PhD Candidate Case Western Reserve University Cleveland Heights, Ohio, United States
Abstract Text:
Background: People with autoimmune disease have worse outcomes when infected with SARS-CoV2. At the same time they have lower antibody responses to COVID19 vaccine. Immune suppressive medications used to treat rheumatoid arthritis (RA) are associated with lower vaccine responses, though contributions of comorbidities, T-cell immunity and age are less clear.
Methods: We evaluated serum samples for anti-spike specific IgG by bead-based assay before and after doses of COVID19 mRNA vaccine, as well as Wuhan and Omicron neutralizing antibody levels, IFN-g and IL-2 production by ELISPOT assay, and immune cell subsets by flow cytometry in 51 RA and 95 non-autoimmune control participants.
Results: RA participants had lower total spike-specific IgG and Wuhan-strain neutralizing antibody levels, and lower spike-specific IFN-g producing peripheral blood mononuclear cells (PBMC) after the vaccine doses. Neutralizing antibody levels against Omicron strain were low in both groups. IFN-g production correlated with IL-2 production and neutralizing antibody levels, while older age negatively correlated with spike-specific IL-2 and IFN-g and IgG levels. Lower antibody levels were driven by age and RA associated factors while lower T cell response was driven by older age.
Conclusions: These data indicate lower COVID19 mRNA vaccine-induced antibody levels in persons with RA compared to controls, perhaps in part attributable to medications. At the same time older age associates with lower antibody and cellular immune response to vaccines. Further study is needed to clarify links between older age associated cellular immune defects and RA associated humoral immune defects in host response to COVID vaccine series.
