In summer 2021, LUPUS UK awarded a research grant of £22,815.73 to Prof Claudia Mauri, Dr Christopher Piper, and Dr Kristine Oleinika for their study investigating how lupus patients respond to COVID-19 vaccines. This study was performed by Claire Meehan MRes, Dr. Hannah Bradford, and Dr. Guillem Montamat at the Institute of Immunity and Transplantation, University College London.

What were the researchers investigating?
In this study, the researchers examined the immune system response to COVID-19 vaccination in people with lupus. They looked at two important measures of response:

• • The number of B cells
    B cells are a type of white blood cell and an essential part of the body’s defenses against bacteria and viruses. After an infection or receiving a vaccine, B cells produce molecules called antibodies.
  • The levels of antibodies
    Antibodies recognise and bind to the bacteria/virus. When bound, the antibodies signal to other types of immune cells to kill and remove the bacteria/virus. One type of antibody called IgA is particularly important for maintaining immune protection in places like the nose, throat, lungs, and gut.

 

B cells that produce these antibodies can last a long time. This means that if a person is re-infected by the same bacteria/virus, the immune system response is much faster because the specific B cells can readily remake these antibodies.

What did they find?
The researchers found that after the first two doses of COVID-19 vaccine, lupus patients did not make as many antibodies, including IgA, as healthy individuals. Although the third vaccination increased the levels of antibody compared to dose 2, the amount of anti-covid-19 antibodies was still lower than those detected in healthy people. In addition to being at lower levels, the anti-covid-19 antibodies from lupus patients were less effective at blocking Omicron (variant started circulating back early 2022), compared to those from healthy people.

Overall, the ability of lupus patients to positively respond to COVID-19 vaccines is weaker compared to the general population. However, the results show that further booster vaccination is important to increase the levels of virus-specific antibodies and the cells that make them.

What are the next steps for this research?
The researchers intend to examine whether their finding of a reduced response to the COVID-19 vaccine is unique, or if it may also extend to other vaccines, such as influenza (flu).

In addition, the researchers intend to further explore whether newer COVID-19 vaccines (called bivalent vaccines) developed to target the Omicron and future variants also produce a weaker immune response for lupus patients.

Finally, they are keen to understand why the B cell and antibody responses in lupus patients after COVID-19 vaccination is weaker.