Research ArticleAccepted Articles
Comparative effectiveness of BNT162b2 and mRNA-1273 vaccines against COVID-19 infection among patients with systemic autoimmune rheumatic diseases on immunomodulatory medications
Claire Cook, Naomi J. Patel, Xiaoqing Fu, Xiaosong Wang, Yumeko Kawano, Kathleen M.M. Vanni, Grace Qian, Emily Banasiak, Emily Kowalski, Hyon K. Choi, Yuqing Zhang, Jeffrey A. Sparks and Zachary S. Wallace
The Journal of Rheumatology January 2023, jrheum.220870; DOI: https://doi.org/10.3899/jrheum.220870
Claire Cook
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Naomi J. Patel
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Xiaoqing Fu
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Xiaosong Wang
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Yumeko Kawano
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Kathleen M.M. Vanni
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Grace Qian
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Emily Banasiak
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Emily Kowalski
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Hyon K. Choi
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Yuqing Zhang
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Jeffrey A. Sparks
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Zachary S. Wallace
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, USA (Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114). Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA (60 Fenwood Road, Boston, MA, 02115). Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114). Harvard Medical School, Boston, MA. Financial support: NJP is supported by the Rheumatology Research Foundation. JAS is funded by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (grant numbers, R01 AR077607, P30 AR070253, and P30 AR072577), the R. Bruce and Joan M. Mickey Research Scholar Fund, and the Llura Gund Award for Rheumatoid Arthritis Research and Care. ZSW is funded by NIH/NIAMS [K23AR073334 and R03AR078938]. Declaration of interests: NJP reports consulting fees from FVC Health unrelated to the current work. JAS reports research support from Bristol Myers Squibb and consultancy fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer. ZSW reports research support from Bristol-Myers Squibb and Principia/Sanofi and consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace. All other authors report no competing interests. Corresponding authors: Zachary S. Wallace, MD, MSc, Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge Street, 16th Floor, Boston, MA 02114; zswallace@mgh.harvard.edu. Jeffrey A. Sparks, MD, MMSc, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115. jsparks@bwh.harvard.edu
Abstract
Objective To compare the effectiveness of mRNA vaccines (BNT162b2 vs mRNA-1273) against COVID-19 infection among patients with systemic autoimmune rheumatic diseases (SARDs) on immunomodulatory medications.
Methods We identified patients with SARDs being treated with DMARDs and/or glucocorticoids in the Mass General Brigham healthcare system who received either BNT162b2 or mRNA-1273 as their initial vaccine series. Patients were followed until positive SARS-CoV-2 test, death, or 2/22/2022. We compared the risk of breakthrough infection between BNT162b2 and mRNA-1273 vaccine recipients using time stratified, overlap propensity score–weighted Cox proportional hazard models.
Results We identified 9838 patients with SARDs who received BNT162b2 or mRNA-1273. Demographic and clinical characteristics were similar in both groups after overlap weighting: mean age 61 years, 75% female, 54% with rheumatoid arthritis, and 74% receiving conventional and 43% receiving biologic DMARDs. Of 5516 BNT162b2 and 4322 mRNA-1273 recipients, 446 and 329 had a breakthrough infection, respectively. The corresponding time-stratified PS weighted rate difference of breakthrough infection was 0.71 (95%CI: -0.70, 2.12) per 1000 person months with a weighted HR of 1.12 (95%CI: 0.90, 1.39). When follow-up was censored prior to the Omicron wave, there was a trend towards higher breakthrough risk with BNT162b2 vs mRNA-1273 (weighted HR 1.34, 95%CI: 0.91, 1.98).
Conclusion Among SARD patients, the risk of breakthrough COVID-19 infection is similar after receiving either BNT162b2 or mRNA-1273. Patients with SARDs initiating the vaccine series should be encouraged to receive whichever mRNA vaccine is available.
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In this issue
The Journal of Rheumatology
Vol. 50, Issue 3
1 Mar 2023
Accepted manuscript
Comparative effectiveness of BNT162b2 and mRNA-1273 vaccines against COVID-19 infection among patients with systemic autoimmune rheumatic diseases on immunomodulatory medications
Claire Cook, Naomi J. Patel, Xiaoqing Fu, Xiaosong Wang, Yumeko Kawano, Kathleen M.M. Vanni, Grace Qian, Emily Banasiak, Emily Kowalski, Hyon K. Choi, Yuqing Zhang, Jeffrey A. Sparks, Zachary S. Wallace
The Journal of Rheumatology Jan 2023, jrheum.220870; DOI: 10.3899/jrheum.220870
Accepted manuscript
Comparative effectiveness of BNT162b2 and mRNA-1273 vaccines against COVID-19 infection among patients with systemic autoimmune rheumatic diseases on immunomodulatory medications
Claire Cook, Naomi J. Patel, Xiaoqing Fu, Xiaosong Wang, Yumeko Kawano, Kathleen M.M. Vanni, Grace Qian, Emily Banasiak, Emily Kowalski, Hyon K. Choi, Yuqing Zhang, Jeffrey A. Sparks, Zachary S. Wallace
The Journal of Rheumatology Jan 2023, jrheum.220870; DOI: 10.3899/jrheum.220870
