Prelog et al.
Humoral and cellular immune response to tick-borne encephalitis (TBE) vaccination depends on booster doses in patients with juvenile idiopathic arthritis
Vaccine. 2021; 39:5918-5927. doi: 10.1016/j.vaccine.2021.08.029
Patients with juvenile idiopathic arthritis (JIA) may have a decreased or delayed immune response after primary and/or booster immunizations. A clinical study has been carried out in 112 patients with JIA and 35 healthy controls (HC). A total of 73 JIA patients (73%) had received complete primary TBE vaccination before diagnosis of JIA, whereas 27 patients completed the primary vaccination after diagnosis. 62 patients (62%) and 18 HC (58.1%) received booster vaccinations.
Humoral (TBE IgG concentration, IgG avidity, neutralization test) and cellular (IFNg ELISPOT, IFNg secretion assay and flow cytometry staining) immune responses to TBE vaccination were investigated in these two groups and showed almost similar, but not identical immune responses: e.g., (i) 98% of the patients and 100% of the HC had TBE IgG concentration ≥165 VIEU/ml, (ii) a high antibody avidity was found in 94.9% of the patients and in all HC, and (iii) 88.5% of the patients and all HC had an NT of at least 10.
A trend to lower avidity has been seen in JIA patients compared to HC and was shown to mainly correlate with methotrexate administration. The number of booster immunizations and early timing of these vaccinations had the most prominent effect on NT antibodies and IgG concentrations in both groups. The cellular immune response was found to be satisfactory in JIA patients, and rates of non-responders in cellular assays were similar to HC.
Several years after primary TBE vaccination, the humoral and cellular immunity was similar in JIA patients compared to HC. Booster vaccinations mounted a significantly higher humoral immune response in JIA patients. These data show the benefit for timely booster for JIA patients and HC living in TBE endemic areas.