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.