Anti-TNF alpha Treatment Impairs Long-Term Immune Responses to COVID-19 mRNA Vaccine in Patients with Inflammatory Bowel Diseases

Keren Masha Rabinowitz, Michal Navon, Hadar Edelman-Klapper, Eran Zittan, Ariella Bar-Gil Shitrit, Idan Goren, Irit Avni-Biron, Jacob E. Ollech, Lev Lichtenstein, Hagar Banai-Eran, Henit Yanai, Yifat Snir, Maor H. Pauker, Adi Friedenberg, Adva Levy-Barda, Arie Segal, Yelena Broitman, Eran Maoz, Baruch Ovadia, Maya Aharoni GolanEyal Shachar, Shomron Ben-Horin, Nitsan Maharshak, Michal Mor, Haim Ben Zvi, Rami Eliakim, Revital Barkan, Tali Sharar-Fischler, Sophy Goren, Noy Krugliak, Edward Pichinuk, Michael Mor, Michal Werbner, Joel Alter, Hanan Abu-Taha, Kawsar Kaboub, Moshe Dessau, Meital Gal-Tanamy, Dani Cohen, Natalia T. Freund, Iris Dotan, Responses COVID-19 Vaccine Israeli

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Patients with inflammatory bowel disease (IBD) treated with anti-tumor-necrosis factor-alpha (TNF alpha) exhibited lower serologic responses one-month following the second dose of the COVID-19 BNT162b2 vaccine compared to those not treated with anti-TNF alpha (non-anti-TNF alpha) or to healthy controls (HCs). We comprehensively analyzed long-term humoral responses, including anti-spike (S) antibodies, serum inhibition, neutralization, cross-reactivity and circulating B cell six months post BNT162b2, in patients with IBD stratified by therapy compared to HCs. Subjects enrolled in a prospective, controlled, multi-center Israeli study received two BNT162b2 doses. Anti-S levels, functional activity, specific B cells, antigen cross-reactivity, anti-nucleocapsid levels, adverse events and IBD disease score were detected longitudinally. In total, 240 subjects, 151 with IBD (94 not treated with anti-TNF alpha and 57 treated with anti-TNF alpha) and 89 HCs participated. Six months after vaccination, patients with IBD treated with anti-TNF alpha had significantly impaired BNT162b2 responses, specifically, more seronegativity, decreased specific circulating B cells and cross-reactivity compared to patients untreated with anti-TNF alpha. Importantly, all seronegative subjects were patients with IBD; of those, >90TNF alpha. Finally, IBD activity was unaffected by BNT162b2. Altogether these data support the earlier booster dose administration in these patients.
Original languageEnglish
Article number1186
JournalVaccines
Volume10
Issue number8
DOIs
StatePublished - 1 Aug 2022
Externally publishedYes

Keywords

  • COVID-19
  • vaccine
  • mRNA-BNT162b2
  • anti-SARS-CoV-2 antibodies
  • serologic response longevity
  • circulating B cells
  • cross-reactivity

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