Dutch study is first to show Covid vaccines work well in most patients with autoimmune disease

Most patients with an autoimmune disease produce roughly the same number of antibodies after being vaccinated against Covid-19 as healthy people, according to preliminary results from a large national study carried out as part of a collaboration between the Amsterdam University Medical Center and the Sanquin network of blood banks. The first results were announced on Saturday in a report by the Volkskrant.

The results were far “beyond expectations,” said Taco Kuijpers. The immunologist led the study, which is the first globally to provide results regarding such a large group of patients, the newspaper said. The study explored if the vaccine was effective in people with a compromised immune system, many of whom take immunosuppressive medications. The initial results of the study were released to help clear up doubts about how people with autoimmune diseases react to the vaccines.

The findings have already been shared with the Ministry of Health. Hugo de Jonge, who leads the ministry, is widely expected to decide which patients qualify for an extra Covid-19 vaccine booster short. Kuijpers told the newspaper that he expects the minister will only extend the invitation to a small percentage of all patients with an autoimmune disease.

“We received many emails from people who have been locked up in their homes for a year-and-a-half for fear of becoming infected,” said immunologist Marieke van Ham. “We can now reassure patients: Most respond to the vaccines just like the rest of the population.”

Hundreds of thousands of people in the Netherlands live with autoimmune diseases, such as multiple sclerosis, inflammatory bowel disease, and rheumatoid arthritis, the newspaper stated. The effectiveness of the vaccine is affected by the type of medicine used to treat those patients, not the disease itself, said neorologist Filipino Eftimov. The most common do not seem to impact the effectiveness of the vaccine.

The immunosuppressive drugs rituximab, ocrelizumab and fingolimod appear to suppress the effectiveness of the Covid-19 vaccine because of the way they interact with a person’s B cells, which produce antibodies. This also does not leave those prescribed to take the medications without any protection against Covid-19. It is being investigated if other cells take over the job of the compromised B cells in those patients.

The study was able to completed relatively quickly because of a separate study set up in 2018, before the coronavirus pandemic. The researchers were already examining overlaps in different autoimmune diseases, and shifted the research to focus on vaccines. The recruited participants drew their own blood at home and sent it to Sanquin.

Thus far, 3,000 people have taken part in the study, with the initial results relating to 1,500 of them. The study will also continue this year and next to determine how fast the antibody levels reduce in patients with an autoimmune disease. “In healthy people, the amount of antibodies usually decreases gradually after vaccination, until a stable level is reached that protects for a longer period of time. The question is whether that process is the same in these patients,” Van Ham said.