COVID-19 vaccination elicits antibody response in immunosuppressed patients

Novel coronavirus (COVID-19) vaccination elicited antibody responses in nearly nine out of 10 people with weakened immune systems, although their responses were only about one-third as strong as those mounted by healthy people, according to a new study by researchers at Washington University School of Medicine in St. Louis published in the journal Annals of Internal Medicine.

The study looked at people taking immunosuppressive medication, s to treat chronic inflammatory diseases such as inflammatory bowel disease and rheumatoid arthritis. Since a minimum level of antibodies needed for protection hasn’t been established, it has been difficult to say whether the levels achieved by people on immune suppressing drugs are high enough to protect them from severe COVID-19, the researchers said.

Previous studies had shown that immunosuppressive medications can blunt people’s responses to other vaccines, such as those for influenza and pneumococcal diseases. The researchers set out to determine how well people taking immunosuppressive drugs respond to COVID-19 vaccination. They pulled together a participant group comprising 133 patients and 53 healthy people for comparison. The patients each were taking at least one immune-suppressing medication for illnesses such as inflammatory bowel disease, rheumatoid arthritis, spondyloarthritis, lupus and multiple sclerosis.

Participants provided blood samples within two weeks before receiving the first dose of the Pfizer or Moderna vaccine and within three weeks after receiving the second dose. The researchers measured each participants’ antibody levels and counted the number of antibody-producing cells in their blood samples. All patients stayed on their prescribed drug regimens, except for three whose medications were paused within one week of immunization.

All healthy participants and 88.7 percent of the immunosuppressed participants produced antibodies against the virus that causes COVID-19. However, antibody levels and the number of antibody-producing cells in the immunosuppressed group were one-third as high as those in the healthy group.

Two classes of drugs led to particularly weak immune responses. Only 65 percent of people taking glucocorticoids and 60 percent of people taking B cell-depleting therapies developed detectable antibody responses. People taking antimetabolites such as methotrexate, TNF inhibitors, or JAK inhibitors, on the other hand, did not generate significantly weaker immune responses than people not taking those drugs, the researchers said.

The U.S. Centers for Disease Control and Prevention (CDC) recently recommended that people taking immunosuppressants receive a third dose of the vaccine to strengthen their immune responses. Nonetheless, the discovery that COVID-19 vaccination elicits a response in people with compromised immune systems, even if not quite as strong a response is encouraging news for a population that faces a high risk of serious illness.

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