Abstract Body

Children with autoimmune inflammatory rheumatic diseases (AIIRD) may have an increased risk of infections due to the disease itself or to treatment with immunosuppressive drugs. Adolescents with AIIRD can be at-risk for disease flare secondary to COVID-19 infection, and to withholding their anti-inflammatory therapy. Therefore, it is crucial to prevent COVID-19 disease in this population.

Understanding the impact of COVID-19 infection on children and young people with AIIRD is important for informing national protection, school attendance and vaccination guidance. A large, cooperative, multinational study found that most children and young people with AIIRD experience mild COVID-19 disease. However, hospitalizations did occur, mainly among those with SLE/MCTD, vasculitis, and rare autoinflammatory syndromes.

The socioeconomic burden of COVID-19 and pressure on healthcare systems can only be alleviated by achieving herd immunity against SARS-CoV-2. Vaccines can lead to this objective. Patients with pediatric-onset AIIRD require a personalized vaccination schedule that considers many factors, including disease activity, treatment, infection risk, and vaccine safety and efficacy.

In continuation of the positive findings of Covid vaccines in adults with AIIRD, an international, prospective, multicenter study demonstrated safety and immunogenicity of the BNT162b2 anti-SARS-CoV-2 vaccine among adolescents and young adults with juvenile-onset AIIRD, including those on immunosuppressive therapy. The seropositivity rate was 97.3% in the AIIRD group compared with 100% among controls. However, anti-S1/S2 antibody titers were significantly lower in the AIIRD group, similar to adults with AIIRD.

We will present, for the first time, results of the effectiveness of the BNT162b2 mRNA COVID-19 vaccine among adolescents with AIIRD. By using a very large dataset from the largest healthcare organization in Israel, we conducted an observational cohort study, demonstrating that the BNT162b2 mRNA vaccine is highly effective in adolescents with AIIRD, similar to healthy controls. Immunosuppressive therapy did not affect effectiveness.

PRES recommends vaccinating pediatric rheumatology patients against COVID-19 using vaccines approved by relevant national health authorities.

Our results and those of other studies demonstrating safety, immunogenicity, and effectiveness, together can make the PRES statement stronger and encourage adolescents with AIIRD to get vaccinated against COVID-19, which will help decrease the global burden of the disease.