Objectives Mass vaccination is the most effective strategy for controlling the COVID-19 pandemic. This study aimed to evaluate the 6-month immunogenicity after BNT162b2-COVID-19 vaccination in adolescents with JIA on TNFi treatment. Methods This single-centre study included adolescents with JIA treated with TNFi for at least 18 months. Patients received two doses of COVID-19 vaccine (Pfizer-BioNTech) from 15 April to 15 May 2021. Quantitative measurement of IgG antibodies to SARS-CoV-2-spike-protein-1 was performed at 1, 3 and 6 months post-vaccination. Results Overall, 21 adolescents with JIA in clinical remission at the time of vaccinations were enrolled. None of them discontinued TNFi/MTX treatment at the time of vaccine administration or during the follow-up period. All patients developed a sustained humoral response against SARS-CoV-2 at 1 and 3 months after vaccination (P < 0.05). The antibody levels decreased significantly at 6 months post-vaccination (P < 0.01). The type of JIA did not reveal any differences in the humoral response at 3 (P = 0.894) or 6 months post-vaccination (P = 0.72). No difference was detected upon comparison of the immunogenicity between the different treatment arms (adalimumab vs etanercept) at 3 (P = 0.387) and 6 months (P = 0.526), or TNFi monotherapy vs combined therapy (TNFi plus methotrexate) at 3 (P = 0.623) and 6 months (P = 0.885). Conclusions Although mRNA vaccines develop satisfactory immunogenicity at 1 month and 3 months post-vaccination in adolescents with JIA on TNFi, SARS-CoV-2 antibody titres decrease significantly overtime, remaining at lower levels at 6 months. Further collaborative studies are required to determine long-term immunogenicity, real duration of immune protection and the need for a booster vaccine dose.

中文翻译：

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接受 TNF 抑制剂治疗的幼年特发性关节炎青少年接种 COVID-19 mRNA 后 6 个月的免疫原性

目标 大规模疫苗接种是控制 COVID-19 大流行的最有效策略。本研究旨在评估接受 TNFi 治疗的 JIA 青少年接种 BNT162b2-COVID-19 后 6 个月的免疫原性。方法 这项单中心研究包括接受 TNFi 治疗至少 18 个月的 JIA 青少年。患者在 2021 年 4 月 15 日至 5 月 15 日期间接受了两剂 COVID-19 疫苗（辉瑞-BioNTech）。在接种后 1、3 和 6 个月对 SARS-CoV-2-spike-protein-1 的 IgG 抗体进行了定量测量接种疫苗。结果 总体而言，21 名 JIA 青少年在接种疫苗时处于临床缓解期。他们中没有人在接种疫苗时或随访期间停止 TNFi/MTX 治疗。所有患者在接种疫苗后 1 个月和 3 个月都对 SARS-CoV-2 产生了持续的体液反应（P < 0.05）。抗体水平在疫苗接种后 6 个月显着下降 (P < 0.01)。JIA 的类型在接种疫苗后 3 个月（P = 0.894）或 6 个月（P = 0.72）时的体液反应没有任何差异。比较不同治疗组（阿达木单抗与依那西普）在 3 个月（P = 0.387）和 6 个月（P = 0.526）或 TNFi 单一疗法与联合疗法（TNFi 加甲氨蝶呤）在 3 个月（P = 0.623) 和 6 个月 (P = 0.885)。结论 尽管 mRNA 疫苗在接种 TNFi 的 JIA 青少年后 1 个月和 3 个月时产生了令人满意的免疫原性，但 SARS-CoV-2 抗体滴度随着时间的推移显着下降，在 6 个月时保持在较低水平。需要进一步的合作研究来确定长期免疫原性、免疫保护的实际持续时间和加强疫苗剂量的需要。