COVID-19 Vaccine Safety and Effectiveness in Patients with Immune-Mediated Inflammatory Diseases
Scientific Study Title:
Safety Immunogenicity of Covid-19 Vaccines in Systemic Immune-mediated Inflammatory Diseases (SUCCEED)
Study Start Date:
April 2021
Study End Date:
Recruitment ended March 2023; analyses are on-going.
Why Did We Do This Research?
Immune-mediated Inflammatory Diseases (IMIDs) such as inflammatory bowel disease, rheumatoid arthritis, systemic lupus erythematosus, and psoriasis, are severe conditions that affect almost 10% of Canadians. To better understand the effectiveness of COVID-19 vaccines in individuals with immune-mediated inflammatory diseases (IMIDs), particularly those undergoing immune-suppressive treatments, we investigated how various factors, such as time since vaccination, impact the body’s immune response to both the virus and the vaccine.
This research is important because it can help people with IMID make informed decisions regarding the timing of additional COVID-19 vaccine doses to ensure their safety, as well as to identify optimal strategies for safeguarding this population against COVID-19.
What Did We Do?
• We recruited participants from Vancouver, Calgary, Winnipeg, Montreal, Quebec City, Sherbrooke, Toronto, and Hamilton.
• We allowed any adult with a clinical IMID diagnosis to participate in the study, regardless of their treatment.
• After participants received their COVID-19 vaccines, we collected data and blood samples from participants.
• Samples were taken when the participants joined the study, and then again 2-4 weeks, 3 months, 6 months, and 12 months after the last vaccine dose.
• We also looked at factors like the medications people were taking, their demographics, and their vaccination history to see how well their immune systems responded to the COVID-19 vaccine.
• We measured levels of antibodies (like anti-RBD IgG and anti-nucleocapsid IgG) in the blood, which are indicators of the immune response to the vaccine.
What Did We Find?
1823 participants were enrolled in this study. Two-thirds were female, and participants’ average age was 53.2 years. The most common IMID among participants was inflammatory bowel disease followed by rheumatoid arthritis.
We found that higher levels of antibodies against a specific part of the COVID-19 virus (RBD) were linked with being female, receiving more vaccine doses, and having a self-reported COVID infection between 2021 and 2023. Certain medications like prednisone, anti-TNF agents, and rituximab were associated with lower antibody levels.
Most people who tested positive for antibodies against another part of the virus (nucleocapsid) had recently been infected with COVID-19. The percentage of people with these antibodies increased significantly after the emergence of the Omicron variant and continued to rise into 2023, especially among those with immune-related conditions, though it remained lower than in the general Canadian population.
The results of this research can help guide people living with IMID make vaccination decisions. We are currently analyzing more data from this research project.
The Research Team
Principal Investigators:
Sasha Bernatsky, MD, MSc, PhD (McGill University)
Vinod Chandran, MBBS, MD, DM, PhD, FRCPC (University of Toronto)
Dawn Bowdish, PhD (McMaster University)
Carol Hitchon, MD, FRCPC, MSc (University of Manitoba)
Co-Investigators:
Anne-Claude Gingras, PhD (University of Toronto)
Nigil Haroon, MD, PhD, DM, FRCPC, MBA (University of Toronto)
Robert Inman, BA, MD (University of Toronto)
Richard Cook, PhD (University of Waterloo)
Gilaad Kaplan, MD, MPH (University of Calgary)
Allison McGeer, MSc, MD, FRCPC (University of Toronto)
Vincent Piguet, MD, PhD, FRCP (University of Toronto)
Proton Rahman, MD, FRCPC (Memorial University)
Mark Silverberg, MD, PhD, FRCPC (University of Toronto)
Tania Watts, PhD (University of Toronto)
Bindee Kuriya, MD, MSc, FRCPC (University of Toronto)
Stephanie Garner, MD, FRCPC (McMaster University)
Maggie Larché, MD, FRCPC, MBChB, MRCP(UK), PhD (McMaster University)
John Marshall, MD, MSc, (McMaster University)
Ishac Nazy, PhD (McMaster University)
Cheryl Barnabe, MD, MSc, FRCPC, Senior Scientist, Arthritis Research Canada (University of Calgary)
Gilles Boire, MD, MSc, FRCPC (Universite de Sherbrooke)
Ines Colmega, MD, Research Scientist, Rheumatology, Arthritis Research Canada (McGill University)
Paul Fortin, MD, MPH, FRCPC, Senior Scientist, Rheumatology, Arthritis Research Canada (McGill University)
Glen Hazlewood, MD, PhD, FRCPC, Research Scientist, Rheumatology, Arthritis Research Canada (University of Calgary)
Antonio Aviña-Zubieta, MD, MSc, PhD, FRCPC, Senior Scientist, Arthritis Research Canada (University of British Columbia)
Diane Lacaille, MD, MHSc, FRCPC, Scientific Director, Arthritis Research Canada (University of British Columbia)
Jessica Widdifield, PhD (University of Toronto)
Karen Colwill, PhD (Lunenfeld-Tanenbaum Research Institute)
Heidi Wood, PhD (Public Health Agency of Canada)
Research staff at the British Columbia site are:
Shelby Marozoff, MSc, Trainee, Arthritis Research Canada
Ayesha Kirmani, MD, Research Assistant, Arthritis Research Canada
Who Funded this Research?
COVID-19 Immunity Task Force (CITF)/Public Health Agency of Canada (PHAC)
Related Publications:
- Habib R, Dayam RM, Hitchon C, Chandran V, Fortin PR, Boire G, Bowdish DME, Gingras AC, Flamand L, Larché MJ, Colmegna I, Lukusa L, Lee JLF, Pereira D, Bernstein CN, Lalonde N, Turnbull E, Bernatsky S, SUCCEED Investigative Team. Duration of Post-vaccination Neutralizing Antibodies to SARS-COV2 and Medication Effects in Immune-mediated Inflammatory Diseases: Results from the SUCCEED Initiative. ACR Open Rheumatology (Accepted April 22, 2024)
- Bowdish DME, Chandran V, Hitchon CA, Kaplan GG, Avina-Zubieta JA, Fortin PR, Larché MJ, Boire G, Gingras AC, Dayam RM, Colmegna I, Lukusa L, Lee JLF, Richards DP, Pereira D, Watts TH, Silverberg MS, Bernstein CN, Lacaille D, Benoit J, Kim J, Lalonde N, Gunderson J, Allard-Chamard H, Roux S, Quan J, Hracs L, Turnbull E, Valerio V, Bernatsky S; SUCCEED investigative team. When Should I Get My Next COVID Vaccine? Data from the SUrveillance of responses to COVID-19 vaCcines in systEmic immunE mediated inflammatory Diseases (SUCCEED)study. J Rheumatol. 2024 Apr 15:jrheum.2023-1214. doi: 10.3899/jrheum.2023-1214. Epub ahead of print. PMID: 38621797.
