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. 2022 Dec 23;62(1):467-472.
doi: 10.1093/rheumatology/keac322.

Low incidence and transient elevation of autoantibodies post mRNA COVID-19 vaccination in inflammatory arthritis

Rebecca B Blank  1 , Rebecca H Haberman  1 , Kun Qian  2 , Marie Samanovic  3 , Rochelle Castillo  1 , Anthony Jimenez Hernandez  1 , Parvathy Vasudevapillai Girija  1 , Sydney Catron  1 , Zakwan Uddin  1 , Paula Rackoff  1 , Gary Solomon  1 , Natalie Azar  1 , Pamela Rosenthal  1 , Peter Izmirly  1 , Jonathan Samuels  1 , Brian Golden  1 , Soumya Reddy  1 , Mark J Mulligan  3 , Jiyuan Hu  2 , Jose U Scher  1
Affiliations

Low incidence and transient elevation of autoantibodies post mRNA COVID-19 vaccination in inflammatory arthritis

Rebecca B Blank et al. Rheumatology (Oxford). .

Abstract

Objectives: Autoantibody seroconversion has been extensively studied in the context of COVID-19 infection but data regarding post-vaccination autoantibody production is lacking. Here we aimed to determine the incidence of common autoantibody formation following mRNA COVID-19 vaccines in patients with inflammatory arthritis (IA) and in healthy controls.

Methods: Autoantibody seroconversion was measured by serum ELISA in a longitudinal cohort of IA participants and healthy controls before and after COVID-19 mRNA-based immunization.

Results: Overall, there was a significantly lower incidence of ANA seroconversion in participants who did not contract COVID-19 prior to vaccination compared with those who been previously infected (7.4% vs 24.1%, P = 0.014). Incidence of de novo anti-CCP seroconversion in all participants was low at 4.9%. Autoantibody levels were typically of low titre, transient, and not associated with increase in IA flares.

Conclusions: In both health and inflammatory arthritis, the risk of autoantibody seroconversion is lower following mRNA-based immunization than following natural SARS-CoV-2 infection. Importantly, seroconversion does not correlate with self-reported IA disease flare risk, further supporting the encouragement of mRNA-based COVID-19 immunization in the IA population.

Keywords: ANA; COVID-19 infection; COVID-19 vaccines; autoantibodies; inflammatory arthritis.

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Figures

<sc>Fig.</sc> 1
Fig. 1
Incidence of ANA seroconversion and disease flare ANA seroconversion incidence in: (A) previously infected healthy control and IA participants compared to those who had not been exposed to natural infection; (B) RA, SpA and healthy controls; and (C) IAs on chronic treatment with csDMARDs, bDMARD/Jaki or combination therapy. ANA seroconversion incidence over time in: (D) previously COVID-19 infected IA participants; and (E) IA participants who hadn’t been exposed to COVID-19 natural infection. ANA incidence is significantly different across all three time-points (P = 0.007) and significantly different between 5-week and 3-month time-points (P = 0.014). (F) Self-reported IA flare incidence in those that ANA seroconverted compared to those that did not. Time-points in (D, E) as follows: prior to vaccination; 5 weeks post first vaccination dose; 3 months post first vaccination dose. Autoantibody conversion status was missing for 14% of participants at 3-month time-point. Status was imputed based on immediately prior or 6-month visit. P-values for overall homogeneity across groups were performed by Fisher’s exact test and reported for (A)–(F). *P < 0.05; **P < 0.01.
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