{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T08:57:03Z","timestamp":1792659423896,"version":"4.5.0"},"reference-count":46,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:00:00Z","timestamp":1649116800000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006260","name":"Rheumatology Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006260","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","award":["K24 AR074534"],"award-info":[{"award-number":["K24 AR074534"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","award":["P30 AR070155"],"award-info":[{"award-number":["P30 AR070155"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","award":["P30 AR070253"],"award-info":[{"award-number":["P30 AR070253"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","award":["P30 AR072577"],"award-info":[{"award-number":["P30 AR072577"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","award":["R01 AR077607"],"award-info":[{"award-number":["R01 AR077607"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2022,2,9]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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 \u226514 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\u2019 demographic and clinical characteristics and COVID-19 symptoms and outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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 (\u00b160) days after the second vaccine dose. Among those fully vaccinated and hospitalised (n=22, age range 36\u201383 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2021-002187","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T14:47:16Z","timestamp":1652194036000},"page":"e002187","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["SARS-CoV-2 breakthrough infections among vaccinated individuals with rheumatic disease: results from the COVID-19 Global Rheumatology Alliance provider registry"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8104-2450","authenticated-orcid":false,"given":"Jean","family":"Liew","sequence":"first","affiliation":[{"name":"Medicine, Section of Rheumatology, Boston University, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Gianfrancesco","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Rheumatology, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly","family":"Harrison","sequence":"additional","affiliation":[{"name":"LupusChat, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1867-0905","authenticated-orcid":false,"given":"Zara","family":"Izadi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Rush","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8611-162X","authenticated-orcid":false,"given":"Saskia","family":"Lawson-Tovey","sequence":"additional","affiliation":[{"name":"Centre for Genetics and Genomics Versus Arthritis, The University of Manchester, Manchester, UK"},{"name":"National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Jacobsohn","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Rheumatology, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clairissa","family":"Ja","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimme L","family":"Hyrich","sequence":"additional","affiliation":[{"name":"University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4528-310X","authenticated-orcid":false,"given":"Laure","family":"Gossec","sequence":"additional","affiliation":[{"name":"INSERM, Institut Pierre Louis d'Epid\u00e9miologie et de Sant\u00e9 Publique, INSERM, Sorbonne Universite, Paris, France"},{"name":"APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6233-022X","authenticated-orcid":false,"given":"Anja","family":"Strangfeld","sequence":"additional","affiliation":[{"name":"Forschungsbereich Epidemiologie, Deutsches Rheuma-Forschungszentrum Berlin, Berlin, 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Examining the immunological effects of COVID-19 vaccination in patients with conditions potentially leading to diminished immune response capacity \u2013 the OCTAVE trial 2021. Lancet 2021.","DOI":"10.2139\/ssrn.3910058"},{"key":"2025090312202861000_8.1.e002187.7","unstructured":"United States food and drug administration. coronavirus (COVID-19) update: FDA Authorizes additional vaccine dose for certain immunocompromised individuals. United States food and drug administration. Available: https:\/\/www.fda.gov\/news-events\/press-announcements\/coronavirus-covid-19-update-fda-authorizes-additional-vaccine-dose-certain-immunocompromised [Accessed 9 Sep 2021]."},{"key":"2025090312202861000_8.1.e002187.8","unstructured":"Israeli Councils For Health . Summary of an urgent meeting on the issue of vaccines against corona for those who have been vaccinated. Israeli councils for health. 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