TY - JOUR
T1 - Breakthrough infections with the SARS-CoV-2 omicron (B.1.1.529) variant in patients with immune-mediated inflammatory diseases
AU - Stalman, Eileen W.
AU - Wieske, Luuk
AU - the T2B! Immunity against SARS-CoV-2 study group
AU - van Dam, Koos P. J.
AU - Kummer, Laura Y.
AU - van Kempen, Zoe L. E.
AU - Killestein, Joep
AU - Volkers, Adriaan G.
AU - Tas, Sander W.
AU - Boekel, Laura
AU - Wolbink, Gertjan J.
AU - Van der Kooi, Anneke J.
AU - Raaphorst, Joost
AU - Lowenberg, Mark
AU - Takkenberg, R. Bart
AU - D'Haens, Geert R. A. M.
AU - Spuls, Phyllis
AU - Bekkenk, Marcel W.
AU - Musters, Annelie H.
AU - Post, Nicoline F.
AU - Bosma, Angela L.
AU - Hilhorst, Marc L.
AU - Vegting, Yosta
AU - Bemelman, Frederique J.
AU - Voskuyl, Alexandre E.
AU - Broens, Bo
AU - Parra Sanchez, Agner
AU - van Els, Cecile A. C. M.
AU - De Wit, Jelle
AU - Rutgers, Abraham
AU - de Leeuw, Karina
AU - Horvath, Barbara
AU - Verschuuren, Jan J. G. M.
AU - Ruiter, Annabel M.
AU - van Ouwerkerk, Lotte
AU - van der Woude, Diane
AU - Allaart, C. F.
AU - Teng, Onno Y. K.
AU - van Paassen, Pieter
AU - Busch, Matthias H.
AU - Jallah, Papay B. P.
AU - Brusse, Esther
AU - van Doorn, Pieter A.
AU - Baars, Adaja Elisabeth
AU - Hijnen, Dirk Jan
AU - Schreurs, Corine R. G.
AU - Van der Pol, W. Ludo
AU - Goedee, H. Stephan
AU - Steenhuis, Maurice
AU - Keijzer, Sofie
AU - Cristianawati, Olvi
N1 - Funding Information:
We thank ZonMw (The Netherlands Organization for Health Research and Development, grant 10430072010007) for the funding of the study and the T2B partners, including the patient groups, and Health Holland for the support in this study. This collaboration project is financed by the PPP Allowance made available by Top Sector Life Sciences & Health to Samenwerkende Gezondheidsfondsen (SGF) under project number LSHM18055-SGF to stimulate public–private partnerships and co-financing by health foundations that are part of the SGF. We also thank E P Moll van Charante (Department of Public and Occupational Health and Department of General Practice, Amsterdam UMC, University of Amsterdam; and Amsterdam Public Health Research Institute, Amsterdam, Netherlands), J A Bogaards (Department of Epidemiology and Data Science, Amsterdam UMC), and R A Scholte (Clinical Research Unit, Amsterdam UMC, University of Amsterdam) for their guidance in the data safety monitoring board.
Publisher Copyright:
© 2022 BMJ Publishing Group. All rights reserved.
PY - 2022/9/5
Y1 - 2022/9/5
N2 - Objectives To compare the cumulative incidence and disease severity of reported SARS-CoV-2 omicron breakthrough infections between patients with immune-mediated inflammatory diseases (IMID) on immunosuppressants and controls, and to investigate determinants for breakthrough infections. Methods Data were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included. The observation period was between 1 January 2022 and 1 April 2022, during which the SARS-CoV-2 omicron (BA.1 and BA.2 subvariant) was dominant. A SARS-CoV-2 breakthrough infection was defined as a reported positive PCR and/or antigen test at least 14 days after primary immunisation. A multivariate logistic regression model was used to investigate determinants. Results 1593 patients with IMID on immunosuppressants and 579 controls were included. The cumulative incidence of breakthrough infections was 472/1593 (29.6%; 95% CI 27% to 32%) in patients with IMID on immunosuppressants and 181/579 (31.3%; 95% CI 28% to 35%) in controls (p=0.42). Three (0.5%) participants had severe disease. Seroconversion after primary immunisation (relative risk, RR 0.71; 95% CI 0.52 to 0.96), additional vaccinations (RR 0.61; 95% CI 0.49 to 0.76) and a prior SARS-CoV-2 infection (RR 0.60; 95% CI 0.48 to 0.75) were associated with decreased risk of breakthrough infection. Conclusions The cumulative incidence of reported SARS-CoV-2 omicron breakthrough infections was high, but similar between patients with IMID on immunosuppressants and controls, and disease severity was mostly mild. Additional vaccinations and prior SARS-CoV-2 infections may reduce the incidence of breakthrough infections.
AB - Objectives To compare the cumulative incidence and disease severity of reported SARS-CoV-2 omicron breakthrough infections between patients with immune-mediated inflammatory diseases (IMID) on immunosuppressants and controls, and to investigate determinants for breakthrough infections. Methods Data were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included. The observation period was between 1 January 2022 and 1 April 2022, during which the SARS-CoV-2 omicron (BA.1 and BA.2 subvariant) was dominant. A SARS-CoV-2 breakthrough infection was defined as a reported positive PCR and/or antigen test at least 14 days after primary immunisation. A multivariate logistic regression model was used to investigate determinants. Results 1593 patients with IMID on immunosuppressants and 579 controls were included. The cumulative incidence of breakthrough infections was 472/1593 (29.6%; 95% CI 27% to 32%) in patients with IMID on immunosuppressants and 181/579 (31.3%; 95% CI 28% to 35%) in controls (p=0.42). Three (0.5%) participants had severe disease. Seroconversion after primary immunisation (relative risk, RR 0.71; 95% CI 0.52 to 0.96), additional vaccinations (RR 0.61; 95% CI 0.49 to 0.76) and a prior SARS-CoV-2 infection (RR 0.60; 95% CI 0.48 to 0.75) were associated with decreased risk of breakthrough infection. Conclusions The cumulative incidence of reported SARS-CoV-2 omicron breakthrough infections was high, but similar between patients with IMID on immunosuppressants and controls, and disease severity was mostly mild. Additional vaccinations and prior SARS-CoV-2 infections may reduce the incidence of breakthrough infections.
UR - http://www.scopus.com/inward/record.url?scp=85137856243&partnerID=8YFLogxK
U2 - 10.1136/ard-2022-222904
DO - 10.1136/ard-2022-222904
M3 - Article
C2 - 36357161
SN - 0003-4967
VL - 81
SP - 1757
EP - 1766
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
IS - 12
M1 - 222904
ER -
