key: cord-0817759-eeutzrak
authors: Pozdnyakova, Valeriya; Botwin, Gregory J.; Sobhani, Kimia; Prostko, John; Braun, Jonathan; McGovern, Dermot P.B.; Melmed, Gil Y.; Appel, Keren; Banty, Andrea; Feldman, Edward; Ha, Christina; Kumar, Rashmi; Lee, Susie; Rabizadeh, Shervin; Stein, Theodore; Syal, Gaurav; Targan, Stephan; Vasiliauskas, Eric; Ziring, David; Debbas, Philip; Hampton, Melissa; Mengesha, Emebet; Stewart, James L.; Frias, Edwin C.; Cheng, Susan; Ebinger, Joseph; Figuereido, Jane; Boland, Brigid; Charabaty, Aline; Chiorean, Michael; Cohen, Erica; Flynn, Ann; Valentine, John; Fudman, David; Horizon, Arash; Hou, Jason; Hwang, Caroline; Lazarev, Mark; Lum, Donald; Fausel, Rebecca; Reddy, Swapna; Mattar, Mark; Metwally, Mark; Ostrov, Arthur; Parekh, Nimisha; Raffals, Laura; Sheibani, Sarah; Siegel, Corey; Wolf, Douglas; Younes, Ziad
title: Decreased Antibody Responses to Ad26.COV2.S Relative to SARS-CoV-2 mRNA Vaccines in Patients with Inflammatory Bowel Disease
date: 2021-08-12
journal: Gastroenterology
DOI: 10.1053/j.gastro.2021.08.014
sha: 2f00f7a6b31cfa7a1d506f8e4912d6f77e8473ac
doc_id: 817759
cord_uid: eeutzrak

nan

Patients with inflammatory bowel disease (IBD) on corticosteroids, immunomodulators and advanced therapies may have normal to slightly decreased humoral responses to the SARS-CoV-2 mRNA vaccine platforms. 1 In addition, patients receiving infliximab and/or thiopurines have significantly lower rates of seroconversion than those on vedolizumab monotherapy following a single dose of either BNT162b2 or ChAdOx1. 2 A study of solid organ transplant recipients showed decreased humoral responses to Ad26.CoV2.S vaccine relative to both mRNA platform vaccines, although it is unknown whether these findings are generalizable to other immune compromised populations. 6 We thus aimed to assess for differences in serologic responses among patients with IBD who received Ad26.CoV2.S relative to those receiving mRNA-1273 or BNT162b2. 

We found that positive levels of IgG(S) were achieved in virtually all IBD vaccine recipients regardless of vaccine type and IMT use. This finding is reassuring for patients with IBD, and supports existing literature that the vast majority of IBD patients, regardless of IMT receipt, achieve positive humoral response to mRNA vaccines. 1, 3 However, we also found that recipients of Ad26.CoV2.S had significantly lower antibody levels than recipients of mRNA platform vaccines, independent of IMT use.

In organ transplant recipients, many of whom receive B-cell depleting therapies, receipt of Ad26.CoV2.S was associated with both lower likelihood of seroconversion as well as lower quantitative levels compared with mRNA vaccines. 4 One successful strategy employed to boost levels among organ transplant recipients receiving the mRNA vaccine BNT162b2 is administration of a third dose approximately 2 months after the second dose. 5, 6 While it is reasonable to hypothesize that administration of a booster dose of Ad26.CoV2.S will similarly boost antibody responses among those without positive titers, the rationale for an early booster among those with qualitatively positive but quantitatively low titers is less clear. 

Humoral Immune Response to mRNA COVID019 Vaccines among Patients with IBD

Infliximab is associated with attenuated immunogenicity to BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines in patients with IBD

Serological response to mRNA COVID-19 vaccines in IBD patients receiving biological therapies

Antibody Response to the Janssen COVID-19 Vaccine in Solid Organ Transplant Recipients

Three Doses of an mRNA Covid-19 Vaccine in Solid-Organ Transplant Recipients

Safety and Immunogenicity of a Third Dose of SARS-CoV-2 Vaccine in Solid Organ Transplant Recipients: A Case Series

Immunogenicity of the Ad26.COV2.S Vaccine for COVID-19

Percentage of participants with a positive anti-Spike IgG value (≥50 AU/mL) based on vaccine type at least 2 weeks after regimen completion. (B) log10(Anti-Spike IgG value) among participants receiving Ad26

Decreased Antibody Responses to Ad26.COV2.S Relative to SARS-CoV-2 mRNA Vaccines in Patients with

Upon completion of vaccine regimen (defined as time of receipt of second dose of mRNA vaccine or time of receipt of the single dose Ad26.COV2.S), whole blood was collected from local participants by venipuncture at three different time points: after regimen completion (2-13 days after completing regimen), week 2 (14-29 days after completing regimen), and week 8 (42-84 days after completing regimen). For participants unable to provide in-person samples

We used t-tests to compare mean log-IgG(S) levels at time of regimen completion, two weeks after regimen completion, and eight weeks after regimen completion across vaccine types. We used multivariable linear regression to adjust for vaccine type, immunosuppressive status (defined as receipt of advanced therapy (biologics or JAK-inhibitor), immunomodulators, or corticosteroids at the time of initiation of initial vaccination) and time elapsed between regimen completion and blood sampling. The study protocol was approved by the Cedars-Sinai institutional review characteristics

Immunosuppression = advanced therapy or immunomodulator or corticosteroids)