COVID-19 severity, breakthrough infections and vaccine safety in young individuals with autoimmune diseases : insights from the COVAD study
Alunno, Alessia Carubbi, Francesco Tan, Ai Lyn Sen, Parikshit Cavagna, Lorenzo Joshi, Mrudula Day, Jessica Saha, Sreoshy GutiƩrrez, Carlos Enrique Toro Caballero-Uribe, Carlo Vinicio
Alunno, Alessia
Carubbi, Francesco
Tan, Ai Lyn
Sen, Parikshit
Cavagna, Lorenzo
Joshi, Mrudula
Day, Jessica
Saha, Sreoshy
GutiƩrrez, Carlos Enrique Toro
Caballero-Uribe, Carlo Vinicio
Abstract
Notwithstanding the wealth of literature on COVID-19, studies focusing on young adults with autoimmune diseases (AD) are lacking. To determine early (within 7 days) and late (after 7 days) anti-SARS-CoV-2 vaccine-related adverse events (AEs), post-vaccine disease flares, COVID-19 severity and breakthrough infections (B-INFs) in young people with rheumatic diseases (RMDs) and non-rheumatic autoimmune diseases (nr-ADs) compared to healthy controls (HC). Data were captured through the international COVID-19 vaccination in autoimmune diseases (COVAD) 1 and 2 questionnaires. Of 20,685 complete responses, we identified 6010 from patients aged 18-35 years (1692 RMD, 400 nrADs, 3918 HC) who received up to 4 vaccine doses. BNT162b2 was the most frequently administered vaccine and prior to vaccination, 7% of people with nrAD were taking immunosuppressants (IS) versus 80% in RMDs. Early mild AEs were more frequent in RMDs (93%) and nr-ADs (92%) compared to HC (85%). The frequency of late mild AEs was < 20% in all groups. Severe AEs were rare. SARS-CoV-2 infection rates were similar across all groups, however, RMD patients reported a single episode of infection more frequently than nrADs and HC, while nrADs reported multiple infections more frequently than RMD. Self-reported disease flares were reported by 10% or RMD and 7% of nrAD patients. Our study reinforces the safety of anti-SARS-CoV-2 vaccine also in young people with ADs, but it also highlights that among young individuals the number and clinical picture of SARS-CoV-2 infections is affected more by the type of AD rather than by coexisting IS therapy.
MIDER Authors
Affiliations
University of L'Aquila and San Salvatore Hospital; Leeds Teaching Hospitals Trust; University of Leeds; Sandwell and West Birmingham NHS Trust; et al.
Citations
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Date
2024-07-13
Type
Article
Subject
Collections
Citation
Alunno A, Carubbi F, Tan AL, Sen P, Cavagna L, Joshi M, Day J, Saha S, GutiƩrrez CET, Caballero-Uribe CV, Distler O, Chinoy H, Aggarwal R, Agarwal V, Gupta L; COVAD Study Group. COVID-19 severity, breakthrough infections and vaccine safety in young individuals with autoimmune diseases: insights from the COVAD study. Rheumatol Int. 2024 Sep;44(9):1725-1731. doi: 10.1007/s00296-024-05654-w. Epub 2024 Jul 13