Humoral and cellular immune responses in persons with rheumatoid arthritis after a third dose of mRNA COVID-19 vaccine
Authors' conclusion
Virus-specific IgG levels significantly increased in RA subjects using DMARDs after completing the primary vaccine series, though fewer than two-thirds achieved a humoral response like healthy controls. Humoral and cellular changes were not correlated.
Study context
- Population
- Rheumatoid arthritis (RA) patients who received 2 doses of mRNA COVID-19 vaccine, enrolled in 2021 before a 3rd dose (mean age 63 years; 88% female)60 RA subjects
- Participants
- 60 vs 50
- Exposure
- Immune responses before vs 4 weeks after a 3rd dose of mRNA COVID-19 vaccine in RA; held vs continued disease-modifying anti-rheumatic drugs (DMARDs); healthy controls as reference
- RAn = 60
- Healthy controlsn = 50reference
- Outcome
- Humoral (anti-S and anti-RBD IgG) and cell-mediated (activated T cells) immune responses after a 3rd dose of mRNA COVID vaccine
- Follow-up
- 4 weeks after the 3rd dose
Main finding
As reported in the abstract
Normal humoral response (ELISA within 1 SD of healthy control mean) · week 4
Normal anti-S response in RA
43%
Normal anti-RBD response in RA
62%
Observational data: associations, not effects.
Further findings
Antibody levels by holding DMARDs
- No differences in antibody levels based on holding DMARDs
- 57% held at least 1 DMARD around the 3rd dose
Median frequency of activated CD4 T cells
- Significantly greater post- vs pre-3rd dose
Correlation of antibody changes with change in activated CD4 T cells
- Changes in antibody levels did not correlate with change in activated CD4 T cells
Original publication
Humoral and cellular immune responses in persons with rheumatoid arthritis after a third dose of mRNA COVID-19 vaccine. Semin Arthritis Rheum. Published 10 February 2023. doi:10.
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