ABSTRACT
OBJECTIVES: Effectiveness of the BNT162b2 mRNA COVID-19 vaccine for adolescents with juvenile-onset inflammatory rheumatic diseases (IRD) is unknown. Several studies suggested attenuated immunogenicity in patients with IRD. This study evaluated the effectiveness of the BNT162b2 mRNA COVID-19 vaccine in preventing COVID-19 infection in adolescents with juvenile-onset IRD compared with controls without immune rheumatic disease. METHODS: We used data from Clalit Health Services, the largest healthcare organization in Israel, to conduct an observational cohort study from February to December 2021, involving adolescents 12-18 years-old, diagnosed with IRD. Study outcomes included documented COVID-19 infection in relation to vaccination status and immunomodulatory therapy. We estimated vaccine effectiveness as one minus the risk ratio. Adolescents without immune rheumatic disease, 12-18 years-old, served as controls. RESULTS: A total of 1,639 adolescents with IRD (juvenile idiopathic arthritis, systemic lupus erythematosus, or familial Mediterranean fever) were included and compared with 524 471 adolescents in the same age range. There was no difference in COVID-19 infection rates after the second dose of vaccine for those with IRD and controls (2.1% vs 2.1% respectively, p= 0.99). The estimated vaccine effectiveness for adolescents with IRD was 76.3% after the first dose, 94.8% after the second and 99.2% after the third dose. CONCLUSION: We found that the BNT162b2 mRNA vaccine is effective against COVID-19 infection in adolescents with IRD, similar to controls without immune rheumatic disease. Immunomodulatory therapy did not affect its effectiveness. These results can encourage adolescents with IRD to get vaccinated against COVID-19.