Anti-SARS-CoV-2 mRNA vaccination among patients living with SLE in Sweden: Coverage and clinical effectiveness.

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2024-10-01 Epub Date: 2024-08-12 DOI:10.1177/09612033241273052
Arthur Mageau, Julia F Simard, Elisabet Svenungsson, Elizabeth V Arkema
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引用次数: 0

Abstract

Objectives: To describe the uptake of anti-SARS-CoV2 vaccination in 2021 and investigate vaccine effectiveness in systemic lupus erythematosus (SLE) patients in Sweden.

Methods: The cumulative incidence of first anti-SARS-CoV2 vaccination was estimated among SLE patients from the Swedish National Patient Register and matched comparators living in Sweden on January 1, 2021. To assess vaccine effectiveness, we included the individuals who received two doses of anti-SARS-CoV2 mRNA vaccines before year 2022, with no COVID-19 diagnosis code before the 2nd vaccine dose. Hospitalization rates with COVID-19 as main diagnosis during the year after second dose were compared between SLE patients and comparators in multivariable-adjusted marginal Cox models, overall and stratified by immunosuppressive treatment received during the year before second vaccine dose.

Results: Vaccination uptake was similar between SLE patients and comparators. By December 2021, 9% of both SLE and comparators had not received any vaccine doses. Among 5585 SLE patients and 37,102 comparators, 11 COVID-19 hospitalizations in the SLE group and 20 in the comparators occurred. SLE was associated with a higher risk of COVID-19 hospitalization (HR = 3.47, 95%CI 1.63-7.39). The HR was higher for immunosuppressive-treated SLE (7.03 95%CI 3.00-16.46) than for immunosuppressive-untreated (1.50 95%CI 0.34-6.60). Vaccination of immunosuppressive-untreated SLE patients had similar effectiveness as comparators.

Conclusion: Anti-SARS-CoV2 vaccination coverage was similar between SLE patients and the general population in Sweden. Even though the incidence of post-vaccination COVID-19 hospitalization was very low, vaccine effectiveness was diminished in SLE patients compared to the general population and lowest in those treated with immunosuppressants.

瑞典系统性红斑狼疮患者接种抗 SARS-CoV-2 mRNA 疫苗:覆盖率和临床效果。
目的描述瑞典系统性红斑狼疮(SLE)患者在 2021 年接种抗 SARS-CoV2 疫苗的情况,并调查疫苗的有效性:方法:我们估算了瑞典全国患者登记册中的系统性红斑狼疮患者首次接种抗SARS-CoV2疫苗的累积发生率,以及2021年1月1日居住在瑞典的匹配比较者。为了评估疫苗的有效性,我们纳入了在2022年之前接种过两剂抗SARS-CoV2 mRNA疫苗、在接种第二剂疫苗之前没有COVID-19诊断代码的患者。在经多变量调整的边际 Cox 模型中,比较了系统性红斑狼疮患者和比较者在接种第二剂疫苗后一年内以 COVID-19 为主要诊断的住院率,包括总体住院率和按接种第二剂疫苗前一年内接受的免疫抑制治疗分层的住院率:结果:系统性红斑狼疮患者和参照者的疫苗接种率相似。截至 2021 年 12 月,9% 的系统性红斑狼疮患者和参照者都没有接种过任何剂量的疫苗。在 5585 名系统性红斑狼疮患者和 37102 名参照者中,系统性红斑狼疮组有 11 例 COVID-19 住院病例,参照者有 20 例。系统性红斑狼疮与较高的 COVID-19 住院风险有关(HR = 3.47,95%CI 1.63-7.39)。接受免疫抑制剂治疗的系统性红斑狼疮患者的HR(7.03 95%CI 3.00-16.46)高于未接受免疫抑制剂治疗的患者(1.50 95%CI 0.34-6.60)。免疫抑制剂未治疗的系统性红斑狼疮患者接种疫苗的效果与对照组相似:结论:瑞典系统性红斑狼疮患者和普通人群的抗SARS-CoV2疫苗接种覆盖率相似。尽管接种COVID-19疫苗后住院的发生率很低,但与普通人群相比,系统性红斑狼疮患者接种疫苗的效果较差,而接受免疫抑制剂治疗的患者接种疫苗的效果最低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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