Physical activity: a strategy to improve antibody response to a SARS-CoV-2 vaccine booster dose in patients with autoimmune rheumatic diseases.

Physical activity associates with improved immunogenicity following a 2-dose schedule of CoronaVac (Sinovac's inactivated SARS-CoV-2 vaccine) in patients with autoimmune rheumatic diseases (ARD). This study evaluates whether physical activity impacts vaccine-induced antibody responses to a booster dose in this population. This was a phase-4 trial conducted in Sao Paulo, Brazil. Patients with ARD underwent a 3-dose schedule of CoronaVac. One month after the booster, we assessed seroconversion rates of anti-SARS-CoV-2 S1/S2 IgG, geometric mean titers of anti-S1/S2 IgG, frequency of positive neutralizing antibodies, and neutralizing activity. Physical activity was assessed through questionnaire. Physically active (n = 362) and inactive (n = 278) patients were comparable for most characteristics; however, physically active patients were younger (P<.01) and had a lower frequency of chronic inflammatory arthritis (P<.01). Adjusted models showed that physically active patients had -2 times odds of seroconversion rates (OR: 2.09; 95% confidence interval, 1.22 to 3.61), -22% greater geometric mean titers of anti-S1/S2 IgG (22.09%; 95% confidence interval, 3.91 to 65.60), and -7% greater neutralizing activity (6.76%; 95% confidence interval, 2.80 to 10.72) than inactive patients. Patients with ARD who are physically active have greater odds of experiencing better immunogenicity to a booster dose of CoronaVac. These results support the recommendation of physical activity to improve vaccination responses, particularly for immunocompromised individuals

Anti-SARS-CoV-2 inactivated vaccine in patients with ANCA-associated vasculitis: Immunogenicity, safety, antibody decay and the booster dose

Objective: To evaluate inactivated CoronaVac prime vaccination, antibody decay, booster dose, and safety in ANCA-Associated Vasculitis (AAV) patients. Methods: Fifty-three AAV patients and 106 Controls (CG) received CoronaVac on days: D0 (first dose), D28(second dose), and D210 (booster dose, 32 AAV: 32 CG). The primary outcome was immunogenicity after the second vaccine dose (day 69) assessed by Seroconversion Rates (SC) of anti-SARS-CoV-2 S1/S2 IgG and Neutralizing Antibodies (NAb). Secondary outcomes were safety, immunogenicity (D28/D240), 6-months antibody decay (D210) and the booster dose response (D240). Results: At D69 SC (65.1% vs. 96.8%, p&nbsp;=&nbsp;0.0001), GMT (21.3&nbsp;UA/mL vs. 67.7&nbsp;UA/mL, p&nbsp;&lt;&nbsp;0.001) and NAb- positivity (53.7% vs. 80.6%, p&nbsp;=&nbsp;0.001) were moderate but lower in naïve-AAV patients than CG. Patients without SC used more often IS (93.3% vs. 53.3%, p&nbsp;=&nbsp;0.015), mycophenolate mofetil (20% vs. 0%, p&nbsp;=&nbsp;0.037) and prednisone (60.0% vs. 28.6%, p&nbsp;=&nbsp;0.057) than seroconverted. NAb negativity in AAV patients was associated with prednisone treatment (57.9% vs. 18.2%, p&nbsp;=&nbsp;0.015) and IS (84.2% vs. 55.0%, p&nbsp;=&nbsp;0.046). Logistic regression analysis models showed that only prednisone was associated with lower seroconversion (OR&nbsp;=&nbsp;0.2, 0,95% CI 0.05‒0.86, p&nbsp;=&nbsp;0.030) and with lower NAb positivity (OR&nbsp;=&nbsp;0.2, 0,95% CI 0.05‒0.88, p&nbsp;=&nbsp;0.034). After six months (D69‒D210) a decrease in IgG positivity occurred in 32 AAV patients (15.7%, p&nbsp;=&nbsp;0.074) and 32 CG (18.7%, p&nbsp;=&nbsp;0.041). For the NAb positivity, the 6-month decrease was not significant (p&nbsp;=&nbsp;0.114) whereas a major reduction occurred for CG (p&nbsp;&lt;&nbsp;0.001). A booster dose (D240) resulted in an increment in IgG-positivity (21.9%, p&nbsp;=&nbsp;0.023) and NAb-positivity (34.4%, p&nbsp;=&nbsp;0.006) in AAV patients. No moderate/severe adverse events attributable to the vaccine were observed. Conclusion: This study provides novel data on the excellent safety and moderate immunogenicity of CoronaVac in AAV patients. A six-month mild antibody waning was observed with a good response to the booster dose, although levels remained lower than CG (CoronavRheum-NCT04754698)