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Cited by 654SARS-CoV-2 and COVID-19 ResearchRheumatoid Arthritis Research and TherapiesSystemic Lupus Erythematosus Research

The DOI matches its Crossref record; its reference list is not available; none of the 30 sources its claims cite is checked for support yet.

Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in adult patients with autoimmune inflammatory rheumatic diseases and in the general population: a multicentre study

Open access
Furer, Victoria, Eviatar, Tali, Zisman, Devy, Peleg, Hagit, Paran, Daphna, Levartovsky, David, Zisapel, Michael, Elalouf, Ofir, Kaufman, Ilana, Meidan, Roni, Broyde, Adi, Polachek, Ari, Wollman, Jonathan, Litinsky, Ira, Meridor, Katya, Nochomovitz, Hila, Silberman, Adi, Rosenberg, Dana, Feld, Joy, Haddad, Amir, Gazzit, Tal, Elias, Muna, Higazi, Nizar, Kharouf, Fadi, Shefer, Gabi, Sharon, Orly, Pel, Sara, Nevo, Sharon, Elkayam, Ori·2021·Annals of the Rheumatic Diseases
DOI 10.1136/annrheumdis-2021-220647
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Abstract

Introduction Vaccination represents a cornerstone in mastering the COVID-19 pandemic. Data on immunogenicity and safety of messenger RNA (mRNA) vaccines in patients with autoimmune inflammatory rheumatic diseases (AIIRD) are limited. Methods A multicentre observational study evaluated the immunogenicity and safety of the two-dose regimen BNT162b2 mRNA vaccine in adult patients with AIIRD (n=686) compared with the general population (n=121). Serum IgG antibody levels against SARS-CoV-2 spike S1/S2 proteins were measured 2-6 weeks after the second vaccine dose. Seropositivity was defined as IgG ≥15 binding antibody units (BAU)/mL. Vaccination efficacy, safety, and disease activity were assessed within 6 weeks after the second vaccine dose. Results Following vaccination, the seropositivity rate and S1/S2 IgG levels were significantly lower among patients with AIIRD versus controls (86% (n=590) vs 100%, p<0.0001 and 132.9±91.7 vs 218.6±82.06 BAU/mL, p<0.0001, respectively). Risk factors for reduced immunogenicity included older age and treatment with glucocorticoids, rituximab, mycophenolate mofetil (MMF), and abatacept. Rituximab was the main cause of a seronegative response (39% seropositivity). There were no postvaccination symptomatic cases of COVID-19 among patients with AIIRD and one mild case in the control group. Major adverse events in patients with AIIRD included death (n=2) several weeks after the second vaccine dose, non-disseminated herpes zoster (n=6), uveitis (n=2), and pericarditis (n=1). Postvaccination disease activity remained stable in the majority of patients. Conclusion mRNA BNTb262 vaccine was immunogenic in the majority of patients with AIIRD, with an acceptable safety profile. Treatment with glucocorticoids, rituximab, MMF, and abatacept was associated with a significantly reduced BNT162b2-induced immunogenicity.

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Crossref · 10.1136/annrheumdis-2021-220647

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  • Findingown data

    Combining TNFi with MTX lowered seropositivity to 93% (p=0.04).

    “The combination of TNFi with MTX reduced the rate of seropositivity to 93% (p=0.04).”
    Quote in the paperSubstantial claim
  • Findingown data

    JAK inhibitors showed a minor, non-significant negative effect on BNTb262-induced antibody production.

    “JAKi, representing a smaller fraction of treatments in our study, demonstrated a minor non-significantly negative effect on the production of BNTb262-induced antibodies.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Postvaccination disease activity indices remained stable in RA, PsA, axSpA, and SLE patients.

    “In patients with RA, PsA, axSpA and SLE, the postvaccination indices of disease activity remained stable (figure 2).”
    • Also stated in: § Abstract · plain
      “Postvaccination disease activity remained stable in the majority of patients.”
    Quote in the paperSubstantial claim
  • Findingown data

    Glucocorticoid, MMF, and abatacept use was significantly associated with absence of humoral response.

