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. 2024 Sep;83(7):544-548.
doi: 10.1007/s00393-024-01555-2. Epub 2024 Sep 23.

[Corona vaccination under immunosuppression]

[Article in German]
Affiliations

[Corona vaccination under immunosuppression]

[Article in German]
R Hasseli-Fräbel et al. Z Rheumatol. 2024 Sep.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to play a major role as a severe and potentially fatal airway infection, especially in vulnerable patient groups. In view of the thin data situation on the influence of treatment and response to vaccination, at the beginning of the corona pandemic it was a major challenge to predict the tolerability and effectiveness in patients with inflammatory rheumatic diseases under immunomodulation or immunosuppression. In the meantime, numerous studies have addressed the questions of response and tolerability, at least for the COVID-19 vaccination. Even in the first months of the vaccination campaign, a small study on a single center cohort could show that apart from patients with B‑cell depletion, all included patients showed a seroconversion after the first two vaccinations. This resulted in neither an increased occurrence of exacerbations of the underlying disease nor new autoimmune phenomena. Various studies have since then confirmed these data.

SARS-CoV‑2 („severe acute respiratory syndrome coronavirus type 2“) spielt auch weiterhin eine große Rolle als schwere und potenziell tödliche Atemwegsinfektion insbesondere bei vulnerablen Patient:innengruppen. Angesichts der dünnen Datenlagen zum Einfluss von Therapien auf Impfantworten war es zu Beginn der Corona-Pandemie eine große Herausforderung, die Verträglichkeit und Wirksamkeit bei Patient:innen mit entzündlich rheumatischen Erkrankungen unter Immunmodulation/Immunsuppression vorherzusagen. Inzwischen haben zahlreiche Studien die Fragen nach Ansprechen und Verträglichkeit zumindest für die COVID-19(Coronavirus-Erkrankung 2019)-Impfung adressiert. Bereits in den ersten Monaten der Impfkampagne konnte eine kleine Studie an einer monozentrischen Kohorte zeigen, dass bis auf Patient:innen unter B‑Zell-Depletion alle eingeschlossenen Patient:innen in der Lage waren, nach den ersten 2 Impfungen eine Serokonversion zu zeigen. Dabei kam es weder zu einem vermehrten Auftreten von Schüben der Grunderkrankungen noch zu neuen Autoimmunphänomenen. Diverse Studien haben diese Daten seitdem bestätigt.

Keywords: B‑cell depletion; COVID-19 vaccination; Inflammatory rheumatic diseases; SARS-CoV‑2; Seroconversion.

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