COVID-19 Vaccine Booster Uptake and Effectiveness Among Persons With Systemic Autoimmune and Rheumatic Diseases

Area of Science:

• Immunology
• Rheumatology
• Infectious Diseases

Background:

• Individuals with Systemic Autoimmune and Rheumatic Diseases (SARDs) are often immunocompromised, increasing their risk of severe COVID-19.
• Understanding the effectiveness of COVID-19 vaccination, including boosters, is critical for protecting this vulnerable population.

Purpose of the Study:

• To evaluate the uptake of coronavirus disease 2019 (COVID-19) booster doses.
• To determine the vaccine effectiveness (VE) of COVID-19 boosters in preventing COVID-19 hospitalization among patients with SARDs.

Main Methods:

• Retrospective analysis of adult patients with SARDs receiving disease-modifying antirheumatic drugs across four US health systems.
• Assessment of monovalent booster receipt before January 1, 2022, and bivalent vaccine receipt between September 1, 2022, and August 31, 2023.
• Follow-up data collected to assess COVID-19 hospitalization rates in relation to vaccination status.

Main Results:

• 63% of 201,165 SARDs patients received a monovalent booster. Monovalent boosters showed an adjusted VE of 38% against COVID-19 hospitalization.
• 36% of 246,991 SARDs patients received a bivalent vaccine. Bivalent vaccines demonstrated an adjusted VE of 32% against COVID-19 hospitalization.
• Both monovalent and bivalent boosters provided significant protection, reducing hospitalization rates in this immunocompromised cohort.

Conclusions:

• COVID-19 booster vaccinations are effective in providing substantial protection against severe COVID-19 outcomes in individuals with SARDs.
• Increased COVID-19 vaccine booster uptake should be a priority for this high-risk immunocompromised population to mitigate severe disease.
• These findings underscore the importance of continued vaccination strategies for immunocompromised patients.