POS0547 RISK OF SARS-COV-2 INFECTION FOLLOWING THREE DOSES OF BNT162B2 OR MRNA-1273 IN PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES

Abstract

BackgroundWe recently performed a long-term, model-based comparison of the humoral immunogenicity following two-dose vaccination with BNT162b2 and mRNA-1273 in individuals from SCQM, the Swiss cohort for patients with inflammatory rheumatic diseases (IRD). Vaccination with mRNA-1273 resulted in higher humoral immunogenicity compared to BNT162b2 throughout 24 weeks post second vaccine dose[1]. In booster vaccinations, the dose of mRNA-1273 was reduced and it is currently unknown if there was a difference in SARS-CoV-2 infections in BNT162b2 and mRNA-1273 recipients with IRD after the third vaccine dose.ObjectivesTo investigate the risk of test-positive SARS-CoV-2 infection after three doses of BNT162b2 or mRNA-1273 in IRD patients.MethodsAdult patients from the SCQM registry who previously participated in an observational cohort study comparing vaccine-induced humoral immune responses following two doses of BNT162b2 or mRNA-1273 were invited to participate in the next phase of the study. Participants answered study questionnaires via the mySCQM patient app, including on subsequent vaccine doses and SARS-CoV-2 infections, here taken as patient-reported positive PCR or antigen tests. Pre and post third vaccination anti-SARS-CoV-2 IgG (anti-S1) levels were quantified by testing self-collected capillary blood samples using the EUROIMMUN ELISA as previously described[1]. To analyze the risk of infection, we used a Cox proportional hazards model. The time of the third mRNA COVID-19 vaccine dose administration was taken as the baseline. Patient follow-up ended on the minimum date of the following events: testing positive for SARS-CoV-2 infection after the third mRNA COVID-19 vaccine dose, receiving a fourth vaccine dose, last data entry in the mySCQM patient app, or study end (2022-12-01). Patients whose follow-up ended in the first 14 days after the third vaccine dose were excluded from the analysis.Results445 patients were included in the study (67% female; mean age 54 yrs; 36% RA, 36% axSpA, 21% PsA, 7% undifferentiated arthritis). Patients received their third dose of mRNA COVID-19 vaccine between 2021-08-06 and 2022-04-04 (BNT162b2: mRNA-1273 51%:49%; homologous vaccination applied in 95% of patients). Between 2021-12-08 and 2022-11-24, 175 patients reported a positive SARS-CoV-2 test occurring at least 14 days after the third vaccine dose (Figure 1A), only 3 of whom required hospitalization.We found no statistically significant difference in the risk of SARS-CoV-2 infection post third dose due to the vaccine received (mRNA-1273 vs BNT162b2) (Figure 1B). Higher anti-S1 levels at baseline were statistically significantly associated with a lower risk of infection post third vaccine dose. A prior SARS-CoV-2 infection also statistically significantly reduced the risk of infection post third vaccine dose.ConclusionThe risk of SARS-CoV-2 infection did not statistically significantly differ between mRNA-1273 and BNT162b2 recipients following a third vaccine dose. Higher anti-S1 levels at the time of the third mRNA COVID-19 vaccine dose, as well as a prior infection, were associated with a statistically significant lower risk of test-positive SARS-CoV-2 infections during follow-up in patients with IRD.Reference[1]Raptis CE et al. Front Immunol. 2022; 13: 1016927AcknowledgementsThis study was investigator-initiated and received independent financial support from an anonymous donation from a research foundation and Moderna Switzerland GmbH. The SCQM is financially supported by pharmaceutical industries and donors. A list of financial supporters can be found onwww.scqm.ch/sponsors. A list of rheumatology offices and hospitals contributing to the SCQM registries can be found onwww.scqm.ch/institutions. The SCQM thanks the patients for their participation in this study.Disclosure of InterestsCatherine Elizabeth Raptis Grant/research support from: This study was investigator-initiated and received independent financial support from an anonymous donation from a research foundation and Moderna Switzerland GmbH. The study sponsors had no role in the study design or in the collection, analysis and interpretation of the data, the writing of the abstract or the decision to submit it., Christos Polysopoulos: None declared, Christoph Berger: None declared, Adrian Ciurea: None declared, Diego Olivier Andrey: None declared, Pierre Lescuyer: None declared, Tanja Maletic: None declared, Myriam Riek: None declared, Almut Scherer: None declared, Isabell von Loga: None declared, Judith Safford: None declared, Kim Lauper Speakers bureau: Honoria/speakers fees for Pfizer, Viatris, Celltrion outside of the submitted work, Burkhard Moeller: None declared, Nicolas Vuilleumier: None declared, Axel Finckh Speakers bureau: AbbVie, BMS, Pfizer, Eli-Lilly, Sandoz outside of the submitted work, Consultant of: AbbVie, Novartis, Pfizer, MSD, Eli-Lilly outside of the submitted work, Grant/research support from: AbbVie, BMS, Galapagos, Lilly, Pfizer outside of the submitted work, Andrea Rubbert-Roth Speakers bureau: Honoraria for consultation and lectures from Abbvie, Amgen, Pfizer, Gilead, Novartis, Janssen, Eli-Lilly, Sanofi, Roche, UCB, BMS outside of the submitted work, Consultant of: Honoraria for consultation and lectures from Abbvie, Amgen, Pfizer, Gilead, Novartis, Janssen, Eli-Lilly, Sanofi, Roche, UCB, BMS outside of the submitted work.