Simeng Lin 1 , Nicholas A Kennedy 2 , Aamir Saifuddin 3 , Diana Muñoz Sandoval 4 , Catherine Reynolds 4 , Rocio Castro Seoane 5 , Sherine Kottoor 6 , Franziska Pieper 4 , Kai-Min Lin 4 , David K Butler 4 , Neil Chanchlani 2 , Rachel Nice 7 , Desmond Chee 2 , Claire Bewshea 8 , Malik Janjua 2 , Timothy J McDonald 7 , Shaji Sebastian 9 , James L Alexander 10 , Laura Constable 6 , James C Lee 11 , Charles D Murray 12 , Ailsa L Hart 13 , Peter M Irving 14 , Gareth-Rhys Jones 15 , Klaartje B Kok 16 , Christopher A Lamb 17 , Charlie W Lees 15 , Daniel M Altmann 5 , Rosemary J Boyton 4 , James R Goodhand 2 , Nick Powell 18 , Tariq Ahmad 2
July 30 2021
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.