COVID-19 vaccine booster dose effective at preventing infection in patients with lupus
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Patients with systemic lupus erythematous achieved an improved serological response following a booster COVID-19 vaccine dose, according to data collected during the omicron BA.1 wave in New York and published in The Lancet Rheumatology.
“In this study we also wanted to evaluate the clinical efficacy of the vaccines in this higher risk population, particularly looking at the utility of an additional — booster — dose,” Amit Saxena, MD, of the department of rheumatology at the New York University School of Medicine, told Healio. “The omicron BA.1 surge of cases in NYC allowed us to ‘pressure test’ vaccine effectiveness in a real-world setting.”
To investigate efficacy and seroreactivity of COVID-19 vaccination in patients with SLE who received an initial two-dose series and those who received a third dose, Saxena and colleagues examined data from the New York University Lupus Cohort, with special attention paid to the timing of the omicron variant wave in New York. To be included in the study, patients needed to fulfill at least one lupus classification criteria set out of the American College of Rheumatology, the Systemic Lupus International Collaborating Clinics or the European League Against Rheumatism/ACR.
Additionally, patients were required to be aged 18 years or older, have had two doses of an mRNA-based vaccine or a single dose of a vector-based vaccine, be willing to provide blood samples following vaccination and be present for clinical follow-ups. Included patients were evaluated regarding COVID-19 infections following vaccination. Evaluations occurred during standard scheduled visits via electronic medical records from New York University and Bellevue Hospital Center. The last patient follow-up was April 24. Positive PCR results were required to validate infections.
Researchers collected data on outcomes, including hospitalization, death, COVID-specific therapies, type of testing used and the timing of the infection in relation to the last-received vaccination dose.
In all, the analysis included 163 participants, of whom 125 patients received a booster dose. Among the patients who received a booster dose, 28 (22%) developed a breakthrough infection, compared with 16 (42%) of those who did not receive a booster dose. Of all 44 breakthrough infections, only two occurred before the start of the omicron wave, officially dated as Dec. 2, 2021.
The study additionally included a serological analysis of 57 patients following the initial vaccine course and after the booster dose. In these patients, the median antibody titer after a mean of 30.2 days was 397 units per mL, and 1,036 units per mL after a mean of 44.7 days. According to the researchers, there was no association between antibody titers after the booster dose and breakthrough infections.
“The takeaways are that COVID vaccines — with or without an additional booster dose — still provided very good protection against severe COVID-19 disease,” Saxena said. “The additional dose did provide increased protection from any SARS-CoV-2 infection, and so receiving booster injections is highly recommended in lupus patients, who are at increased risk.”
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