    “GC, MMF, and abatacept was significantly associated with a lack of humoral response.”
    Quote in the paperSubstantial claim
  • Findingown data

    The lowest seropositivity rate, below 40%, occurred in AAV and IIM patients.

    “In patients with RA, the seropositive rate was 82.1%, whereas the lowest seropositive rate (<40%) was observed in patients with AAV and IIM (table 3).”
    Quote in the paperNot a substantial claim
  • It may state two separate claims as one. 26
  • Probably not a substantial claim. 16

  • It may state two separate claims as one.

    Findingown data

    Anti-CD20 therapies, mainly rituximab, significantly reduced vaccine-induced humoral response, with seropositivity of 41.3% as monotherapy and 36% with MTX.

    “Treatment with anti-CD20 therapies, mainly represented by rituximab in this study, significantly reduced vaccineinduced humoral response, with seropositivity of 41.3% when administered as monotherapy and 36% when administered in combination with MTX.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    Adverse events of special interest in AIIRD included uveitis (n=2), herpes labialis (n=1), pericarditis (n=1), and non-disseminated herpes zoster in five patients after dose one and one after dose two.

    “Adverse events of special interest in patients with AIIRD included uveitis (n=2), herpes labialis (n=1), pericarditis (n=1), and non-disseminated herpes zoster (HZ) 15 in five patients after the first vaccine dose and in one patient after the second vaccine dose.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    In this study, abatacept treatment lowered the humoral response to vaccination, with seropositivity of 71% as monotherapy and 40% when combined with MTX.

    “Treatment with abatacept reduced vaccine-induced humoral response, with a seropositive rate of 71% as monotherapy, reduced to 40% when combined with MTX.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    In univariate logistic regression, age over 65, RA, IIM, or AAV diagnosis, and treatment with GC, MMF, anti-CD20, or abatacept were associated with lack of humoral response.

    “In the univariate logistic regression model (table 5), age >65 years,diagnosis of RA, IIM, and AAV and treatment with GC, MMF, and anti-CD20, and abatacept were associated with a lack of humoral response to vaccination.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    No symptomatic COVID-19 occurred among AIIRD patients during follow-up, while one control developed mild COVID-19 after the second dose.

    “There were no COVID-19 symptomatic disease among AIIRD patients during the study follow-up, whereas one subject in the control group was diagnosed with mild COVID-19 after the second vaccine dose.”
    • Also stated in: § Abstract · plain
      “There were no postvaccination symptomatic cases of COVID-19 among patients with AIIRD and one mild case in the control group.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The methods used to ascertain COVID-19 (participant questioning and medical file review) detected all symptomatic infections during follow-up.

  • It may state two separate claims as one.

    Findingown data

    Seropositivity was under 20% when vaccination occurred within 6 months after rituximab, rising to about 50% at 1 year after rituximab.

    “The seropositivity rate in patients vaccinated within 6 months after rituximab treatment was below 20% but increased to about 50% in patients vaccinated 1 year after rituximab treatment.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    MTX as monotherapy or in combination was associated with significantly reduced seropositivity (92% and 84%, respectively), though less than anti-CD20, MMF, or abatacept.

    “Seropositivity rate in patients treated with MTX monotherapy and in combination with other treatments was significantly reduced (92% and 84%, respectively), although at a lesser magnitude than with anti-CD20, MMF, and abatacept treatments.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    In this study, MMF treatment reduced humoral response, with a seropositivity rate of 64% among 28 patients.

    “Treatment with MMF reduced humoral response to a seropositivity rate of 64% in 28 patients.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    Anti-CD20 therapy markedly reduced vaccine immunogenicity, with the lowest seropositivity rate at 39%.

    “Anti-CD20 significantly impaired vaccine's immunogenicity, with the lowest seropositivity rate of 39%.”
    • Also stated in: § Abstract · plain
      “Rituximab was the main cause of a seronegative response (39% seropositivity).”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    After two BNT162b2 doses, the seropositivity rate was 86% in AIIRD patients versus 100% in controls, a significant difference (p<0.0001).

