How Does COVID-19 Booster Affect Patients With GCA and Low Primary Vaccine Response?

Humoral protection after SARS-CoV-2 booster vaccination remained lower in patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) who responded poorly to primary vaccination, according to study results published online ahead of print in Arthritis Care & Research.

“Vaccination remains essential in preventing morbidity of SARS-CoV-2 infections,” wrote corresponding author Yannick van Sleen, PhD, of the University Medical Center Groningen Department of Rheumatology and Clinical Immunology in the Netherlands, and coauthors. “We previously showed that >10 mg/day prednisolone and methotrexate use associated with reduced antibody concentrations after primary vaccination in patients with GCA and PMR.”

To follow up, researchers again measured antibody concentrations in 24 patients from the previous study 6 months after primary vaccination, as well as in 46 patients 1 month after booster vaccination.

Compared with age-, sex-, and vaccine-matched controls, antibody concentrations after primary vaccination waned faster over time in patients with GCA and PMR, according to the study. The steeper decline was associated with prednisolone treatment during primary vaccination.

After booster vaccination, however, antibody increases were similar between patients and controls. Prednisolone or methotrexate use during booster vaccination did not affect immunogenicity of the booster shot. Nevertheless, a patient’s antibody concentrations after primary vaccination predicted antibody concentrations after booster vaccination, researchers found.

“Patients with low antibody concentrations following primary vaccination remained at an immunogenic disadvantage after a single booster vaccination,” researchers wrote. “This longitudinal study in GCA/PMR patients stresses the importance of repeated booster vaccination for patients with poor responses to primary vaccination.”

—Jolynn Tumolo

Reference
van Sleen Y, van der Geest KS, Buisman AM, Sandovici M, van Baarle D, Brouwer E. Humoral SARS-CoV-2 vaccine responses in patients with giant cell arteritis and polymyalgia rheumatica: decay after primary vaccination and effects of the booster. Arthritis Care Res. Published online June 18, 2023. doi:10.1002/acr.25173