Table 2. Anti–Receptor Binding Domain Response to 2-Dose Messenger RNA SARS-CoV-2 Vaccination Stratified by Vaccine Platform.
| Antibody titer, U/mLa | BNT162b2, % | mRNA-1273, % | IRR (95% CI) | P value |
|---|---|---|---|---|
| Patients with RMDs not receiving immunosuppression (n = 220) b | ||||
| ≥50 | 98.3 | 95.1 | 0.97 (0.92-1.02) | .20 |
| ≥100 | 95.8 | 95.1 | 0.99 (0.94-1.05) | .81 |
| ≥250 | 91.5 | 93.1 | 1.02 (0.94-1.10) | .67 |
| Patients with RMDs receiving immunosuppression (n = 938) b | ||||
| ≥50 | 75.4 | 83.1 | 1.10 (1.03-1.17) | .005 |
| ≥100 | 72.4 | 82.4 | 1.13 (1.06-1.21) | <.001 |
| ≥250 | 60.5 | 79.2 | 1.30 (1.20-1.42) | <.001 |
| SOTRs not receiving mycophenolic acid or mycophenolate mofetil (n = 260) c | ||||
| ≥50 | 59.1 | 78.9 | 1.38 (1.16-1.64) | <.001 |
| ≥100 | 54.6 | 77.3 | 1.47 (1.22-1.77) | <.001 |
| ≥250 | 44.7 | 66.4 | 1.56 (1.24-1.96) | <.001 |
| SOTRs receiving mycophenolic acid or mycophenolate mofetil (n = 437) c | ||||
| ≥50 | 12.8 | 21.8 | 1.69 (1.11-2.58) | .02 |
| ≥100 | 7.7 | 18.8 | 2.40 (1.42-4.07) | .008 |
| ≥250 | 4.3 | 11.4 | 2.62 (1.28-5.37) | .01 |
Abbreviations: IRR, incidence rate ratio; RMD, rheumatic and musculoskeletal disease; SOTRs, solid organ transplant recipients.
Roche Elecsys anti–receptor binding domain panimmunoglobulin titer of 0.8 U/mL or higher is considered positive per manufacturer (commercial upper ceiling >250 U/mL, with later expansion to >2500 U/mL). Patients with RMDs not receiving immunosuppression, hydroxychloroquine, or intravenous immunoglobulin had a median titer greater than 250 U/mL (IQR, >250-717.3 U/mL); patients with RMDs receiving immunosuppression had a median titer greater than 250 U/mL (IQR, 126.8-434.6 U/mL); SOTRs not receiving mycophenolic acid or mycophenolate mofetil had a median titer greater than 250 U/mL (IQR, 17.72->250 U/mL); and SOTRs receiving mycophenolic acid or mycophenolate mofetil had a median titer less than 0.8 U/mL (IQR, <0.8-9.44 U/mL).
Rheumatic and musculoskeletal diseases include inflammatory arthritis, systemic lupus erythematosus, systemic sclerosis, myositis, Sjogren syndrome, systemic vasculitis, and overlap connective tissue disease as well as chronic noninflammatory conditions, including osteoarthritis and fibromyalgia.
Organ transplants include liver, kidney, pancreas, lung, heart, intestine, and multiple organ transplants.