TY - JOUR T1 - SARS-CoV-2 breakthrough infections among vaccinated individuals with rheumatic disease: results from the COVID-19 Global Rheumatology Alliance provider registry JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2021-002187 VL - 8 IS - 1 SP - e002187 AU - Jean Liew AU - Milena Gianfrancesco AU - Carly Harrison AU - Zara Izadi AU - Stephanie Rush AU - Saskia Lawson-Tovey AU - Lindsay Jacobsohn AU - Clairissa Ja AU - Kimme L Hyrich AU - Laure Gossec AU - Anja Strangfeld AU - Loreto Carmona AU - Martin Schäfer AU - Elsa Frãzao-Mateus AU - Inita Bulina AU - Frances Stafford AU - Abdurrahman Tufan AU - Christine Graver AU - Gözde Kübra Yardımcı AU - Julija Zepa AU - Samar Al Emadi AU - Claire Cook AU - Fatemah Abutiban AU - Dfiza Dey AU - Genevieve Katigbak AU - Lauren Kaufman AU - Emily Kowalski AU - Marco Ulises Martínez-Martínez AU - Naomi J Patel AU - Greta Reyes-Cordero AU - Evelyn Salido AU - Ellison Smith AU - David Snow AU - Jeffrey Sparks AU - Leanna Wise AU - Suleman Bhana AU - Monique Gore-Massy AU - Rebecca Grainger AU - Jonathan Hausmann AU - Emily Sirotich AU - Paul Sufka AU - Zachary Wallace AU - Pedro M Machado AU - Philip C Robinson AU - Jinoos Yazdany Y1 - 2022/04/01 UR - http://rmdopen.bmj.com/content/8/1/e002187.abstract N2 - 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. ER -