Abstract

The COVID-19 pandemics has caused the death of almost six million people worldwide. In order to establish collective immunity, the first vaccines that were approved in Germany were the vector virus-based vaccine Vaxzevria and the mRNA vaccines Comirnaty and Spikevax, respectively. As it was reported that SARS-CoV-2 can trigger autoimmunity, it is of significant interest to investigate whether COVID-19 vaccines evoke the formation of autoantibodies and subsequent autoimmunity. Here, we analyzed immune responses after different vaccination regimens (mRNA/mRNA, Vector/Vector or Vector/mRNA) with respect to anti-SARS-CoV-2-specific immunity and the development of autoantibodies well known for their appearance in distinct autoimmune diseases. We found that anti-SARS-CoV-2 antibody levels were 90% lower after Vector/Vector vaccination compared to the other vaccinations and that Vector/mRNA vaccination was more effective than mRNA/mRNA vaccination in terms of IgM and IgA responses. However, until 4 months after booster vaccination we only detected increases in autoantibodies in participants with already pre-existing autoantibodies whereas vaccinees showing no autoantibody formation before vaccination did not respond with sustained autoantibody production. Taken together, our study suggests that all used COVID-19 vaccines do not significantly foster the appearance of autoantibodies commonly associated with lupus erythematodes, rheumatoid arthritis, Celiac disease and antiphospholipid-syndrome but provide immunity to SARS-CoV-2.

Highlights

  • At the end of 2019, the first cases of a novel disease causing flu-like symptoms appeared

  • We here analyzed anti-SARS-CoV-2 responses and concomitant production of autoantibodies frequently associated with lupus erythematodes, rheumatoid arthritis, celiac disease and antiphospholipid syndrome in healthcare workers before and after applying heterologous and homologous prime-boost vaccination protocols against COVID-19

  • The participants of this manuscript are from the CoVac study that was conducted between April and October 2021 as a prospective, observational study surveying the induction of autoimmunity upon anti-COVID-19 vaccination

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Summary

Introduction

At the end of 2019, the first cases of a novel disease causing flu-like symptoms appeared. COVID-19 is limited to the lungs but can affect the skin, the kidneys, the nervous system and the hematological system [5] These SARS-CoV-2 infections often show a remarkable imbalance in the immune response, e.g., a hyperactivation of neutrophils and an excessive production of proinflammatory cytokines. From an immunological point of view, the immune reaction in response to SARS-CoV-2 infections shares similarities to autoimmune diseases In this context it was reported that COVID-19 patients carrying antinuclear antibodies (ANAs), antiphospholipid antibodies or anti-SS-A/Ro show more severe COVID-19 courses than patients devoid of these autoantibodies [7,8,9,10]. We here analyzed anti-SARS-CoV-2 responses and concomitant production of autoantibodies frequently associated with lupus erythematodes, rheumatoid arthritis, celiac disease and antiphospholipid syndrome in healthcare workers before and after applying heterologous and homologous prime-boost vaccination protocols against COVID-19

Materials and Methods
Characterization of the Study Cohort
Reactogenicity
Result
Discussion
Full Text
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