    “Following vaccination, the seropositivity rate and S1/S2 IgG levels were significantly lower among patients with AIIRD versus controls (86% (n=590) vs 100%, p<0.0001 and 132.9±91.7 vs 218.6±82.06BAU/mL, p<0.0001, respectively).”
    • Also stated in: § Immunogenicity of the BNT162b2 vaccine · plain
      “The seropositivity rate was 86% (n=590) in patients with AIIRD compared with 100% in controls (p<0.0001).”
    • Also stated in: § DISCUSSION · plain
      “with a seropositivity rate of 86% vs 100%, respectively.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The control group, composed mainly of healthcare personnel, is representative of the general population for assessing vaccine immunogenicity.

  • It may state two separate claims as one.

    Findingown data

    In this study, the BNT162b2 vaccine showed a good safety profile, with most adverse events being transient and mild, and overall good tolerance in adult AIIRD patients.

    “Regarding the safety of vaccination, our study provides a reassurance for a good safety profile of the vaccine, with most adverse events being transient and mild, consistent with two other studies.4 6”
    • Also stated in: § Epidemiology · boosted
      “Importantly, this study provides evidence of overall good tolerance of the BNT162b2 mRNA vaccine in adult patients with AIIRD.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    Among the herpes zoster patients, two were on JAK inhibitors and one was on rituximab plus MMF.

    “Two patients were treated with JAKi and one with rituximab and MMF, indicating a baseline increased risk for HZ, whereas three others had a low level of immunosuppression, calling for a potential causal link between the events.15”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    The AIIRD patients who developed herpes zoster were women aged 36-61 years (mean 49±11) with mild or stable rheumatic disease.

    “In this study, the affected patients were women within the age range of 36-61 years (mean, 49±11 years) with a mild or stable rheumatic disease.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Study design and conductown data

    The study population's mean GC dose was relatively low (6.2 mg/day), preventing analysis of a dose-dependent GC effect on vaccination response.

    “The mean GC dose in our study population was relatively low (6.2 mg/day), precluding analysis on the dose-dependent effect of GC on vaccination response.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    For rheumatoid arthritis patients on rituximab, the amount of B-cell recovery when vaccinated is linked to the strength of the humoral response, a pattern also seen with influenza vaccine.

    “The degree of B-cell recovery at the time of vaccination correlated with the extent of the humoral response to vaccination, as reported for influenza vaccine in patients with RA treated with rituximab.38”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Eisenberg, 2013, Rituximab-treated patients have a poor response to influenza vaccination, J Clin Immunol source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    In RA patients, tofacitinib produced a considerable influenza vaccine response but an impaired pneumococcal vaccine response, especially with MTX.

    “Limited data regarding other vaccines have shown that patients with RA treated with tofacitinib achieved a considerable response to influenza vaccine but an impaired response to a pneumococcal vaccine, especially when combined with MTX.32”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Winthrop, 2016, The effect of tofacitinib on pneumococcal and influenza vaccine responses in rheumatoid arthritis, Ann Rheum Dis source

  • Probably not a substantial claim.

    Study design and conductown data

    The final analysis included 686 AIIRD patients and 121 controls after excluding missing serology tests.

    “The final analysis included 686 patients with AIIRD and 121 controls due to missing serology tests (table 1; online supplemental figure S1).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    MTX may reduce humoral response to influenza and pneumococcal vaccines in RA patients.

    “MTX may reduce humoral response to influenza and pneumococcal vaccines in patients with RA .[17][18][19][20]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17][18][19][20]

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Prior findings on how abatacept affects other vaccination-related immunity are inconsistent.

    “Previous data regarding the impact of abatacept on other vaccination-related immunity are conflicting.29 42”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [29] Crnkic Kapetanovic, 2013, Rituximab and abatacept but not tocilizumab impair antibody response to pneumococcal conjugate vaccine in patients with rheumatoid arthritis, Arthritis Res Ther source
    • cites [42] Alten, 2016, Antibody response to pneumococcal and influenza vaccination in patients with rheumatoid arthritis receiving abatacept, BMC Musculoskelet Disord source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Study design and conductnone given

    Confidence intervals were not adjusted for multiplicity, and inferences may not be reproducible.

    “The widths of the intervals have not been adjusted for multiplicity, and the inferences drawn from inferences may not be reproducible.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Study design and conductcitation

    The LIAISON assay has clinical sensitivity and specificity above 98%.

