COVID-19 vaccine boosters are beneficial for patients suffering from Lupus — ScienceDaily

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A new study has shown that people with systemic Lupus Erythematosus (or SLE) who were given a “booster” dose SARS-CoV-2 vaccine following full vaccination are approximately half as likely to develop a subsequent COVID-19 infection.

Researchers say the finding should be reassuring to the over 200,000 Americans suffering from SLE. SLE is a condition that causes the immune system to attack its own healthy tissues, particularly joints and skin. Steroids, which suppress the immune system and are used to treat symptoms of the disease, can put people at greater risk for infection, including SARS-CoV-2.

The new study was led by NYU Grossman School of Medicine researchers. It tracked 163 fully-vaccinated men, and women, who were being treated for SLE in its affiliated hospitals in New York City. Researchers wanted to determine who was infected by the virus within six months. This was because more than half of those vaccinated were on at least one immuno-suppressing medication. All had received some combination of the vaccines manufactured by Pfizer, Moderna, or Johnson & Johnson prior to June 2021, but only 125 had received a third or booster dose of vaccine.

The journal publishes authors The Lancet RheumatologyOnline July 12, the study revealed that 44 of 44 SLE patients had developed breakthrough infections by the end the monitoring period (April 24, 2022). Two of these patients required hospitalization, but both survived.

28 out of 125 (or 22%) had had a booster. 16 of 38 (42%), had not. Investigators found that 42 of 44 breakthrough infections occurred after the Dec. 2, 2021 detection of the highly contagious Omicron variant.

Another important finding of the study was that 57 participants in the study agreed to have blood antibody levels tested after receiving their booster and after receiving full vaccination.

Researchers discovered that even patients on immunosuppression, who did not respond to the first round of vaccination, experienced an immediate increase in antibody levels following the administration of a booster shot. Research had previously shown that antibody levels in patients initially vaccinated for rheumatic conditions, such as SLE, were lower than those who were on immunosuppressing drugs. This led to fears about the possibility of losing immunity to COVID-19.

Study results revealed that those with higher levels antibodies to stop the SARS-Cov-2 spike protein from infecting human cells and protect them from future infection, were not as protected from the virus than those with lower levels.

However, their research has revealed that the immune system is stronger in fully vaccinated patients with Lupus. This could explain the absence of severe disease in people with breakthrough infections.

“Our study results give people with systemic Lupus Erythematosus clinical evidence that vaccines can be highly effective in protecting against severe COVID-19 despite the increased risk of contracting the disease,” said Amit Saxena MD MS, co-lead researcher and rheumatologist.

“COVID-19 vaccine boosters or third shots offered an additional, doubled layer of defense against breakthrough infection,” said Saxena. He is an assistant professor at NYU Langone Health’s Department of Medicine. “Even in cases where SARS-CoV-2 was present, patients with SLE were more likely to be vaccinated than those who were not.

Peter Izmirly MD (co-senior investigator) says that even though they are on immune suppression, most people with systemic leukemia have good results. Izmirly is an associate Professor in the Department of Medicine at NYU Langone Health.

Researchers warn that patients with SLE should be monitored closely to see if they have an antibody threshold below which they are more susceptible to SARS-CoV-2.

The researchers found that NYU Langone’s SLE hospitalization rates in the initial pandemic wave of spring 2020 were nearly twice those of patients without the condition. However, death rates were similar.

The National Institutes of Health (P50AR07059) as well as Bloomberg Philanthropies’ COVID-19 Response grants provided financial support.

Apart from Saxena and Izmirly the other NYU Langone researchers who participated in this study include Alexis Engel (BS), co-lead investigator; Ghadeerhasan, MD and Nicola Fraser, BS. Study co-investigators are Brittany Banbury and Mala Masson, BA, Rebecca Haberman and Jose Scher, MDs; Gary Ho, MD and Jammie Law, MDs; Paula Rackoff and Chung-E Tseng and H. Michael Belmont, MDseng, MDse Michael Belmont, MDse, MDse; Robert Clancy, MD and Robert Clancy, PhD.

Saxena has received consulting fees from AstraZeneca and GlaxoSmithKline as well as Bristol-Myers Squibb and Eli Lilly. Izmirly served as consultant to Momenta/Janssen on an advisory board sponsored in part by GlaxoSmithKline. Janssen has had Haberman, Scher, and Sanofi’s Scher as consultants. Scher also received and consulted for research funding from Novartis and Pfizer. Momenta/Janssen has had Clancy and Buyon as consultants. Buyon, on the other hand, has consulted for or served on data safety monitoring boards for Equillium, Ventus, and GlaxoSmithKline. These arrangements are being handled in accordance to the NYU Langone policies and procedures.

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