SARS-CoV-2 Breakthrough Infections among Vaccinated Individuals with Rheumatic Disease: Results from the COVID-19 Global Rheumatology Alliance Provider Registry - Sorbonne Université Access content directly
Journal Articles RMD Open : Rheumatic & Musculoskeletal Diseases Year : 2022

SARS-CoV-2 Breakthrough Infections among Vaccinated Individuals with Rheumatic Disease: Results from the COVID-19 Global Rheumatology Alliance Provider Registry

Carly Harrison
  • Function : Author
Martin Schäfer
  • Function : Author
Elsa Frãzao-Mateus
  • Function : Author
Inita Bulina
  • Function : Author
Frances Stafford
  • Function : Author
Abdurrahman Tufan
  • Function : Author
Christine Graver
  • Function : Author
Julija Zepa
  • Function : Author
Samar Al Emadi
  • Function : Author
Fatemah Abutiban
  • Function : Author
Dfiza Dey
  • Function : Author
Genevieve Katigbak
  • Function : Author
Lauren Kaufman
  • Function : Author
Greta Reyes-Cordero
  • Function : Author
Evelyn Salido
  • Function : Author
Ellison Smith
  • Function : Author
David Snow
  • Function : Author
Leanna Wise
  • Function : Author
Suleman Bhana
  • Function : Author
Monique Gore-Massy
  • Function : Author
Paul Sufka
  • Function : Author
Philip C Robinson
  • Function : Author

Abstract

Objective While COVID-19 vaccination prevents severe infections, poor immunogenicity in immunocompromised people threatens vaccine effectiveness. We analysed the clinical characteristics of patients with rheumatic disease who developed breakthrough COVID-19 after vaccination against SARS-CoV-2. Methods We included people partially or fully vaccinated against SARS-CoV-2 who developed COVID-19 between 5 January and 30 September 2021 and were reported to the Global Rheumatology Alliance registry. Breakthrough infections were defined as occurring ≥q14 days after completion of the vaccination series, specifically 14 days after the second dose in a two-dose series or 14 days after a single-dose vaccine. We analysed patients' demographic and clinical characteristics and COVID-19 symptoms and outcomes. Results SARS-CoV-2 infection was reported in 197 partially or fully vaccinated people with rheumatic disease (mean age 54 years, 77% female, 56% white). The majority (n=140/197, 71%) received messenger RNA vaccines. Among the fully vaccinated (n=87), infection occurred a mean of 112 (±60) days after the second vaccine dose. Among those fully vaccinated and hospitalised (n=22, age range 36\textendash 83 years), nine had used B cell-depleting therapy (BCDT), with six as monotherapy, at the time of vaccination. Three were on mycophenolate. The majority (n=14/22, 64%) were not taking systemic glucocorticoids. Eight patients had pre-existing lung disease and five patients died. Conclusion More than half of fully vaccinated individuals with breakthrough infections requiring hospitalisation were on BCDT or mycophenolate. Further risk mitigation strategies are likely needed to protect this selected high-risk population.
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hal-03896038 , version 1 (30-04-2024)

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Jean Liew, Milena Gianfrancesco, Carly Harrison, Zara Izadi, Stephanie Rush, et al.. SARS-CoV-2 Breakthrough Infections among Vaccinated Individuals with Rheumatic Disease: Results from the COVID-19 Global Rheumatology Alliance Provider Registry. RMD Open : Rheumatic & Musculoskeletal Diseases, 2022, 8 (1), pp.e002187. ⟨10.1136/rmdopen-2021-002187⟩. ⟨hal-03896038⟩
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