Updated: September 6, 2021 1:34:51 am
THE Covid-19 pandemic has introduced numerous challenges to the healthcare system. It has disproportionately affected the disadvantaged populations, including those with autoimmune disease, who have been considered to be at increased risk of adverse outcomes from Covid-19. The response to Covid-19 vaccination in patients who have underlying immune mediated inflammatory diseases, and are on immune suppressing medication, is a significant global concern.
A systematic study published from PGI in Autoimmunity Reviews, a high-impact Elsevier journal, is the first report which has evaluated the vaccine responses in various antirheumatic and immune modulating drugs. The results suggest that the response to Covid-19 vaccination in patients with such diseases is less compared to the general population. Immune mediated inflammatory diseases are a group of disorders which result from malfunction of the body’s immune system and include many common diseases like inflammatory bowel disease, rheumatoid arthritis, systemic lupus erythematosus and vasculitis.
Dr Anuraag Jena and Dr Shubhra Mishra, the lead co-authors for the paper, suggested that the patients with these disorders could be candidates for testing for response to the double dose of Covid-19 vaccine. Further studies are required to assess the need for booster diseases in improving the efficacy of vaccination in this sub-group of patients. Prof Aman Sharma, a rheumatologist, said that the care of patients with autoimmune disorders has been challenging during the Covid-19 and the issues of vaccine efficacy have been a major concern amongst rheumatologists globally. There has been some evidence of early fall in antibodies in such patients after vaccination.
Dr Vishal Sharma, the senior author, whose expertise is inflammatory bowel disease, said that while some drugs do not seem to impact response to double dose of vaccines like infliximab, adalimumab, five-aminosalicylates and vedolizumab, certain drugs like rituximab, steroids and immunomodulators reduced the immune responses to the vaccination even after the double dose. “People with comorbidities were excluded from randomised vaccine trials. When we treated such patients for Covid-19, we realised that their immune response to the vaccine may not be robust. That’s why we decided to do this study. The single vaccine dose response in such patients was not good, so we did not want the second dose of the vaccine to be delayed. Even after the second dose, the immune response was not reaching the height in a sub-group of patients with IMIDs, as compared to the general population. So, these patients should strictly continue Covid-appropriate behaviour, social distancing and use of masks.”
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