{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:58:22Z","timestamp":1787803102597,"version":"build-2784847793"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T00:00:00Z","timestamp":1640649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["AI148574"],"award-info":[{"award-number":["AI148574"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["AR07059"],"award-info":[{"award-number":["AR07059"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015283","name":"Bloomberg Philanthropies","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015283","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate seroreactivity and disease flares after COVID\u201019 vaccination in a multiethnic\/multiracial cohort of patients with systemic lupus erythematosus (SLE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety SLE patients and 20 healthy controls receiving a complete COVID\u201019 vaccine regimen were included. IgG seroreactivity to the SARS\u2013CoV\u20102 spike receptor\u2010binding domain (RBD) and SARS\u2013CoV\u20102 microneutralization were used to evaluate B cell responses; interferon\u2010\u03b3 (IFN\u03b3) production was measured by enzyme\u2010linked immunospot (ELISpot) assay in order to assess T cell responses. Disease activity was measured by the hybrid SLE Disease Activity Index (SLEDAI), and flares were identified according to the Safety of Estrogens in Lupus Erythematosus National Assessment\u2013SLEDAI flare index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, fully vaccinated SLE patients produced significantly lower IgG antibodies against SARS\u2013CoV\u20102 spike RBD compared to fully vaccinated controls. Twenty\u2010six SLE patients (28.8%) generated an IgG response below that of the lowest control (&lt;100 units\/ml). In logistic regression analyses, the use of any immunosuppressant or prednisone and a normal anti\u2013double\u2010stranded DNA antibody level prior to vaccination were associated with decreased vaccine responses. IgG seroreactivity to the SARS\u2013CoV\u20102 spike RBD strongly correlated with the SARS\u2013CoV\u20102 microneutralization titers and correlated with antigen\u2010specific IFN\u03b3 production determined by ELISpot. In a subset of patients with poor antibody responses, IFN\u03b3 production was similarly diminished. Pre\u2010 and postvaccination SLEDAI scores were similar in both groups. Postvaccination flares occurred in 11.4% of patients; 1.3% of these were severe.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a multiethnic\/multiracial study of SLE patients, 29% had a low response to the COVID\u201019 vaccine which was associated with receiving immunosuppressive therapy. Reassuringly, severe disease flares were rare. While minimal protective levels remain unknown, these data suggest that protocol development is needed to assess the efficacy of booster vaccination.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.41937","type":"journal-article","created":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T16:18:54Z","timestamp":1628093934000},"page":"284-294","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":136,"title":["Evaluation of Immune Response and Disease Status in Systemic Lupus Erythematosus Patients Following <scp>SARS<\/scp>\u2013<scp>CoV<\/scp>\u20102 Vaccination"],"prefix":"10.1002","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5445-2182","authenticated-orcid":false,"given":"Peter M.","family":"Izmirly","sequence":"first","affiliation":[{"name":"New York University Grossman School of Medicine  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi 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