Susceptibility to COVID-19 and Immunologic Response to Vaccination in Patients With Immune-Mediated Inflammatory Diseases

Immune-mediated inflammatory diseases (IMIDs) are a highly heterogeneous group of diseases that share a common etiology of immune dysregulation, such as rheumatoid arthritis, inflammatory bowel disease, and psoriasis, among others. It is estimated that the prevalence of IMIDs ranges between 5% and 7% in developed countries. As current management of IMIDs includes the use of immunomodulatory medications, the resulting weakened immune response can increase the risk of infection, including with SARS-CoV-2 (the causative agent of COVID-19) and reduce response to vaccination, placing these individuals at continued risk of severe outcomes from COVID-19. In this article, we summarize the current literature related to COVID-19 outcomes and the immunogenicity and reactogenicity of COVID-19 mRNA vaccination among patients with rheumatologically dominated IMIDs, as well as the effect of immunomodulatory therapies on these outcomes. We conclude by providing current COVID-19 vaccination recommendations for individuals with IMID.

Automated summary

Immune-mediated inflammatory diseases (IMIDs) are a diverse group of diseases characterized by immune dysregulation, such as rheumatoid arthritis, inflammatory bowel disease, and psoriasis. The prevalence of IMIDs ranges between 5% and 7% in developed countries. The use of immunomodulatory medications in the management of IMIDs can weaken the immune response and increase the risk of severe outcomes from COVID-19, as well as reduce the efficacy of COVID-19 vaccination. This article summarizes the current literature on COVID-19 outcomes, vaccination responses, and the impact of immunomodulatory therapies in patients with rheumatologically dominated IMIDs, and provides vaccination recommendations for individuals with IMID.