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Immunogenicity of COVID-19 booster vaccines in children receiving immunosuppressive medications
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DOI：10.1038/s41390-025-04174-y.png)
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Abstract
En 中文
As many jurisdictions move towards seasonal COVID-19 vaccines, there remains insufficient data on optimal vaccination strategies for children with immune-mediated inflammatory diseases (IMID) treated with immunomodulatory therapies. A prospective observational cohort study was performed, with clinical data and biosamples longitudinally collected to determine the effect of immunomodulatory therapies on the antibody response to four COVID-19 vaccine doses. Antibodies against the SARS-CoV-2 spike, receptor-binding domain, and nucleocapsid proteins were measured. Following doses two and three, antibody responses were lowest in participants treated with biologic or targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs), of which TNF inhibitors were the most common. Rates of antibody decay were similar between treatment groups, but weaker initial responses in the b/tsDMARD group led to antibody levels dipping to low values within four months of vaccination. The fourth vaccine dose significantly boosted antibody levels in the b/tsDMARD group, resulting in a sustained response. Among additional samples collected from children with hybrid immunity (i.e., vaccinated and prior SARS-CoV-2 infection), no differences in antibody levels were found between participants who were or were not treated with b/tsDMARDs. These data support providers in counselling families regarding the importance of annual COVID-19 booster vaccines in children with IMID.
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