Patients with lupus benefit from COVID 19 vaccine booster

People with systemic lupus erythematosus, or SLE, who received a "booster" dose of SARS-CoV-2 vaccine after full vaccination are roughly half as likely to have a subsequent "breakthrough" COVID-19 infection, a new study shows.

The finding, researchers say, should offer reassurance to the more than 200,000 Americans who have systemic lupus erythematosus, a condition in which the body's immune system mistakenly attacks its own healthy tissues, especially joints and skin. Immune-suppressing drugs, such as steroids, needed to control symptoms of the disease, place them at increased risk of infections, including SARS-CoV-2.

Publishing in the journal The Lancet Rheumatology online July 12, the study showed that at the end of the monitoring period (April 24, 2022), 44 vaccinated systemic lupus erythematosus patients had breakthrough infections, with two needing hospitalization.

Among those with breakthrough infections, 28 of 125, or 22%, had received a booster, while 16 of 38, or 42%, had not. Researchers found that even those on immunosuppression who had not responded to the initial round of vaccination had an immediate rise in antibody levels after the administration of a booster shot. Previous research had shown that these antibody levels were lower among many initially vaccinated patients with rheumatic diseases, including systemic lupus erythematosus, who were taking immune-suppressing drugs, sparking fears of waning immunity to COVID-19 over time.

However, study results showed those with higher levels of antibodies, needed to block the SARS-Cov-2 "spike" protein and prevent the virus from infecting human cells, were no more protected from breakthrough infection than those with lower spike-protein antibody levels.

Researchers concluded that study results offer people living with systemic lupus erythematosus clinical confirmation that vaccines are highly effective at guarding against severe COVID-19, despite their increased risk of catching the disease.

Reference: "COVID-19 Breakthrough Infections, Morbidity, and Seroreactivity in SLE Patients Following Initial SARS-CoV-2 Vaccination Series and Additional Dose through the Omicron BA.1 Wave in New York City"; The Lancet Rheumatology.