A recent study done in the US shows that mRNA vaccine antibody response is impaired in those with chronic medical conditions. (Note: In the US it was Pfizer & Moderna mRNA vaccines used and hence the study is on those) The study was done in a pulmonary specialty outpatient clinic, Colorado.
This raises concerns that SARS-CoV-2 vaccination may not result in protective immunity in all populations and may have implications for some as masking and distancing strategies are abandoned.
In this study with 226 outpatients, 79% of the patients had chronic pulmonary diseases and 26% of them had no antibody detected over 14 days after the second dose of mRNA vaccines.
Also they found that interstitial lung disease (ILD) is an independent risk factor for reduced antibody response. Additionally CHF (Congstive Heart Failure) and some biologic/JAK inhibitor use (particularly rituximab) are independent risk factors for decreased antibody response. The effect of rituximab use is consistent with a previous study too.
BUT no significant effects on antibody response were observed with other medications including systemic/inhaled corticosteroids, and other immunosuppressants including methotrexate, mycophenolate mofetil, azathioprine, leflunomide, cyclosporine, tacrolimus, mycophenolic acid, sirolimus, and everolimus.
While the exact antibody level that confers protection against SARS-CoV-2 is unknown and there are other markers of B cell and T cell-mediated protection.
They report that further studies of immunologic response (including neutralizing antibodies and other markers of B cell and T cell response) and protection in vulnerable populations are needed to define ongoing COVID-19 risk and inform recommendations regarding additional vaccination and behaviors to mitigate risk.
Multivariate logistic regression of the association between antibody response and clinical characteristics. OR: odds ratio; CI: confidence interval; COPD: chronic obstructive pulmonary disease; ACE/ARB: angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers. *Biologics: Anti- IL-5, -IL-6, -IL-12/23, -IL-17, -IgE, -CD20, and -TNF-α inhibitors †BNT162b2 (Pfizer-BioNTech) compared to mRNA-1273 (Moderna) ‡Days after 2nd vaccine dose.
This raises concerns that SARS-CoV-2 vaccination may not result in protective immunity in all populations and may have implications for some as masking and distancing strategies are abandoned.
In this study with 226 outpatients, 79% of the patients had chronic pulmonary diseases and 26% of them had no antibody detected over 14 days after the second dose of mRNA vaccines.
Also they found that interstitial lung disease (ILD) is an independent risk factor for reduced antibody response. Additionally CHF (Congstive Heart Failure) and some biologic/JAK inhibitor use (particularly rituximab) are independent risk factors for decreased antibody response. The effect of rituximab use is consistent with a previous study too.
BUT no significant effects on antibody response were observed with other medications including systemic/inhaled corticosteroids, and other immunosuppressants including methotrexate, mycophenolate mofetil, azathioprine, leflunomide, cyclosporine, tacrolimus, mycophenolic acid, sirolimus, and everolimus.
While the exact antibody level that confers protection against SARS-CoV-2 is unknown and there are other markers of B cell and T cell-mediated protection.
They report that further studies of immunologic response (including neutralizing antibodies and other markers of B cell and T cell response) and protection in vulnerable populations are needed to define ongoing COVID-19 risk and inform recommendations regarding additional vaccination and behaviors to mitigate risk.
Multivariate logistic regression of the association between antibody response and clinical characteristics. OR: odds ratio; CI: confidence interval; COPD: chronic obstructive pulmonary disease; ACE/ARB: angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers. *Biologics: Anti- IL-5, -IL-6, -IL-12/23, -IL-17, -IgE, -CD20, and -TNF-α inhibitors †BNT162b2 (Pfizer-BioNTech) compared to mRNA-1273 (Moderna) ‡Days after 2nd vaccine dose.
