COVID-19 mRNA vaccine immunogenicity decay and breakthrough illness in adolescents and young adults with childhood-onset rheumatic diseases
Authors' conclusion
Over half of AYAs with cRDs had a significant drop in SARS-CoV-2 nAb at 6-month despite an initial robust humoral response. JIA and aTNF usage are predictors of a faster decay rate.
Study context
- Population
- And young adults (AYAs) with childhood-onset rheumatic diseases (cRDs) after two-dose COVID-19 mRNA vaccinationJIA 58%, SLE 18%
- Participants
- 169 participants
- Outcome
- Humoral immunogenicity (SARS-CoV-2 nAb, cPass assay; seroconversion ≥30% inhibition)
- Follow-up
- 6 months after second dose
Methodological detailsmonocentric, observational
- Monocentric
- Observational
Main finding
As reported in the abstract
SARS-CoV-2 nAb after second dose
Seroconverted after second dose
99%
Median neutralization antibody (nAb) titre after second dose, IU/ml (IQR 882.8-2541.9)
1779.8
Median nAb titre at 3 months, IU/ml (IQR 261.0-1514.9)
935.6
Median nAb titre at 6 months, IU/ml (IQR 163.5-1400.5)
683.2
Observational data: associations, not effects.
Further findings
Predictors of >50% drop of nAb titres at 6 months
| OR (95% CI) | P value | ||
|---|---|---|---|
| JIAIndependently associated | 10.1 (1.8–58.4) | P = 0.010 | |
| aTNF treatmentIndependently associated | 10.1 (1.5–70.0) | P = 0.019 | |
| 0.050.21520Odds ratio (log scale) |
Withholding MTX or MMF
- Did not affect vaccine response or decay rate
COVID-19 breakthrough infection
- Cases/1000 patient-months
- 18.2
- No clinical risk factors identified
Original publication
COVID-19 mRNA vaccine immunogenicity decay and breakthrough illness in adolescents and young adults with childhood-onset rheumatic diseases. Rheumatology (Oxford). Published 20 January 2023. doi:10.
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