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This study was funded by the Public Health Agency of Canada. Widdifield reports receiving support from the Arthritis Society Stars Career Development Award. Please see the survey for all other authors’ relevant financial information.
A two-dose vaccine course is “very 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 that evaluating the efficacy of COVID-19 vaccines in patients with immune-mediated inflammatory diseases was a priority as these patients were excluded from the initial clinical vaccine trials,” Jessica Widdifield, PhD, from the Sunnybrook Research Institute in Toronto, Healio said. “Studies have also shown that these patients have an increased risk of severe COVID-19 outcomes, and immunogenicity studies have shown lower humoral responses after COVID-19 vaccination in these patients compared to healthy controls, probably due to immunosuppression and altered immunity. . “
To investigate the effectiveness of mRNA COVID-19 vaccines in patients with immune-mediated inflammatory diseases, Widdifield and colleagues performed 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 acted as the embedded cohort, and vaccine status was compared between positive and negative test results.
Data from the tests were collected from the Ontario Laboratories Information System. Researchers did not include long-term caregivers because of their frequent test protocols and general fragility compared to the general population. In addition, for the sake of the study, serious outcomes were defined as hospitalizations 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 was retrieved from a centralized COVID-19 vaccine registry in Ontario.
During 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 researchers who have 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 effect was 89% (95% CI, 83-93). In patients with psoriasis the effect was 84% (95% CI, 81-86), and in patients with IBD the effect was 79% (95% CI, 74-82).
“The vaccine’s efficacy against infection peaked 31 to 60 days after the second dose (82% to 90%) and decreased with each additional month, but returned again on receipt of a third dose“These findings are crucial in helping rheumatologists encourage the continued uptake of COVID-19 vaccination among their patients,” said Widdifield.