    “This Food and Drug Administration-authorised assay has a clinical sensitivity and specificity above 98%.14”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Criscuolo, 2021, Weak correlation between antibody titers and neutralizing activity in sera from SARS-CoV-2 infected subjects, J Med Virol source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    A prednisone dose of at least 10 mg/day was associated with reduced humoral response to pneumococcal vaccine in patients with inflammatory diseases.

    “A dose of ≥10 mg/day was associated with a reduced vaccine-induced humoral response to pneumococcal vaccine in patients with various inflammatory diseases.16”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Fischer, 2015, Pneumococcal polysaccharide vaccination in adults undergoing immunosuppressive treatment for inflammatory diseases–a longitudinal study, Arthritis Res Ther source

  • It may state two separate claims as one.

    Interpretationown data

    The BNT162b2 vaccine was immunogenic in most AIIRD patients and had an acceptable safety profile.

    “mRNA BNTb262 vaccine was immunogenic in the majority of patients with AIIRD, with an acceptable safety profile.”
    • Also stated in: § DISCUSSION · boosted
      “demonstrating that BNT162b2 mRNA vaccine was immunogenic in the majority of patients with AIIRD compared with controls”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The control group, composed mainly of healthcare personnel, is representative of the general population for assessing vaccine immunogenicity.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Stopping MTX for 2 weeks after influenza vaccination improved immunogenicity in RA patients.

    “Temporary discontinuation of MTX for 2 weeks after vaccination improved the immunogenicity of influenza vaccination in patients with RA.21 22”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [21] Park, 2017, Effect of methotrexate discontinuation on efficacy of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomised clinical trial, Ann Rheum Dis source
    • cites [22] Park, 2018, Impact of temporary methotrexate discontinuation for 2 weeks on immunogenicity of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomised clinical trial, Ann Rheum Dis source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductown data

    AIIRD patients were significantly older than controls (mean 56.76 vs 50.76 years, p<0.0001).

    “Patients with AIIRD included a subgroup of elderly patients aged ≥65 years (32.8%,n=225) and were significantly older than controls, mean age±SD 56.76±14.88vs 50.76±14.68,respectively; p<0.0001.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    BNT162b2 has shown high efficacy and an acceptable safety profile.

    “BNT162b2, a messenger RNA (mRNA)-based vaccine, has demonstrated a high efficacy rate with an acceptable safety profile. 1 2”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] Polack, 2020, Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine, N Engl J Med source
    • cites [2] Dagan, 2021, BNT162b2 mRNA Covid-19 vaccine in a nationwide mass vaccination setting, N Engl J Med source

  • It may state two separate claims as one.

    Premisecitation

    Prior data show anti-CD20 therapy negatively impacts humoral response to various vaccines, though seroprotection can still occur in rituximab- and ocrelizumab-treated patients.

    “Our findings are in line with the previously published data regarding the negative impact of anti-CD20 therapy on the humoral response to various vaccines, although seroprotection could be still achieved after vaccination in rituximab-treated 20 26 34-36 and ocrelizumab-treated 37 patients.”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [20] Hua, 2014, Effect of methotrexate, anti-tumor necrosis factor α, and rituximab on the immune response to influenza and pneumococcal vaccines in patients with rheumatoid arthritis: a systematic review and meta-analysis, Arthritis Care Res source
    • cites [26] Rondaan, 2019, Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations, RMD Open source
    • cites [34] Bingham, 2010, Immunization responses in rheumatoid arthritis patients treated with rituximab: results from a controlled clinical trial, Arthritis Rheum source
    • cites [35] van Assen, 2010, Humoral responses after influenza vaccination are severely reduced in patients with rheumatoid arthritis treated with rituximab, Arthritis Rheum source
    • cites [36] Westra, 2014, Rituximab impairs immunoglobulin (Ig)M and IgG (subclass) responses after influenza vaccination in rheumatoid arthritis patients, Clin Exp Immunol source

  • It may state two separate claims as one.

    Study design and conductown data

    Immunomodulatory drug changes occurred in 3% of patients after the first dose and 4.04% after the second dose.

