INTRODUCTION
Patients with juvenile-onset autoimmune inflammatory rheumatic diseases (AIIRD) on immunomodulatory treatment are prone to infections, including SARS CoV-2 infection. Thus far, vaccination, along with personal protective measures have been the mainstay approach to preventing COVID-19 infection.
Studies on adults with AIIRD demonstrated that the two-dose BNTb262 regimen was associated with comparable immunogenicity in patients and healthy controls. Most patients developed an adequate immunogenic response to the vaccines, except for patients on B-cell-depleting therapy.
Data regarding the safety and immunogenicity of COVID-19 vaccination in adolescents with AIIRD on immunomodulation was initially lacking, as these individuals were excluded from the vaccine trials. Since 2022, a few studies demonstrated that the two-dose COVID-19 vaccine regimen was safe and immunogenic in adolescents with AIIRD as compared to healthy adolescents.
The waning of vaccine-induced immunity after the two-dose BNT162b2 mRNA vaccine regimen was well-documented. In October 2021, the American College of Rheumatology recommended a booster vaccine dose for AIIRD patients receiving any immunosuppressive treatment. This was also supported by the EULAR and PReS recommendations.
Since then, several studies have shown that the third vaccine dose induce an augmented immunogenic response among patients with AIIRD. The booster vaccination was also shown to reduce the rates of both confirmed COVID-19 and severe COVID-19 in a large Israeli population of participants ages60 years or older.
However, longitudinal data on the safety and the dynamics of anti-S antibody titre following the second and third doses of COVID-19 vaccine in adolescents with AIIRD receiving different immunomodulatory regimens, is lacking. Here, we report the results of a multicentre, prospective longitudinal study, conducted to investigate the safety and dynamics of the immunogenic response following the second and third doses of the BNT162b2 COVID-19 vaccine in adolescents with AIIRD and healthy controls.