157 patients were included in this study and 88 % had juvenile idiopathic arthritis (JIA). One hundred thirty-seven patients were fully vaccinated, of which 47 % used biological agents at the time of vaccination, and 20 patients were unvaccinated. Geometric mean concentrations (GMCs) of post-vaccine antibody levels against SARS-CoV-2 were above the threshold for positivity in patients who did and did not use biological agents at the time of vaccination, although biological users demonstrated significantly lower antibody levels (adjusted GMC ratio: 0.38, 95 % CI: 0.21 - 0.70). T-cell responses were adequate in all but two patients (9 %). The adjusted rate of reported COVID-19 was significantly lower for fully vaccinated patients compared to non-vaccinated patients (HR: 0.53, 95 % CI: 0.29 - 0.97). JIA disease activity scores were not significantly different after vaccination, and no serious AEs were reported.COVID-19 mRNA vaccines were immunogenic (both cellular and humoral), effective and safe in a large cohort of pedAIIRD patients despite their use of immunosuppressive medication.
Druh dokumentu: Article
Popis súboru: application/pdf
Jazyk: English
ISSN: 0264-410X
DOI: 10.1016/j.vaccine.2024.01.047
Prístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/38262809
https://dspace.library.uu.nl/handle/1874/451164
https://hdl.handle.net/10029/627263
Rights: CC BY
Prístupové číslo: edsair.doi.dedup.....bf9935803b996feca22c308af65f7e44
Databáza: OpenAIRE
Popis
Abstrakt:To evaluate immunogenicity, effectiveness and safety of COVID-19 vaccination in patients with pediatric autoimmune inflammatory rheumatic disease (pedAIIRD).A prospective cohort study was performed at the pediatric rheumatology department of the Wilhelmina Children's Hospital in Utrecht, the Netherlands. Vaccination dates, COVID-19 cases and vaccine-related adverse events (AEs) were registered for all pedAIIRD patients during regular clinic visits from March 2021 - August 2022. SARS-CoV-2 IgG antibody levels and T-cell responses were measured from serum samples after vaccination, and clinical and drug therapy data were collected from electronic medical records. Rate of COVID-19 disease was compared between vaccinated and unvaccinated patients in a time-varying Cox regression analysis.A total of 157 patients were included in this study and 88 % had juvenile idiopathic arthritis (JIA). One hundred thirty-seven patients were fully vaccinated, of which 47 % used biological agents at the time of vaccination, and 20 patients were unvaccinated. Geometric mean concentrations (GMCs) of post-vaccine antibody levels against SARS-CoV-2 were above the threshold for positivity in patients who did and did not use biological agents at the time of vaccination, although biological users demonstrated significantly lower antibody levels (adjusted GMC ratio: 0.38, 95 % CI: 0.21 - 0.70). T-cell responses were adequate in all but two patients (9 %). The adjusted rate of reported COVID-19 was significantly lower for fully vaccinated patients compared to non-vaccinated patients (HR: 0.53, 95 % CI: 0.29 - 0.97). JIA disease activity scores were not significantly different after vaccination, and no serious AEs were reported.COVID-19 mRNA vaccines were immunogenic (both cellular and humoral), effective and safe in a large cohort of pedAIIRD patients despite their use of immunosuppressive medication.
ISSN:0264410X
DOI:10.1016/j.vaccine.2024.01.047