    “During the study period, changes in immunomodulatory drugs after the first vaccine dose were reported in 3% (n=20) of patients and after the second vaccine dose in 4.04% (n=27).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may be too vague to check against evidence.

    Interpretationown data

    Therefore, the timing of vaccination is critical in these cases.

    “Therefore, timing of vaccination has a critical role in these cases.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationreasoning

    A lack of humoral response does not rule out T-cell-mediated vaccine-induced immunity.

    “Yet, the absence of a humoral response does not preclude T-cell-mediated vaccine-induced immunity”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    Case reports have recently described herpes zoster after BNT162b2 mRNA vaccination in individuals without immunosuppression and in one AAV patient in remission.

    “Case reports on HZ following the BNT162b2 mRNA vaccination in subjects without immunosuppressive treatment 45 46 and in one patient with AAV in remission 47 were recently published.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [45] Rodríguez-Jiménez, 2021, Varicella-Zoster virus reactivation after SARS-CoV-2 BNT162b2 mRNA vaccination: report of 5 cases, JAAD Case Rep source
    • cites [46] Bostan, 2021, Herpes zoster following inactivated COVID-19 vaccine: a coexistence or coincidence?, J Cosmet Dermatol source
    • cites [47] Eid, 2021, Herpes zoster emergence following mRNA COVID-19 vaccine, J Med Virol source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Study design and conductown data

    The study followed the Declaration of Helsinki and was approved by the ethics committees of the three participating medical centres.

    “The study was performed in accordance with the principles of the Declaration of Helsinki and approved by the research ethics committees of the three medical centres: TLV-1055-20, CMC-0238-20 and HMO-0025-21, respectively.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationown data

    Most immunosuppressive treatments, including csDMARDs, anticytokine biologics and JAK inhibitors, can be continued safely without significantly reducing vaccine-induced immunogenicity.

    “Most immunosuppressive treatments, including csDMARDs, anticytokine biologics and JAKi, can be safely continued without significantly attenuating vaccine-induced immunogenicity.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductown data

    Participants provided informed consent at recruitment.

    “The participants signed an informed consent on recruitment into the study.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Study design and conductown data

    The disease activity assessment was exploratory and used variable pre- and post-vaccination time frames.

    “Yet, this should be interpreted with a certain caution due to an exploratory analysis of disease activity assessment performed within a variable prevaccination and postvaccination time frame.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductown data

    Patients and controls were not matched by age.

    “The limitations of our study include a non-randomised design, a lack of matching between patients and controls by age, and the absence of long-term follow-up data.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductown data

    The study was non-randomised.

    “The limitations of our study include a non-randomised design, a lack of matching between patients and controls by age, and the absence of long-term follow-up data.”
    Quote in the paperNot a substantial claim
37 of 37

  • The authors state this as an assumption.

    Missing serology data are missing at random.

    “Missing data were assumed as missing at random.”

  • The paper relies on this without support.

    The control group, composed mainly of healthcare personnel, is representative of the general population for assessing vaccine immunogenicity.

    “The control group included a sample of the general population, consisting mainly of healthcare personnel.”

  • The paper relies on this without support.

    The methods used to ascertain COVID-19 (participant questioning and medical file review) detected all symptomatic infections during follow-up.

    “The participants were questioned whether they contracted COVID-19 infection, confirmed by PCR, following each vaccine dose.In addition, up to the data cut-off, the patient files were reviewed for evidence of COVID-19 infection.”

  • The paper relies on this without support.

    The mRNA vaccine clinical trials did not specifically capture herpes zoster occurrence.

    “As the occurrence of HZ was not specifically captured in the mRNA vaccine clinical trials, no data are available on the postvaccination HZ prevalence in the general population.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Regardless of the vaccine received, reductions in vaccine-elicited humoral immunity is likely to be clinically significant for persons with impaired immunity as a result of underlying disease, immunosuppressive drugs or older age.

    “Moreover, regardless of the vaccine received, reductions in vaccine-elicited humoral immunity is likely to be clinically significant for persons with impaired immunity as a result of underlying disease, immunosuppressive drugs or older age [241][242][243][244] .”

