Humoral Immune Response in IBD Patients Three and Six Months after Vaccination with the SARS-CoV-2 mRNA Vaccines mRNA-1273 and BNT162b2.

Richard Vollenberg,Marc Hennies,Göran Boeckel,Tobias Max Nowacki,Florian Rennebaum,Arne Bokemeyer,Eva Lorentzen,Tina Schomacher,Joachim Ewald Kühn,Markus Strauss,Phil-Robin Tepasse

doi:10.3390/biomedicines10010171

Abstract

Severe acute respiratory syndrome coronovirus-2 (SARS-CoV-2) is the cause of the coronavirus disease 2019 (COVID-19) pandemic. Vaccination is considered the core approach to containing the pandemic. There is currently insufficient evidence on the efficacy of these vaccines in immunosuppressed inflammatory bowel disease (IBD) patients. The aim of this study was to investigate the humoral response in immunosuppressed IBD patients after COVID-19 mRNA vaccination. In this prospective study, IgG antibody levels (AB) against the SARS-CoV-2 receptor-binding domain (spike-protein) were quantitatively determined. For assessing the potential neutralizing capacity, a SARS-CoV-2 surrogate neutralization test (sVNT) was employed in IBD patients (n = 95) and healthy controls (n = 38). Sera were examined prior to the first/second vaccination and 3/6 months after second vaccination. Patients showed lower sVNT (%) and IgG-S (AU/mL) AB both before the second vaccination (sVNT p < 0.001; AB p < 0.001) and 3 (sVNT p = 0.002; AB p = 0.001) and 6 months (sVNT p = 0.062; AB p = 0.061) after the second vaccination. Although seroconversion rates (sVNT, IgG-S) did not differ between the two groups 3 months after second vaccination, a significant difference was seen 6 months after second vaccination (sVNT p = 0.045). Before and three months after the second vaccination, patients treated with anti-tumor necrosis factor (TNF) agents showed significantly lower AB than healthy subjects. In conclusion, an early booster shot vaccination should be discussed for IBD patients on anti-TNF therapy.

Highlights

Severe acute respiratory syndrome coronovirus-2 (SARS-CoV-2) is the cause of the coronavirus disease 2019 (COVID-19) pandemic [1]
All patients who were not vaccinated with mRNA vaccines or who were not inoculated with the same vaccine on both occasions were excluded
There were no differences in body mass index (BMI) between inflammatory bowel disease (IBD) patients and healthy controls (p = 0.171)

Summary

Introduction

Severe acute respiratory syndrome coronovirus-2 (SARS-CoV-2) is the cause of the coronavirus disease 2019 (COVID-19) pandemic [1]. In remission induction and maintenance therapy of both diseases, immunosuppressive drugs are generally used to reduce inflammatory activity in the gastrointestinal tract [10,11]. The use of immunosuppressive therapies can lead to serious side-effects, such as opportunistic infections. Patients under immunosuppression have a higher susceptibility to severe disease following infection with common pathogens [12]. The COVID-19 pandemic has raised major concerns about the treatment of IBD patients. Recent studies have indicated the possibility of more severe disease progression in IBD patients due to their altered immunological status and existing immunosuppressive drug therapies [13]. Therapeutic approaches to combat COVID-19 are being developed worldwide; until recently, few therapies have proven effective

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