TY - JOUR
T1 - Breakthrough infections with the SARS-CoV-2 omicron (B.1.1.529) variant in patients with immune-mediated inflammatory diseases
AU - T2B Immunity Against SARS Co
AU - Stalman, Eileen W.
AU - Wieske, Luuk
AU - van Dam, Koos P. J.
AU - Kummer, Laura Y.
AU - van Kempen, Zoe L. E.
AU - Killestein, Joep
AU - Volkers, Adriaan G.
AU - Tas, Sander W.
AU - Boekel, Laura
AU - Wolbink, Gertjan J.
AU - Van der Kooi, Anneke J.
AU - Raaphorst, Joost
AU - Lowenberg, Mark
AU - Takkenberg, R. Bart
AU - D'Haens, Geert R. A. M.
AU - Spuls, Phyllis
AU - Bekkenk, Marcel W.
AU - Musters, Annelie H.
AU - Post, Nicoline F.
AU - Bosma, Angela L.
AU - Hilhorst, Marc L.
AU - Vegting, Yosta
AU - Bemelman, Frederique J.
AU - Voskuyl, Alexandre E.
AU - Broens, Bo
AU - Parra Sanchez, Agner
AU - van Els, Cecile A. C. M.
AU - De Wit, Jelle
AU - Rutgers, Abraham
AU - de Leeuw, Karina
AU - Horvath, Barbara
AU - Verschuuren, Jan J. G. M.
AU - Ruiter, Annabel M.
AU - van Ouwerkerk, Lotte
AU - van der Woude, Diane
AU - Allaart, C. F.
AU - Teng, Onno Y. K.
AU - van Paassen, Pieter
AU - Busch, Matthias H.
AU - Jallah, Papay B. P.
AU - Brusse, Esther
AU - van Doorn, Pieter A.
AU - Baars, Adaja Elisabeth
AU - Hijnen, Dirk Jan
AU - Schreurs, Corine R. G.
AU - Van der Pol, W. Ludo
AU - Goedee, H. Stephan
AU - Steenhuis, Maurice
AU - Keijzer, Sofie
AU - Rispens, Theo
PY - 2022/9/5
Y1 - 2022/9/5
N2 - Objectives To compare the cumulative incidence and disease severity of reported SARS-CoV-2 omicron breakthrough infections between patients with immune-mediated inflammatory diseases (IMID) on immunosuppressants and controls, and to investigate determinants for breakthrough infections. Methods Data were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included. The observation period was between 1 January 2022 and 1 April 2022, during which the SARS-CoV-2 omicron (BA.1 and BA.2 subvariant) was dominant. A SARS-CoV-2 breakthrough infection was defined as a reported positive PCR and/or antigen test at least 14 days after primary immunisation. A multivariate logistic regression model was used to investigate determinants. Results 1593 patients with IMID on immunosuppressants and 579 controls were included. The cumulative incidence of breakthrough infections was 472/1593 (29.6%; 95% CI 27% to 32%) in patients with IMID on immunosuppressants and 181/579 (31.3%; 95% CI 28% to 35%) in controls (p=0.42). Three (0.5%) participants had severe disease. Seroconversion after primary immunisation (relative risk, RR 0.71; 95% CI 0.52 to 0.96), additional vaccinations (RR 0.61; 95% CI 0.49 to 0.76) and a prior SARS-CoV-2 infection (RR 0.60; 95% CI 0.48 to 0.75) were associated with decreased risk of breakthrough infection. Conclusions The cumulative incidence of reported SARS-CoV-2 omicron breakthrough infections was high, but similar between patients with IMID on immunosuppressants and controls, and disease severity was mostly mild. Additional vaccinations and prior SARS-CoV-2 infections may reduce the incidence of breakthrough infections.
AB - Objectives To compare the cumulative incidence and disease severity of reported SARS-CoV-2 omicron breakthrough infections between patients with immune-mediated inflammatory diseases (IMID) on immunosuppressants and controls, and to investigate determinants for breakthrough infections. Methods Data were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included. The observation period was between 1 January 2022 and 1 April 2022, during which the SARS-CoV-2 omicron (BA.1 and BA.2 subvariant) was dominant. A SARS-CoV-2 breakthrough infection was defined as a reported positive PCR and/or antigen test at least 14 days after primary immunisation. A multivariate logistic regression model was used to investigate determinants. Results 1593 patients with IMID on immunosuppressants and 579 controls were included. The cumulative incidence of breakthrough infections was 472/1593 (29.6%; 95% CI 27% to 32%) in patients with IMID on immunosuppressants and 181/579 (31.3%; 95% CI 28% to 35%) in controls (p=0.42). Three (0.5%) participants had severe disease. Seroconversion after primary immunisation (relative risk, RR 0.71; 95% CI 0.52 to 0.96), additional vaccinations (RR 0.61; 95% CI 0.49 to 0.76) and a prior SARS-CoV-2 infection (RR 0.60; 95% CI 0.48 to 0.75) were associated with decreased risk of breakthrough infection. Conclusions The cumulative incidence of reported SARS-CoV-2 omicron breakthrough infections was high, but similar between patients with IMID on immunosuppressants and controls, and disease severity was mostly mild. Additional vaccinations and prior SARS-CoV-2 infections may reduce the incidence of breakthrough infections.
KW - Autoimmune Diseases
KW - Covid-19
KW - Autoimmunity
KW - Vaccination
U2 - 10.1136/ard-2022-222904
DO - 10.1136/ard-2022-222904
M3 - Article
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
SN - 0003-4967
ER -