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Ammitzbøll C, Thomsen MK, Andersen JB, Bartels LE, Hermansen MLF, Johannsen AD, Mistegaard CE, Mikkelsen S, Vils SR, Erikstrup C, Hauge EM, Troldborg A. COVID-19 Vaccination in Patients with Rheumatic Diseases Leads to a High Seroconversion Rate and Reduced Self-Imposed Isolation and Shielding Behavior. Mod Rheumatol 2022:6647614. [PMID: 35860843 PMCID: PMC9384499 DOI: 10.1093/mr/roac069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/03/2022] [Accepted: 07/20/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION We investigated the effect of a two-dose mRNA vaccine on antibody levels against SARS-CoV-2 and patient behavior and shielding concerning fear of COVID-19 in patients with systemic lupus erythematosus or rheumatoid arthritis. METHODS Three-hundred-and-three patients and 44 blood donors were included. All patients received two doses of an mRNA vaccine and had total antibodies against SARS-CoV-2 measured before vaccination and 2 and 9 weeks after the second vaccination. Further, patients answered an electronic questionnaire before and after vaccination concerning behavior, anxiety, and symptoms of depression (PHQ-9). RESULTS Significantly fewer patients (90%) had measurable antibodies against SARS-CoV-2 compared to blood donors (100%) after the second vaccination (p<0.001). Treatment with rituximab was the strongest predictor of an unfavorable vaccine response, as only 27% had measurable antibodies. Nearly all patients (97%) not treated with rituximab experienced seroconversion. Prednisone and methotrexate had a negative effect on seroconversion, but no effect of age or comorbidity was observed. Patients experienced significant improvement after vaccination in 10 out of 12 questions regarding behavior and fear of COVID-19, while no change in PHQ-9 or anxiety was observed. CONCLUSION We find a very high seroconversion rate among rheumatic patients, and reduced self-imposed isolation and shielding after COVID-19 vaccination.
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Affiliation(s)
- Christian Ammitzbøll
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Marianne Kragh Thomsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Lars Erik Bartels
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Clara Elbæk Mistegaard
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Signe Risbøl Vils
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Christian Erikstrup
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Ellen-Margrethe Hauge
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Anne Troldborg
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
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El Kibbi L, Metawee M, Hmamouchi I, Abdulateef N, Halabi H, Eissa M, El Rakawi M, Masri B, Abutiban F, Hamdi W, Adnan A, Najm AA, Felten R, Arnaud L, Ziadé N. Acceptability of the COVID-19 vaccine among patients with chronic rheumatic diseases and health-care professionals: a cross-sectional study in 19 Arab countries. THE LANCET. RHEUMATOLOGY 2022; 4:e160-e163. [PMID: 34927089 PMCID: PMC8668191 DOI: 10.1016/s2665-9913(21)00368-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lina El Kibbi
- Division of Rheumatology, Specialized Medical Center, Riyadh, Saudi Arabia
| | - Mona Metawee
- Department of Internal Medicine, Specialized Medical Center, Riyadh, Saudi Arabia
| | - Ihsane Hmamouchi
- Rheumatology Unit, Temara Hospital, Laboratory of Biostatistics, Clinical Research and Epidemiology, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Nizar Abdulateef
- Rheumatology Unit, Department of Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Hussein Halabi
- Rheumatology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mervat Eissa
- Rheumatology Department, Cairo University, Cairo, Egypt
| | - Manal El Rakawi
- Rheumatology Department, Douera Hospital, Faculty of Medicine, Saad Dahlab, Blida, Algeria
| | - Basel Masri
- Rheumatology Division, Internal Medicine Department, Jordan Hospital, Amman, Jordan
| | - Fatemah Abutiban
- Rheumatology Unit, Department of Medicine, Jaber Alahmed Alsabah Hospital, Kuwait City, Kuwait
| | - Wafa Hamdi
- Rheumatology Department, Kassab Institute of Orthopedics, UR17SP04, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Asal Adnan
- Rheumatology Unit, Department of Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Antonella Abi Najm
- Medicine Department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Renaud Felten
- Rheumatology Department, Centre National de Référence des Maladies Auto-immunes Systémiques Rares Est Sud-Ouest RESO, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Laurent Arnaud
- Rheumatology Department, Centre National de Référence des Maladies Auto-immunes Systémiques Rares Est Sud-Ouest RESO, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Nelly Ziadé
- Rheumatology Department, Saint-Joseph University and Hotel-Dieu de France Hospital, Beirut 1100, Lebanon
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Local and systemic reactogenicity of COVID-19 vaccine BNT162b2 in patients with systemic lupus erythematosus and rheumatoid arthritis. Rheumatol Int 2021; 41:1925-1931. [PMID: 34476603 PMCID: PMC8412379 DOI: 10.1007/s00296-021-04972-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/10/2021] [Indexed: 02/02/2023]
Abstract
Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were launched in December 2020. Vaccination of patients with rheumatic diseases is recommended, as they are considered at higher risk of severe COVID-19 than the general population. Patients with rheumatic disease have largely been excluded from vaccine phase 3 trials. This study explores the safety and reactogenicity of BNT162b2 among patients with rheumatic diseases. Patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), median age 58.8 years, 285 subjects in total, were vaccinated twice with the BNT162b2 (Pfizer/BioNTech). Questionnaires on reactogenicity matching the original phase 3 study were answered seven days after completed vaccination. The majority of SLE and RA patients experienced either local (78.0%) or systemic reactions (80.1%). Only 1.8% experienced a grade-4 reaction. Compared to the original study, we found more frequent fatigue [Odds ratio (OR) 2.2 (1.7–2.8)], headache [OR 1.7 (1.3–2.2)], muscle pain [OR 1.8 (1.4–2.3)], and joint pain [OR 2.3 (1.7–3.0)] in patients. In contrast, the use of antipyretics was less frequent [OR 0.5 (0.3–0.6)]. Patients with SLE and RA experience reactogenicity to the Pfizer-BioNTech BNT162b2 COVID-19 vaccine. Reactogenicity was more frequent in patients, however, not more severe compared with healthy controls.
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