    From The biological and clinical significance of emerging SARS-CoV-2 variants (2021) · cites this paper as [242]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • RA JAK-inhibitor percentage does not match its count

    Minor

    For the 263 patients with RA, 46 JAK-inhibitor users represent 17.49%, rather than the reported 16.9%.

    Reported 16.9 · recomputed 17.490494

  • Overall JAK-inhibitor percentage does not match its count

    Minor

    The treatment table gives 49 JAK-inhibitor users among 686 patients, which is 7.14%, not 6.9%.

    Reported 6.9 · recomputed 7.142857

  • Two different mean glucocorticoid doses are reported

    Minor

    The results give a mean prednisone dose of 6.7 mg/day, while the discussion gives 6.2 mg/day for the study population.

  • Other-vasculitis seropositivity percentage is overstated

    Minor

    Nineteen seropositive patients out of 23 is 82.61%, rather than 86.6%. The regression table separately reports 82.61% for the same group.

    Reported 86.6 · recomputed 82.608696

  • Older-age subgroup counts cannot both be correct

    Minor

    The paper reports 225 patients aged at least 65, but the regression table lists 246 patients older than 65. The narrower, older-than-65 group cannot contain more patients.

  • JAK-inhibitor counts across diagnoses do not reach the reported total

    Minor

    The treatment table lists 46 JAK-inhibitor users with RA and two with PsA, with zero in every other diagnostic group. Those entries total 48, not the reported 49.

    Reported 49 · recomputed 48

  • Anti-CD20 monotherapy response is assigned the overall treatment rate

    Minor

    The discussion states 41.3% seropositivity for anti-CD20 monotherapy, but the treatment table reports 11 of 28 monotherapy patients seropositive, or about 39%. The 41.3% figure corresponds instead to the overall anti-CD20 group.

7 of 7

Citations

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References 52 · Cited by 654

