PT  - JOURNAL ARTICLE
AU  - Liew, Jean
AU  - Gianfrancesco, Milena
AU  - Harrison, Carly
AU  - Izadi, Zara
AU  - Rush, Stephanie
AU  - Lawson-Tovey, Saskia
AU  - Jacobsohn, Lindsay
AU  - Ja, Clairissa
AU  - Hyrich, Kimme L
AU  - Gossec, Laure
AU  - Strangfeld, Anja
AU  - Carmona, Loreto
AU  - Schäfer, Martin
AU  - Frãzao-Mateus, Elsa
AU  - Bulina, Inita
AU  - Stafford, Frances
AU  - Tufan, Abdurrahman
AU  - Graver, Christine
AU  - Yardımcı, Gözde Kübra
AU  - Zepa, Julija
AU  - Al Emadi, Samar
AU  - Cook, Claire
AU  - Abutiban, Fatemah
AU  - Dey, Dfiza
AU  - Katigbak, Genevieve
AU  - Kaufman, Lauren
AU  - Kowalski, Emily
AU  - Martínez-Martínez, Marco Ulises
AU  - Patel, Naomi J
AU  - Reyes-Cordero, Greta
AU  - Salido, Evelyn
AU  - Smith, Ellison
AU  - Snow, David
AU  - Sparks, Jeffrey
AU  - Wise, Leanna
AU  - Bhana, Suleman
AU  - Gore-Massy, Monique
AU  - Grainger, Rebecca
AU  - Hausmann, Jonathan
AU  - Sirotich, Emily
AU  - Sufka, Paul
AU  - Wallace, Zachary
AU  - Machado, Pedro M
AU  - Robinson, Philip C
AU  - Yazdany, Jinoos
TI  - SARS-CoV-2 breakthrough infections among vaccinated individuals with rheumatic disease: results from the COVID-19 Global Rheumatology Alliance provider registry
AID  - 10.1136/rmdopen-2021-002187
DP  - 2022 Apr 01
TA  - RMD Open
PG  - e002187
VI  - 8
IP  - 1
4099  - http://rmdopen.bmj.com/content/8/1/e002187.short
4100  - http://rmdopen.bmj.com/content/8/1/e002187.full
SO  - RMD Open2022 Apr 01; 8
AB  - Objective While COVID-19 vaccination prevents severe infections, poor immunogenicity in immunocompromised people threatens vaccine effectiveness. We analysed the clinical characteristics of patients with rheumatic disease who developed breakthrough COVID-19 after vaccination against SARS-CoV-2.Methods We included people partially or fully vaccinated against SARS-CoV-2 who developed COVID-19 between 5 January and 30 September 2021 and were reported to the Global Rheumatology Alliance registry. Breakthrough infections were defined as occurring ≥14 days after completion of the vaccination series, specifically 14 days after the second dose in a two-dose series or 14 days after a single-dose vaccine. We analysed patients’ demographic and clinical characteristics and COVID-19 symptoms and outcomes.Results SARS-CoV-2 infection was reported in 197 partially or fully vaccinated people with rheumatic disease (mean age 54 years, 77% female, 56% white). The majority (n=140/197, 71%) received messenger RNA vaccines. Among the fully vaccinated (n=87), infection occurred a mean of 112 (±60) days after the second vaccine dose. Among those fully vaccinated and hospitalised (n=22, age range 36–83 years), nine had used B cell-depleting therapy (BCDT), with six as monotherapy, at the time of vaccination. Three were on mycophenolate. The majority (n=14/22, 64%) were not taking systemic glucocorticoids. Eight patients had pre-existing lung disease and five patients died.Conclusion More than half of fully vaccinated individuals with breakthrough infections requiring hospitalisation were on BCDT or mycophenolate. Further risk mitigation strategies are likely needed to protect this selected high-risk population.Data are available upon reasonable request. Researchers interested in performing additional analyses from survey data are invited to submit proposals through the COVID-19 Global Rheumatology Alliance at rheum-covid.org. For approved projects, we will be able to provide summary tables and data analyses as requested. We do not currently have IRB approval to make the raw data available to other researchers.