Objectives The effectiveness of the BNT162b2 mRNA COVID-19 vaccine for adolescents with juvenile-onset inflammatory or immune rheumatic diseases (IRDs) is unknown. Several studies have suggested attenuated immunogenicity in patients with IRD. This study evaluated the effectiveness of the BNT162b2 mRNA COVID-19 vaccine in preventing COVID-19 infection in adolescents with juvenile-onset IRD compared with controls without immune rheumatic disease. Methods We used data from Clalit Health Services, the largest health-care organization in Israel, to conduct an observational cohort study from February to December 2021, involving 12–18 year-old adolescents diagnosed with IRD. Study outcomes included documented COVID-19 infection in relation to vaccination status and immunomodulatory therapy. We estimated vaccine effectiveness as one minus the risk ratio. Adolescents aged 12–18 years without immune rheumatic disease served as controls. Results A total of 1639 adolescents with IRD (juvenile idiopathic arthritis, SLE, or familial Mediterranean fever) were included and compared with 524 471 adolescents in the same age range without IRD. There was no difference in COVID-19 infection rates after the second dose of vaccine between those with IRD and controls (2.1% vs 2.1% respectively, P = 0.99). The estimated vaccine effectiveness for adolescents with IRD was 76.3% after the first dose, 94.8% after the second and 99.2% after the third dose. Conclusion We found that the BNT162b2 mRNA vaccine was similarly effective against COVID-19 infection in adolescents with and without IRD. Immunomodulatory therapy did not affect its effectiveness. These results can encourage adolescents with IRD to get vaccinated against COVID-19.

中文翻译：

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BNT162b2 mRNA COVID-19 疫苗在患有青少年炎症性风湿病的青少年中的有效性

目标 BNT162b2 mRNA COVID-19 疫苗对患有青少年炎症或免疫性风湿病 (IRD) 的青少年的有效性尚不清楚。几项研究表明 IRD 患者的免疫原性减弱。本研究评估了 BNT162b2 mRNA COVID-19 疫苗与没有免疫性风湿病的对照组相比，在预防青少年 IRD 青少年 COVID-19 感染方面的有效性。方法 我们使用以色列最大的医疗保健组织 Clalit Health Services 的数据，在 2021 年 2 月至 12 月期间开展了一项观察性队列研究，研究对象为被诊断为 IRD 的 12-18 岁青少年。研究结果包括记录在案的 COVID-19 感染与疫苗接种状态和免疫调节疗法有关。我们将疫苗有效性估计为 1 减去风险比。没有免疫性风湿病的 12-18 岁青少年作为对照。结果 总共纳入了 1639 名患有 IRD（幼年特发性关节炎、SLE 或家族性地中海热）的青少年，并与同一年龄段没有 IRD 的 524471 名青少年进行了比较。在接种第二剂疫苗后，IRD 组和对照组之间的 COVID-19 感染率没有差异（分别为 2.1% 和 2.1%，P = 0.99）。估计 IRD 青少年的疫苗有效性在第一剂后为 76.3%，第二剂后为 94.8%，第三剂后为 99.2%。结论 我们发现 BNT162b2 mRNA 疫苗对患有和不患有 IRD 的青少年的 COVID-19 感染具有相似的有效性。免疫调节疗法不影响其有效性。