“Do people with vasculitis mount an effective response to the Covid-19 vaccination and how long does it last?”
Vasculitis and its treatment affect the immune system. People with vasculitis may not develop as effective a response to the COVID-19 vaccine as healthy people of a similar age. It is also possible that the response following the vaccine among people with vasculitis may not last as long as those who are healthy and are of similar age.
This means that those with vasculitis may be less protected following the vaccine and perhaps may need more frequent booster doses than those people who are healthy.
To answer this question, Vasculitis UK has given a grant of £53,364 to a one-year project to be led by Professor Lucy Fairclough (above), Associate Professor of Immunology at Nottingham University
Following the introduction of the vaccines, there has been a lot of discussion in the Vasculitis UK online support groups and many questions from members by email and via the telephone helpline. It is clear that many people with vasculitis (including those on immune suppressing regimes and especially those on regular rituximab) have serious concerns about they will respond to the vaccines, and about how much impact future immune suppression might have on their immunity. Many Vasculitis UK members are Clinically Extremely Vulnerable and immune suppressed to some degree – and frequently so in the older age groups.
Rituximab deserves special scrutiny as it is given intravenously in a single dose at widely spaced intervals, so it has a heavy & long lasting impact on the immune system. Other concerns focus around how long immunity will last and the need for repeat “booster” doses. There are other studies which are looking at these problems in the immune compromised population in general, but the VUK research is focused on the vasculitis community and problems specific to our group.
The initial period of the study is one year, but there might be earlier results to report on. We might provide additional funding to extend the study beyond a year to see how long the immunity conferred by the vaccine lasts.
The VUK trustees held an online Zoom meeting with the applicants to seek answers to their reservations and questions about the project, before unanimously approving the grant of £53,364 for the one-year project.
The investigating team is led by Lucy Fairclough, Associate Professor of Immunology at the University of Nottingham.
Co-applicants, all from the University of Nottingham, are:
Dr Paddy Tighe, Professor of Immunology
Dr Peter Lanyon, Consultant Rheumatologist
Dr Megan Rutter, Clinical Research Fellow
Dr Mithun Chakravarty, Clinical Research Fellow in Vasculitis and Connective Tissue disease
The research in detail
The plan is to test the response of 50 people with vasculitis to the vaccine and compare with 50 healthy people of a similar age.
Recruiting patients will be carried out from the large number of people with vasculitis at the rheumatology department in Nottingham and from the general population through a local GP practice.
All patients will receive their vaccine as planned. The study will involve asking people to give blood samples to test their response to the vaccine both before and after vaccination.
Research has shown that there are two key components to the immune system response that protect against COVID-19 infection – these are levels of protective antibodies, and numbers of protective memory T cells produced. The protective T cell response may be particularly important in people who have been treated with rituximab, because rituximab directly affects the cells which make antibodies.
Further blood samples will be taken and analysed 1, 3, 6 and 12 months after having the vaccine. This will allow measurement of how effective the response to the vaccine is among people with vasculitis and how long it lasts. Also measured, will be to see if particular treatments eg: steroids , or rituximab affect the vaccine.
The results from this study will be used to inform discussions with the makers of health policy around the vaccine.
The initial blood test results taken at one month after vaccination, will enable feedback to the policy-makers, whether vaccination with a single dose of vaccine is effective in people with vasculitis. The later blood test results taken at 3, 6 and 12 months will inform how long the response lasts for.