Pfizer COVID-19 vaccine offers similar protection in adolescents with, without IRDs
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The Pfizer-BioNTech COVID-19 vaccine offers similar protection against the disease in adolescent patients with and without inflammatory or immune rheumatic conditions, according to data published in Rheumatology.
The researchers additionally concluded that immunomodulatory therapy did not impact the vaccine’s effectiveness.
“In a recent prospective study that included 20 hospitals in Israel, 17.8% of children hospitalized due to COVID-19 or multisystem inflammatory syndrome in children (MIS-C) had moderate or severe disease,” Amit Ziv, MD, of the pediatric rheumatology unit at Meir Medical Center, in Israel, and colleagues wrote. “Young adolescents and children are significant vectors in SARS-CoV-2 transmission and can infect the elderly, who are susceptible to severe disease.”
To investigate the effectiveness of the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) in adolescent patients with juvenile-onset inflammatory or immune rheumatic diseases (IRDs), Ziv and colleagues conducted an observational cohort study. The study drew information from Clalit Health Services, which includes information on 53% of the population in Israel. To be eligible for inclusion, patients needed to be aged 12 to 18 years, be members of Clalit Health Services and have a documented diagnosis of juvenile idiopathic arthritis, systemic lupus erythematosus or familial Mediterranean fever.
The authors also gathered patient data including vaccination status and current treatments, calling out conventional disease-modifying antirheumatic drugs and biologic DMARDs. The control group consisted of adolescents without IRDs. The authors calculated risk ratios for vaccination compared with patients who were not vaccinated, and also estimated vaccine effectiveness in this group of patients.
The study included 1,639 adolescent patients with IRDs, including JIA, SLE and familial Mediterranean fever. The analysis also included 524,471 patients in the same age range who did not have IRDs. Following the second vaccination dose, both groups demonstrated a 2.1% COVID-19 infection rate (P=.99), according to the researchers. The estimated vaccine efficacy among adolescents with IRDs was 76.3% following the first dose, 94.8% following the second and 99.2% following a third dose.
“The current study demonstrates that immunomodulatory drug treatment did not affect the effectiveness of the vaccine,” Ziv and colleagues wrote. “No COVID-19 infections were documented for adolescents treated with cDMARDS or bDMARDS who received two or three doses of vaccine.
“In addition, it was found that unvaccinated adolescents with IRD were at increased risk of contracting COVID-19, compared with adolescents without IRD,” they added.
References:
- Ben-Schimol S, et al. J Pediatric Infect Dis Soc. 2021;doi:10:757–65.
- Kelvin AA, et al. Lancet Infect Dis. 2020;doi:20:633–4.
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