Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.
Department of Medical Laboratory Sciences, Kashan Branch, Islamic Azad University, Kashan, Iran.
Immun Inflamm Dis. 2023 May;11(5):e858. doi: 10.1002/iid3.858.
Vaccination plays a fundamental role in mastering the COVID-19 pandemic and protecting vulnerable groups. Persons with autoimmune inflammatory rheumatic diseases (AIIRD) requiring immunosuppressive therapies are prioritized for vaccination. However, data concerning immunogenicity and safety of the BBIBP-CorV vaccine in immunosuppressed patients are not found. This study presents data on the efficacy and safety of the BBIBP-CorV vaccine in immunosuppressed patients compared to healthy controls.
Study population consisted of 100 healthy controls and 100 patients with AIIRD. Vaccination was performed according to national guidelines with the BBIBP-CorV vaccine. SARS-CoV-2 neutralizing antibody titers were quantified by enzyme-linked immunosorbent assay before initial vaccination and 1-3 months after secondary vaccination. Adverse events were assessed before study initiation and 7 days after the second dose. Disease activity was studied before entering the study and 3-8 weeks after the second dose.
Vaccination-induced positive immunogenic response rates and SARS-CoV-2 neutralizing antibody titers were significantly lower in the AIIRD patients than healthy subjects (p < .05). There are significant differences in neutralizing antibody titers among patients suffering from rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis, and ankylosing spondylitis (p < .01-.05). The rates of seropositive vaccine responses were similarly distributed across all diseases. Healthy and AIIRD individuals had a similar profile in adverse events. No significant difference was observed in SARS-CoV-2 antibody titers between subjects suffering from side effects and those who did not have. SARS-CoV-2 neutralizing antibody levels were significantly higher in subjects with a history of COVID-19 infection than seronegative individuals (p < .01-0.05). Seropositive subjects had a significant increase in the percentage of vaccine-related adverse events compared to seronegative persons (p < .05). Despite a minor change in the disease activity of patients with RA and SLE, disease activity indices were overall stable in the AIIRD patients.
These findings revealed that the BBIBP-CorV vaccine is effective in the development of neutralizing antibodies in immunosuppressed patients without considerable reactogenicity or induction of disease flares.
疫苗接种在控制 COVID-19 大流行和保护弱势群体方面发挥着重要作用。需要免疫抑制治疗的自身免疫性炎症性风湿病(AIIRD)患者被优先接种疫苗。然而,目前尚无关于 BBIBP-CorV 疫苗在免疫抑制患者中的免疫原性和安全性的数据。本研究介绍了 BBIBP-CorV 疫苗在免疫抑制患者中的疗效和安全性数据,并与健康对照组进行了比较。
研究人群由 100 名健康对照者和 100 名 AIIRD 患者组成。根据国家指南,用 BBIBP-CorV 疫苗进行接种。在初次接种前和二次接种后 1-3 个月,通过酶联免疫吸附试验定量检测 SARS-CoV-2 中和抗体滴度。在研究开始前和第二次接种后 7 天评估不良事件。在进入研究前和第二次接种后 3-8 周评估疾病活动度。
与健康受试者相比,AIIRD 患者的疫苗接种诱导的阳性免疫反应率和 SARS-CoV-2 中和抗体滴度显著降低(p < 0.05)。患有类风湿关节炎(RA)、系统性红斑狼疮(SLE)、系统性硬化症和强直性脊柱炎的患者之间的中和抗体滴度存在显著差异(p < 0.01-0.05)。在所有疾病中,血清阳性疫苗反应率的分布相似。健康人和 AIIRD 个体的不良事件谱相似。在有副作用的受试者和没有副作用的受试者之间,SARS-CoV-2 抗体滴度没有显著差异。有 COVID-19 感染史的受试者的 SARS-CoV-2 中和抗体水平明显高于血清阴性个体(p < 0.01-0.05)。血清阳性受试者的疫苗相关不良事件百分比与血清阴性者相比显著增加(p < 0.05)。尽管 RA 和 SLE 患者的疾病活动度略有变化,但 AIIRD 患者的疾病活动指数总体保持稳定。
这些发现表明,BBIBP-CorV 疫苗在不引起明显的反应原性或诱导疾病发作的情况下,在免疫抑制患者中能有效地产生中和抗体。