In spite of these immunogenicity benefits, patients who stopped methotrexate had significantly higher rates of flare (CDAI >10 points) 6 weeks after the second vaccine dose (31.7 vs 13.0%) and numerically, but not significantly, higher rates of flare at the time of the second dose (21.7 vs 11.6%).

People with systemic autoimmune myopathies have moderate seroconversion rates following two doses of the Sinovac inactivated SARS-CoV-2 vaccine, with reduced immunogenicity relative to that seen in healthy controls, researchers report.

On the other hand, they found that immunogenicity after the first vaccine dose was “poor and significantly hampered by [glucocorticoids] and methotrexate,” with an IgG positivity rate of just 41.7% in the GCA group, compared with 94.2% for the healthy controls.

The Sinovac inactivated SARS-CoV-2 vaccine elicits a reduced antibody response in people with rheumatic and musculoskeletal diseases compared with healthy controls, but the short-term immunogenicity is adequate, researchers report.

Research confirms immunogenicity with the Pfizer–BioNTech COVID-19 vaccine in most patients with autoimmune inflammatory rheumatic diseases.

Influenza vaccination gives rise to an adequate immune response among patients with rheumatic conditions, researchers report.

The researchers also investigated the immunogenicity of a pandemic influenza vaccine containing the A/California/7/2009 (H1N1pdm) strain in 93 of the patients with rheumatic disease and 15 healthy controls, and 63 rheumatic patients received a second dose of the pandemic vaccine after 3–5 weeks according to guideline recommendations.

Temporary suspension of methotrexate treatment is associated with improved immunogenicity of influenza vaccination among patients with rheumatoid

This addresses an important knowledge gap, because most previous studies conducted in this population “have evaluated the immunogenicity (ability to induce humoral and cellular immune responses) of vaccines, rather than the effect of vaccination on infection rates (i.e. vaccine efficacy or effectiveness),” explain the researchers in Rheumatology .

Commenting on the VROOM trial in an accompanying article, Jeffrey Sparks and Sara Tedeschi, both from Brigham and Women’s Hospital in Boston, Massachusetts, USA, say that the results “extend previous findings showing that interruption of methotrexate improves vaccine immunogenicity,” and suggest that this may be “broadly applicable across different vaccine types.”

Anu Sreekanth (Sree Sudheendra Medical Mission, Kochi, India), presenting the trial data at the EULAR 2022 Congress in Copenhagen, Denmark, commented that to improve immunogenicity “the ACR guidelines state to hold methotrexate for 1 to 2 weeks as disease activity allows after each COVID-19 vaccine dose but with a moderate level of evidence.”

Study findings suggest that mRNA vaccines against SARS-CoV-2 have good short-term safety and immunogenicity profiles in adolescents with juvenile-onset rheumatic diseases.

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How can rheumatologists respond to the challenges associated with rituximab use during the pandemic?

Potential benefits in terms of reduced immunogenicity have also been suggested.

Findings from the VERVE trial suggest that the live attenuated zoster vaccine has favorable short-term immunogenicity and safety profiles in people with immune-mediated diseases treated with TNF inhibitors.

Although a switch from a reference product to a licensed biosimilar version (or vice versa) is a medical decision robustly supported by the stepwise accumulation of clinical trial evidence concerning comparable safety, immunogenicity, and efficacy between these products, a switch from one biosimilar to another biosimilar of the same reference product, or a cross-switch, is not.

Furer noted that these predictive factors were confirmed in an independent validation cohort of 48 AIIRD patients taking rituximab, of whom 21 responded to the vaccine and 27 did not, and when used in a calculator predicted the likelihood for immunogenicity in these patients with 59.3% specificity and 90.5% sensitivity.

Among people with immune-mediated diseases, COVID-19 vaccines have greater immunogenicity following the second compared with the first dose, and individuals with prior SARS-CoV-2 infection have robust antibody responses, research suggests.