Scientists from Johns Hopkins found a lower-than-normal immune response to the messenger RNA (mRNA) COVID-19 vaccines for patients with joint and muscle diseases.
These health conditions often need treatment with medications that suppress the immune system.
The findings suggest that patients with these diseases who are on immunosuppressive therapies have less-than-optimal responses to vaccination and are still at risk for COVID-19 infection.
The research is published in the Annals of Internal Medicine and was conducted by Caoilfhionn Connolly et al.
According to the American College of Rheumatology, rheumatic and musculoskeletal diseases (RMDs) are a diverse group of autoimmune diseases that affect children and adults and can impact any organ of the body, often the joints.
Most RMDs are due to problems with the immune system, which can result in inflammation and gradual deterioration of joints, muscles and bones.
Over 46 million people in the United States are living with some type of RMD, including rheumatoid arthritis, systemic lupus erythematosus, scleroderma, vasculitis and Sjögren’s syndrome.
In the study, the team examined patients aged 18 and older with RMDs for the immune response study.
One month after the participants received their second dose of either the Pfizer-BioNTech or Moderna mRNA COVID-19 vaccine, the team analyzed blood samples to check neutralizing antibodies against the target of both vaccines, SARS-CoV-2 spike protein.
They found twenty patients did not have detectable antibodies.
The majority were women (95%), white (90%), diagnosed with lupus (50%) and receiving multiple immunosuppressive agents (80%)—of which the most common medications were rituximab (55%), a biologic used to treat autoimmune disorders such as rheumatoid arthritis and vasculitis, and mycophenolate (50%), a drug commonly used as first-line therapy for scleroderma lung disease and lupus nephritis (kidney inflammation).
Both immune suppressants work by depleting B-lymphocytes (also known as B-cells), immune cells that produce antibodies in response to foreign invaders such as bacteria and viruses.
Based on the findings, the scientists suggest patients with autoimmune diseases who are taking these particular immunosuppressive drugs continue practicing recommended COVID-19 safety measures, even after vaccination.
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