Research works printed but not linked: 35

  1. Geisen, 2021, Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort, Ann Rheum Dis, 80, 1302, 10.1136/annrheumdis-2021-220272 · DOI
  2. Boyarsky, 2021, Antibody response to a single dose of SARS-CoV-2 mRNA vaccine in patients with rheumatic and musculoskeletal diseases, Ann Rheum Dis, 80, 1098, 10.1136/annrheumdis-2021-220289 · DOI
  3. Connolly, 2021, Safety of the first dose of mRNA SARS-CoV-2 vaccines in patients with rheumatic and musculoskeletal diseases, Ann Rheum Dis, 80, 1100, 10.1136/annrheumdis-2021-220231 · DOI
  4. Aletaha, 2010, Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against rheumatism collaborative initiative, Arthritis Rheum, 2010, 2569, 10.1002/art.27584 · DOI
  5. Taylor, 2006, Classification criteria for psoriatic arthritis: development of new criteria from a large international study, Arthritis Rheum, 54, 2665, 10.1002/art.21972 · DOI
  6. Rudwaleit, 2009, The development of assessment of spondyloarthritis International Society classification criteria for axial spondyloarthritis (Part II): validation and final selection, Ann Rheum Dis, 68, 777, 10.1136/ard.2009.108233 · DOI
  7. Hochberg, 1997, Updating the American College of rheumatology revised criteria for the classification of systemic lupus erythematosus, Arthritis Rheum, 40, 1725, 10.1002/art.1780400928 · DOI · Paper page
  8. Jennette, 1994, Nomenclature of systemic vasculitides. proposal of an international consensus conference, Arthritis Rheum, 37, 187, 10.1002/art.1780370206 · DOI
  9. Lundberg, 2017, European League against Rheumatism/American College of rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups, Ann Rheum Dis, 2017, 1955, 10.1136/annrheumdis-2017-211468 · DOI
  10. Criscuolo, 2021, Weak correlation between antibody titers and neutralizing activity in sera from SARS-CoV-2 infected subjects, J Med Virol, 93, 2160, 10.1002/jmv.26605 · DOI · Paper page
  11. Kapetanovic, 2006, Influence of methotrexate, TNF blockers and prednisolone on antibody responses to pneumococcal polysaccharide vaccine in patients with rheumatoid arthritis, Rheumatology, 45, 106, 10.1093/rheumatology/kei193 · DOI
  12. Kapetanovic, 2011, Antibody response is reduced following vaccination with 7-valent conjugate pneumococcal vaccine in adult methotrexate-treated patients with established arthritis, but not those treated with tumor necrosis factor inhibitors, Arthritis Rheum, 63, 3723, 10.1002/art.30580 · DOI
  13. Ribeiro, 2011, Reduced seroprotection after pandemic H1N1 influenza adjuvant-free vaccination in patients with rheumatoid arthritis: implications for clinical practice, Ann Rheum Dis, 70, 2144, 10.1136/ard.2011.152983 · DOI
  14. Park, 2017, Effect of methotrexate discontinuation on efficacy of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomised clinical trial, Ann Rheum Dis, 76, 1559, 10.1136/annrheumdis-2017-211128 · DOI · Paper page
  15. Park, 2018, Impact of temporary methotrexate discontinuation for 2 weeks on immunogenicity of seasonal influenza vaccination in patients with rheumatoid arthritis: a randomised clinical trial, Ann Rheum Dis, 77, 898, 10.1136/annrheumdis-2018-213222 · DOI · Paper page
  16. Fomin, 2006, Vaccination against influenza in rheumatoid arthritis: the effect of disease modifying drugs, including TNF alpha blockers, Ann Rheum Dis, 65, 191, 10.1136/ard.2005.036434 · DOI
  17. Elkayam, 2010, The effect of infliximab and timing of vaccination on the humoral response to influenza vaccination in patients with rheumatoid arthritis and ankylosing spondylitis, Semin Arthritis Rheum, 39, 442, 10.1016/j.semarthrit.2008.12.002 · DOI
  18. Kivitz, 2014, Vaccine responses in patients with rheumatoid arthritis treated with certolizumab pegol: results from a single-blind randomized phase IV trial, J Rheumatol, 41, 648, 10.3899/jrheum.130945 · DOI
  19. Rondaan, 2019, Efficacy, immunogenicity and safety of vaccination in adult patients with autoimmune inflammatory rheumatic diseases: a systematic literature review for the 2019 update of EULAR recommendations, RMD Open, 5, e001035, 10.1136/rmdopen-2019-001035 · DOI · Paper page
  20. Mori, 2012, Impact of tocilizumab therapy on antibody response to influenza vaccine in patients with rheumatoid arthritis, Ann Rheum Dis, 71, 2006, 10.1136/annrheumdis-2012-201950 · DOI
  21. Tsuru, 2014, Immune response to influenza vaccine and pneumococcal polysaccharide vaccine under IL-6 signal inhibition therapy with tocilizumab, Mod Rheumatol, 24, 511, 10.3109/14397595.2013.843743 · DOI
  22. Richi, 2019, Secukinumab does not impair the immunogenic response to the influenza vaccine in patients, RMD Open, 5, e001018, 10.1136/rmdopen-2019-001018 · DOI
  23. Furer, 2020, Immunogenicity and safety of vaccination against seasonal influenza vaccine in patients with psoriatic arthritis treated with secukinumab, Vaccine, 38, 847, 10.1016/j.vaccine.2019.10.081 · DOI
  24. Winthrop, 2016, The effect of tofacitinib on pneumococcal and influenza vaccine responses in rheumatoid arthritis, Ann Rheum Dis, 75, 687, 10.1136/annrheumdis-2014-207191 · DOI · Paper page
  25. Winthrop, 2019, Evaluation of pneumococcal and tetanus vaccine responses in patients with rheumatoid arthritis receiving baricitinib: results from a long-term extension trial substudy, Arthritis Res Ther, 21, 102, 10.1186/s13075-019-1883-1 · DOI · Paper page
  26. Westra, 2014, Rituximab impairs immunoglobulin (Ig)M and IgG (subclass) responses after influenza vaccination in rheumatoid arthritis patients, Clin Exp Immunol, 178, 40, 10.1111/cei.12390 · DOI · Paper page
  27. Bar-Or, 2020, Effect of ocrelizumab on vaccine responses in patients with multiple sclerosis: the VELOCE study, Neurology, 95, e1999, 10.1212/WNL.0000000000010380 · DOI
  28. Spiera, 2021, Rituximab, but not other antirheumatic therapies, is associated with impaired serological response to SARS- CoV-2 vaccination in patients with rheumatic diseases, Ann Rheum Dis, 80, 1352, 10.1136/annrheumdis-2021-220604 · DOI · Paper page
  29. Grifoni, 2020, Targets of T cell responses to SARS-CoV-2 coronavirus in humans with COVID-19 disease and unexposed individuals, Cell, 181, 1489, 10.1016/j.cell.2020.05.015 · DOI · Paper page
  30. Jeyanathan, 2020, Immunological considerations for COVID-19 vaccine strategies, Nat Rev Immunol, 20, 615, 10.1038/s41577-020-00434-6 · DOI · Paper page
  31. Grupper, 2021, Reduced humoral response to mRNA SARS-CoV-2 BNT162b2 vaccine in kidney transplant recipients without prior exposure to the virus, Am J Transplant
  32. Peled, 2021, BNT162b2 vaccination in heart transplant recipients: clinical experience and antibody response, J Heart Lung Transplant, 10.1016/j.healun.2021.04.003 · DOI · Paper page
  33. Rodríguez-Jiménez, 2021, Varicella-Zoster virus reactivation after SARS-CoV-2 BNT162b2 mRNA vaccination: report of 5 cases, JAAD Case Rep, 12, 58, 10.1016/j.jdcr.2021.04.014 · DOI · Paper page
  34. Bostan, 2021, Herpes zoster following inactivated COVID-19 vaccine: a coexistence or coincidence?, J Cosmet Dermatol, 20, 1566, 10.1111/jocd.14035 · DOI · Paper page
  35. Eid, 2021, Herpes zoster emergence following mRNA COVID-19 vaccine, J Med Virol, 10.1002/jmv.27036 · DOI · Paper page

