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Postvaccination Immunogenicity of BNT162b2 SARS-CoV-2 Vaccine and Its Predictors in Pediatric Inflammatory Bowel
Jiri Bronsky1, Ivana Copova1, Marianna Durilova1
1From the Department of Paediatrics, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Insights
Pediatric patients with inflammatory bowel disease (IBD) showed robust immunity after the messenger RNA BNT162b2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine, with higher anti-spike S2 IgG levels compared to controls. Previous SARS-CoV-2 infection boosted antibody production, while anti-tumor necrosis factor treatment was linked to lower levels.
Area of Science:
- Immunology
- Vaccinology
- Gastroenterology
Background:
- Inflammatory bowel disease (IBD) can impact immune responses.
- Understanding vaccine-induced immunity in pediatric IBD patients is crucial for public health.
- The BNT162b2 vaccine is widely used for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevention.
Purpose of the Study:
- To compare postvaccination immunity in pediatric IBD patients over 12 years old against the SARS-CoV-2 BNT162b2 vaccine with healthy controls.
- To identify predictors of robust vaccine-induced immunity in pediatric IBD patients.
Main Methods:
- A prospective study involving 139 pediatric patients with IBD and 1744 healthy controls.
- Measurement of anti-receptor binding domain, anti-spike S2, and anti-nucleocapsid immunoglobulin-G (IgG) and immunoglobulin-A levels using microblot array.
- Analysis of antibody titers and associations with IBD status, vaccination history, and treatments.
Main Results:
- All participants developed positive anti-receptor binding domain IgG antibodies.
- Pediatric IBD patients exhibited higher proportions and titers of anti-spike S2 IgG compared to controls.
- Anti-spike S2 IgG levels were associated with time since vaccination, prior SARS-CoV-2 infection, and anti-tumor necrosis factor treatment.
Conclusions:
- Pediatric patients with IBD demonstrate enhanced postvaccination anti-spike S2 antibody production compared to healthy controls.
- Previous SARS-CoV-2 infection positively correlates with higher antibody levels, whereas anti-tumor necrosis factor treatment is associated with lower levels.
- The BNT162b2 vaccine appears effective in inducing immunity in pediatric IBD patients, though treatment-specific factors may modulate the response.
Objectives:
We prospectively compared the postvaccination immunity to messenger ribonucleic acid BNT162b2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine of our pediatric patients over 12 years old with inflammatory bowel disease (IBD) to that of healthy controls and looked for predictors of its robustness.
Methods:
Anti-receptor binding domain, anti-spike S2, and anti-nucleocapsid immunoglobin-G (IgG) and immunoglobin-A levels were measured in 139 pediatric patients with IBD [65 fully vaccinated (2 doses), median age 16.3, interquartile range (IQR) 15.2-17.8 years, median time from vaccination (IQR) 61.0 (42.0-80.0) days] and 1744 controls (46, 37-57 years) using microblot array.
Results:
All IBD and control patients developed positive anti-receptor binding domain IgG antibodies at comparable titers. The proportion of observations with positive anti-spike S2 IgG was higher in patients with IBD than in controls [63% vs 21%, odds ratio 2.99 (1.51-5.90)], as was its titer [median (IQR) 485 (92-922) vs 79 [33-180] IU/mL]. Anti-receptor binding domain and anti-spike S2 IgG levels were associated with IBD status. We found an association between anti-spike S2 IgG levels and time since vaccination (β -4.85, 95% CI -7.14 to 2.71, P = 0.0001), history of SARS-CoV-2 polymerase chain reaction positivity (206.76, 95% CI 39.93-374.05, P = 0.0213), and anti-tumor necrosis factor treatment (-239.68, 95% CI -396.44-83.55, P = 0.0047). Forty-three percent of patients reported vaccination side effects (mostly mild). Forty-six percent of observations with positive anti-nucleocapsid IgG had a history of SARS-CoV-2 infection.
Conclusions:
Patients with IBD produced higher levels of postvaccination anti-spike S2 antibodies than controls. Previous SARS-CoV-2 infection is associated with higher production of postvaccination antibodies and anti-tumor necrosis factor treatment with lower production.
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