COVID Vaccines Produce Immune Responses in Patients with Chronic Inflammatory Diseases

Most patients on immunosuppressive drugs for chronic inflammatory conditions, like rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease, can still produce antibodies after receiving the mRNA COVID-19 vaccines, researchers at UC San Francisco and Washington University have concluded.

The study, published online on Aug. 30, 2021, in Annals of Internal Medicine, found that 89 percent of patients with inflammatory conditions produced detectable antibodies in response to the vaccine. These responses differed by drug, however, and some participants produced low antibody levels.

“Since it is unknown what the cutoff is for antibody protection, it is hard to predict the extent to which the reduced antibody titers alter protection of patients with chronic inflammatory disease,” said co-author Mary Nakamura, MD, of the UCSF Rheumatoid Arthritis Clinic, who led the UCSF research team.

“Additionally, it is difficult to distinguish between the role of the underlying disease and the role of medications in contributing to the diminished capacity of the vaccine to prompt an immune response.”

The study included 186 participants at UCSF, Zuckerberg San Francisco General Hospital and Washington University School of Medicine, in St. Louis, Mo., 133 of whom had a chronic inflammatory condition, and 53 of whom did not.

The most common conditions were inflammatory bowel disease, which includes Crohn’s disease and ulcerative