Metadata

Authors
Furer, V., Eviatar, T., Zisman, D., Peleg, H., Paran, D., Levartovsky, D., Zisapel, M., Elalouf, O., Kaufman, I., Meidan, R., Broyde, A., Polachek, A., Wollman, J., Litinsky, I., Meridor, K., Nochomovitz, H., Silberman, A., Rosenberg, D., Feld, J., Haddad, A., Gazzit, T., Elias, M., Higazi, N., Kharouf, F., Shefer, G., Sharon, O., Pel, S., Nevo, S., & Elkayam, O.
Affiliations
  • Tel Aviv University (IL)
  • Technion – Israel Institute of Technology (IL)
  • Hadassah Medical Center (IL)
  • Tel Aviv Sourasky Medical Center (IL)
  • Carmel Medical Center (IL)
  • Hebrew University of Jerusalem (IL)
Corresponding author
Furer, Victoria
ORCID
Venue
Annals of the Rheumatic Diseases
Publisher
Elsevier BV
Published
2021-10
Volume
80
Issue
10
Pages
1330-1338
ISSN
0003-4967 (ISSN-L)
DOI
10.1136/annrheumdis-2021-220647
OpenAlex
W3164069651
Cited by
654
References
52
Citations by year
2026: 16 · 2025: 36 · 2024: 86 · 2023: 162 · 2022: 254 · 2021: 99
FWCI
47.73
Type
journal article
Language
en
Update notices
erratum (2022-07-01)
Open access
Licence
Locations
  • Annals of the Rheumatic Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
  • Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
Keywords
BNT162b2 mRNA vaccine, COVID-19 vaccination, autoimmune inflammatory rheumatic diseases, vaccine immunogenicity, vaccine safety, rituximab, glucocorticoids, mycophenolate mofetil, abatacept, disease activity, adverse events, herpes zoster, uveitis, pericarditis
MeSH terms
Immunogenicity, Vaccine, COVID-19, SARS-CoV-2, COVID-19 Vaccines, BNT162 Vaccine, Adolescent, Adult, Aged, Aged, 80 and over, Antibodies, Viral, Autoimmune Diseases, Female, Humans, Immunoglobulin G, Immunosuppressive Agents, Male, Middle Aged, Rheumatic Diseases, Immunocompromised Host, Young Adult

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