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      Covid-19 vaccine-induced antibodies are attenuated and decay rapidly in infliximab treated patients

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          Abstract

          To inform healthcare policy for immunosuppressed patients there is a need to define SARS-CoV-2 vaccine responses. Here we report SARS-CoV-2 vaccine-induced antibody and T cell responses in patients treated with anti-tumour necrosis factor (anti-TNF), a commonly used biologic in inflammatory diseases, compared to patients treated with vedolizumab, a gut-specific antibody targeting integrin a4b7 that does not impair systemic immunity. In anti-TNF recipients, the magnitude of anti-SARS-CoV2 antibodies was reduced five-fold, and rapidly decayed towards the seroconversion threshold by 14 weeks after second dose of vaccine. In contrast, anti-SARS-CoV-2 antibodies were sustained up to 16 weeks in vedolizumab-treated patients. Anti-SARS-CoV2 antibody decay was not observed in vaccinated patients previously infected with SARS-CoV-2. T cell responses were absent in one-fifth of anti-TNF and vedolizumab-treated patients after a second dose of either vaccine. Our data have important implications for anti-TNF recipients, including the need for vaccine prioritization, booster doses, and social distancing strategies.

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          Journal
          Research Square
          July 30 2021
          Affiliations
          [1 ]Royal Devon and Exeter NHS Foundation Trust
          [2 ]Department of Gastroenterology, Royal Devon and Exeter NHS Foundation Trust
          [3 ]Department of Gastroenterology, St Marks Hospital and Academic Institute
          [4 ]Department of Infectious Disease, Imperial College London
          [5 ]Department of Immunology and Inflammation, Imperial College London
          [6 ]Department of Metabolism, Digestion and Reproduction, Imperial College London
          [7 ]Department of Biochemistry, Exeter Clinical Laboratory International, Royal Devon and Exeter NHS Foundation Trust
          [8 ]Exeter Inflammatory Bowel Disease and Pharmacogenetics Research Group, University of Exeter
          [9 ]Department of Gastroenterology, Hull University Teaching Hospitals NHS Trust
          [10 ]Department of Gastroenterology, Imperial College Healthcare NHS Trust
          [11 ]Genetic Mechanisms of Disease Laboratory, The Francis Crick Institute
          [12 ]Department of Gastroenterology, Royal Free London NHS Foundation Trust
          [13 ]Department of Gastroenterology, St Mark’s Hospital and Academic Institute
          [14 ]Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust
          [15 ]Department of Gastroenterology, Western General Hospital, NHS Lothian
          [16 ]Department of Gastroenterology, Royal London Hospital, Barts Health NHS Trust
          [17 ]Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust
          [18 ]Department of Metabolism, Digestion and Reproduction, Imperial College London
          Article
          10.21203/rs.3.rs-755879/v1
          61332d7c-ef69-4193-a377-eb33c1bf23f4
          © 2021
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