Yonsei Med J.
2025 May;66(5):259-268. 10.3349/ymj.2024.0129.
Immunologic Response and Effects of COVID-19 Vaccines in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis
- Affiliations
-
- 1Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- 2Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- 3Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
- 4Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
- KMID: 2567203
- DOI: http://doi.org/10.3349/ymj.2024.0129
Abstract
- Purpose
The immunological response and adverse effects of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) in patients receiving coronavirus disease-2019 (COVID-19) vaccines remain unclear. We aimed to evaluate the effects of these vaccines on AAV disease activity.
Materials and Methods
We reviewed the medical records of 52 patients with AAV who had received at least second doses of the COVID-19 vaccine and evaluated their immunogenicity by measuring the anti-spike (S) antibody (Ab) titer levels using the Roche Elecsys® immunoassay. Responses to the Birmingham Vasculitis Activity Score (BVAS) tool and 36-Item Short Form Survey before and after vaccination were obtained to assess AAV disease activity. Vaccine reactivity was measured using a standardized questionnaire.
Results
We enrolled 52 patients with AAV. No differences were found between those who received second and third doses of vaccination in terms of AAV type, disease activity, vaccine type, or the use of immunosuppressive agents, including steroids. The median anti-S Ab titer was 3967.0 after third doses compared to 419.0 after second doses (p=0.001). Except for mycophenolate mofetil (MMF), when immunosuppressants were administered in conjunction with steroids, the Ab titer was higher after the third vaccination than that after the second dose. The BVAS remained unchanged before and after second and third doses. No life-threatening adverse events were reported.
Conclusion
Although COVID-19 vaccine may not produce sufficient antibodies in patients taking MMF, the vaccine did not exacerbate disease activity or cause severe side effects. Therefore, COVID-19 vaccines should be considered in patients with AAV.
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