PGIMER study suggests immune suppressive medications may impact response to COVID vaccination
COVID pandemic has brought in numerous challenges to the healthcare system. The pandemic has disproportionately affected the disadvantaged populations including those with autoimmune disease who have been considered to be at increased risk of adverse outcomes from COVID. The response to COVID vaccination in patients who have underlying immune mediated inflammatory diseases and are on immune suppressing medication is a significant global concern.
A systematic study published from the PGIMER is the first report which has evaluated the vaccine responses in various antirheumatic and immune modulating drugs. The results suggest that the response to COVID vaccination in patients with such diseases is less compared to the general population. Immune mediated inflammatory diseases are a group of disorders which result from malfunction of the body’s immune system and include many common diseases like inflammatory bowel disease, rheumatoid arthritis, systemic lupus erythematosus and vasculitis.
Dr Anuraag Jena and Dr Shubhra Mishra, the lead co-authors for the paper, suggested that the patients with these disorders could be candidates for testing for response to the double dose of COVID vaccine. Further studies are required to assess the need for booster diseases in improving the efficacy of vaccination in this subgroup of patients. Prof Aman Sharma, rheumatologist, informed that the care of patients with autoimmune disorders has been challenging during the COVID pandemic and the issues of vaccine efficacy have been a major concern amongst rheumatologists globally. There has been some evidence of early fall in antibodies in such patients after vaccination which is concerning.
Dr Vishal Sharma, the senior author, said that while some drugs do not seem to impact response to double dose of vaccines like infliximab, adalimumab, 5-aminosalicylates and vedolizumab. However, certain drugs like rituximab, steroids and immunomodulators reduced the immune responses to the vaccination even after the double dose. Such patients should continue COVID appropriate behaviour including physical distancing and use of masks even after complete vaccination. The systematic review has been published in Autoimmunity Reviews, a high impact Elsevier journal.
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https://www.sciencedirect.com/science/article/pii/S1568997221002020
