COVID-19 mRNA vaccines ‘highly effective’ in immune-mediated inflammatory disease
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COVID-19 mRNA vaccines are “highly effective” against COVID-19 infection and severe outcomes in patients with rheumatoid arthritis, ankylosing spondylitis, psoriasis and inflammatory bowel disease, according to data.
“We felt it was a priority to evaluate the effectiveness of COVID-19 vaccines in patients with immune-mediated inflammatory diseases, as these patients were excluded from the initial vaccine clinical trials,” Jessica Widdifield, PhD, of the Sunnybrook Research Institute, in Toronto, told Healio. “Studies have also shown that these patients are at an increased risk of severe COVID-19 outcomes, and immunogenicity studies have showed lower humoral responses after COVID-19 vaccination in these patients compared to healthy controls, likely due to immunosuppression and altered immunity.”
To examine the efficacy of the mRNA COVID-19 vaccines in patients with immune-mediated inflammatory diseases, Widdifield and colleagues conducted a population-based analysis across four disease cohorts from March 1, 2021, to November 22, 2021. These cohorts included RA, AS, psoriasis and IBD. In each group, patients tested for SARS-CoV-2 served as the nested cohort, and vaccine status was compared between positive and negative test results.
Data from the tests were gathered from the Ontario Laboratories Information System. Researchers did not include long-term care residents due to their frequent testing protocols and overall frailness, compared with the general population. Additionally, severe outcomes, for the sake of the investigation, were defined as hospital admissions or deaths attributed to COVID-19. The number of vaccine doses, ranging from one to three, was assessed at the time of testing. Vaccination status and formulation were obtained from a centralized COVID-19 vaccine registry in Ontario.
Throughout the study period, the researchers identified 2,127 positive COVID-19 cases among 36,145 patients with RA (5.9%), 476 positive cases among 7,863 patients with AS (6.1%), 3,089 positive cases among 47,199 patients with psoriasis (6.5%) and 1,702 positive cases among 31,311 patients with IBD (5.4%).
According to the researchers, who published their findings in The Lancet Rheumatology, the adjusted vaccine efficacy of two doses in patients with RA was 83% (95% CI, 80-86). In patients with AS, the adjusted efficacy was 89% (95% CI, 83-93). In patients with psoriasis, the efficacy was 84% (95% CI, 81-86), and for patients with IBD, the efficacy was 79% (95% CI, 74-82).
“Vaccine effectiveness against infection peaked 31 to 60 days after the second dose (82% to 90%) and waned with each additional month, but rebounded again upon receipt of a third dose,” Widdifield said. “These findings are crucial to help rheumatologists encourage continued uptake of COVID-19 vaccination amongst their patients.”
Editor’s note: This story’s lede and headline was altered to more closely align with data on May 27, 2022.
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