COVID Vaccination Responses in IMID Patients

September 9, 2021

Today, the Research Institute of the McGill University Health Center announced a new study evaluating the impact of COVID-19 vaccines in participants living with immune-mediated inflammatory diseases (IMID). Common IMIDs include lupus, rheumatoid arthritis, Crohn’s disease, and Type 1 Diabetes. The study will include 2,500 patients with IMIDs, testing antibody levels up to 12 months after a full dose of the COVID-19 vaccine.

The efficacy and safety of COVID-19 vaccines in those with IMIDs has yet to be thoroughly studied, but merits specific investigation as this population often requires immunosuppressive drugs as part of treating their disease. These drugs have been known to inhibit a sufficient antibody response to vaccination.

One study conducted in Germany analyzed vaccine responses in untreated, conventionally treated, and anti-cytokine-treated patients with IMIDs. The most common autoimmune diseases included in the study were spondyloarthritis, rheumatoid arthritis, inflammatory bowel disease, and psoriasis. 42.9% of patients received biologic or targeted synthetic disease-modifying anti-rheumatic drugs, 23% were treated with conventional synthetic DMARDs, and 26.8% were not on any treatment.

181 of 182 control participants created anti-SARS-CoV-2 IgG antibodies. Of 84 patients with IMIDs, 76 developed neutralizing antibodies; 5 failed to respond to vaccination altogether. Of the eight who failed to develop neutralizing activity, three were taking Janus kinase inhibitors, two methotrexate, one was being treated with an interleukin-17 inhibitor, and two IMID patients were untreated. “Roughly 1 out of 10 patients with IMID fails to develop neutralizing antibodies after SARS-CoV-2 vaccination, while it is only 1 out of 100 in the controls.”

These results show that overall responses were delayed and reduced in IMID patients regardless of treatment method compared to controls. This may be due to the fact that “patients affected by immune-mediated inflammatory diseases (IMIDs) show aberrant immune responses, increased risk to infections and are exposed by drugs that interfere with immune pathways.”