Immunogenicity and safety of BNT162b2 vaccination in adolescents with systemic lupus erythematosus
Issued Date
2024-01-01
Resource Type
ISSN
09612033
eISSN
14770962
Scopus ID
2-s2.0-85184919987
Pubmed ID
38335115
Journal Title
Lupus
Rights Holder(s)
SCOPUS
Bibliographic Citation
Lupus (2024)
Suggested Citation
Piyaphanee N., Charuvanij S., Thepveera S., Toh Z.Q., Licciardi P.V., Pattaragarn A., Wongprompitak P., Boonnak K., Pheerapanyawaranun C., Chokephaibulkit K. Immunogenicity and safety of BNT162b2 vaccination in adolescents with systemic lupus erythematosus. Lupus (2024). doi:10.1177/09612033241232576 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/97301
Title
Immunogenicity and safety of BNT162b2 vaccination in adolescents with systemic lupus erythematosus
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Corresponding Author(s)
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Abstract
Objectives: We evaluated the immunogenicity and safety of BNT162b2 vaccination in adolescents with systemic lupus erythematosus (adoSLE) receiving either high- or low-dose immunosuppressant (High-IS and Low-IS). Methods: Patients aged 12–18 years diagnosed with SLE were enrolled. High-IS was defined as >7.5 mg/day prednisolone or with other immunosuppressant, while Low-IS was defined as only ≤7.5 mg/day of prednisolone and no immunosuppressant. Two doses of BNT162b2 vaccination were given 4 weeks apart, followed by a booster (third) dose at 4–6 months later. Anti-spike receptor binding domain (anti-RBD) IgG against Wuhan, neutralising antibody (NT) against Wuhan and Omicron variants, and cellular immune response by IFN-γ-ELISpot assay were evaluated following vaccination. Adverse events (AEs) and SLE flare were monitored. Results: A total of 73 participants were enrolled, 40 and 33 in the High-IS and Low-IS group, respectively. At 4 weeks following the 2nd dose, overall anti-RBD IgG seropositivity was 97.3%, with no difference between the groups (p =.498). AdoSLE on High-IS had lower anti-RBD IgG (p <.001), Wuhan NT (p <.001), and IFN-γ-ELISpot (p =.022) than those on Low-IS. A 3rd dose induced significantly higher antibody responses than after the 2nd dose (p <.001) in both groups and established seroconversion against Omicron variants, with persistent lower antibody levels in High-IS group. SELENA-SLEDAI scores within 12 weeks after 2-dose vaccination was higher than before vaccination (3.1 vs 2.5; p <.036); however, the occurrence of disease flare by SELENA-SLEDAI flare index was not different after vaccination compared to before vaccination, consistent across groups. Non-severe AEs occurred similarly in both groups. Conclusion: AdoSLE on High-IS induced lower SARS-CoV-2 vaccine immune responses than Low-IS. Vaccination can increase disease activity and requires close monitoring for disease flare.