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We read with interest the recent findings by Kennedy et al, which concluded that infliximab (IFX) impairs antibody responses to a single dose of the mRNA-BNT162b2 SARS-CoV-2 vaccine in adult patients with IBD.1 2 Interestingly, another study showed that antibodies against SARS-CoV-2 diminish over time following infection in adult patients with IBD.3 In general, more robust antibody responses have been observed in adolescents compared with adults in the BNT162b2 vaccine trial.4 However, the true impact of immunosuppressant therapies on SARS-CoV-2 vaccine efficacy in paediatric IBD (PIBD) patients is unknown as they were excluded from the trials. Therefore, analysing vaccine responses directly in these patients is necessary to determine the best strategy.5 6
We undertook a study to evaluate immunogenicity of mRNA-based SARS-CoV-2 vaccines in PIBD patients treated with anti-TNF therapies. Given the urgent need for data, we herein present preliminary findings. The study prospectively enrolled PIBD patients 12–17 years, treated with anti-TNF agents either alone or in combination with an immunomodulator, who received the BNT162b2 vaccine. Serum antibody levels for (spike protein, receptor-binding domain (RBD) and nucleocapsid protein) were measured at baseline, 28 days and 3 months after the first vaccine dose. Antibody responses were assessed using the V-PLEX SARS-CoV-2 Panel 2 (IgG) assay (Meso Scale …
Contributors KJ has full access to all data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis. KJ and PML conceived the study. KJ, PML, SL, ZJS and FR designed the study. ZJS and HS were responsible for clinical data. PML, FR, LG and AM were responsible for serological data. PNL was responsible for neutralisation data. KJ, PML, SL, ZJS and FR analysed the data. ZJS drafted the manuscript. All authors interpreted the data and provided critical revisions of the manuscript for important intellectual content. All authors approved the final draft of the manuscript.
Funding KJ is a Senior Clinician Scientist supported by the Children with Intestinal and Liver Disorders (CHILD) Foundation and the BC Children’s Hospital Research Institute Clinician Scientists Award Program, University of British Columbia. PML is supported by a salary award from the BC Children’s Hospital Foundation through the Investigator Grant Award Program. ZJS is supported by the Moffat Family Foundation. FR is funded by the Deutsche Forschungsgemeinschaft (German Research Foundation), award number RE 4598/1-1.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.