{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T08:32:00Z","timestamp":1779179520095,"version":"3.51.4"},"reference-count":62,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T00:00:00Z","timestamp":1660262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministero della Salute, Ricerca Finalizzata call, BIAS","award":["COVID-2020-12371760"],"award-info":[{"award-number":["COVID-2020-12371760"]}]},{"name":"\u201cPiano Riparti Piemonte\u201d, Azione n. 173 \u201cINFRA-P. Realizzazione, rafforzamento e ampliamento infrastrutture di ricerca pubbliche\u2014bando INFRA-P2-TECNOMED-HUB n.378-48\u201d","award":["COVID-2020-12371760"],"award-info":[{"award-number":["COVID-2020-12371760"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Vaccines are the most effective means to prevent the potentially deadly effects of SARS-CoV-2 infection, but not all vaccinated individuals gain the same degree of protection. Patients undergoing chronic immunosuppressive therapy due to autoimmune diseases or liver transplants, for example, may show impaired anti-SARS-CoV-2 antibody response after vaccination. We performed a prospective observational study with parallel arms, aiming to (a) evaluate seroconversion after anti-SARS-CoV-2 mRNA vaccine administration in different subgroups of patients receiving immunosuppressive treatment for rheumatological or autoimmune diseases or to prevent organ rejection after liver transplantation and (b) identify negative predictors of IgG anti-SARS-CoV-2 development. Out of 437 eligible patients, 183 individuals were enrolled at the Rheumatology and Hepatology Tertiary Units of \u201cMaggiore della Carit\u00e0\u201d University Hospital in Novara: of those, 52 were healthy subjects, while among the remaining 131 patients, 30 had a diagnosis of spondyloarthritis, 25 had autoimmune hepatitis, 10 were liver transplantation recipients, 23 suffered from connective tissue diseases (including 10 cases that overlapped with other diseases), 40 were treated for rheumatoid arthritis, and 5 had vasculitis. Moreover, all patients were receiving chronic immunosuppressive therapy. The immunogenicity of mRNA COVID-19 vaccines was evaluated by measuring IgG anti-SARS-CoV-2 antibody titers before vaccination and after 10, 30, and 90 days since the first dose administration. Of the selected cohort of patients, 24.0% did not develop any detectable anti-SARS-CoV-2 IgG after a complete mRNA-based two doses primary vaccination cycle. At univariate analysis, independent predictors of an absent antibody response to vaccine were a history of liver transplantation (OR 11.5, 95% CI 2.5\u201353.7, p = 0.0018), the presence of a comorbid active neoplasia (OR 26.4, 95% CI 2.8\u2013252.4, p = 0.0045), and an ongoing immunosuppressive treatment with mycophenolate (MMF) (OR 14.0, 95% CI 3.6\u201354.9, p = 0.0002) or with calcineurin inhibitors (OR 17.5, 95% CI 3.1\u201399.0, p = 0.0012). At multivariate analysis, only treatment with MMF (OR 24.8, 95% CI 5.9\u2013103.2, p &lt; 0.0001) and active neoplasia (OR 33.2, 95% CI 5.4\u2013204.1, p = 0.0002) were independent predictors of seroconversion failure. These findings suggest that MMF dose reduction or suspension may be required to optimize vaccine response in these patients.<\/jats:p>","DOI":"10.3390\/v14081766","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T03:40:32Z","timestamp":1660621232000},"page":"1766","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Ongoing Mycophenolate Treatment Impairs Anti-SARS-CoV-2 Vaccination Response in Patients Affected by Chronic Inflammatory Autoimmune Diseases or Liver Transplantation Recipients: Results of the RIVALSA Prospective Cohort"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2134-6986","authenticated-orcid":false,"given":"Erika","family":"Zecca","sequence":"first","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"COVID-19 Unit, Department of Internal Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"COVID-19 Sub-Intensive Unit, Division of Emergency Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6174-7111","authenticated-orcid":false,"given":"Manuela","family":"Rizzi","sequence":"additional","affiliation":[{"name":"Internal Medicine and Rheumatology Unit, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stelvio","family":"Tonello","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"Center for Autoimmune and Allergic Diseases (CAAD), Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Matino","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"COVID-19 Unit, Department of Internal Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"COVID-19 Sub-Intensive Unit, Division of Emergency Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"COVID-19 Unit, Department of Internal Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"COVID-19 Sub-Intensive Unit, Division of Emergency Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9615-2452","authenticated-orcid":false,"given":"Eleonora","family":"Rizzi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"COVID-19 Unit, Department of Internal Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"COVID-19 Sub-Intensive Unit, Division of Emergency Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe Francesco","family":"Casciaro","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"COVID-19 Unit, Department of Internal Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"COVID-19 Sub-Intensive Unit, Division of Emergency Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia Francesca","family":"Manfredi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"Internal Medicine and Rheumatology Unit, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Acquaviva","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"Internal Medicine and Rheumatology Unit, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ileana","family":"Gagliardi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"Internal Medicine and Rheumatology Unit, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Calzaducca","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"Internal Medicine and Rheumatology Unit, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9664-481X","authenticated-orcid":false,"given":"Venkata Ramana","family":"Mallela","sequence":"additional","affiliation":[{"name":"Internal Medicine and Rheumatology Unit, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3196-940X","authenticated-orcid":false,"given":"Davide","family":"D\u2019Onghia","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7548-9731","authenticated-orcid":false,"given":"Rosalba","family":"Minisini","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1488-8736","authenticated-orcid":false,"given":"Mattia","family":"Bellan","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"COVID-19 Unit, Department of Internal Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"COVID-19 Sub-Intensive Unit, Division of Emergency Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"Internal Medicine and Rheumatology Unit, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"Center for Autoimmune and Allergic Diseases (CAAD), Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8248-1976","authenticated-orcid":false,"given":"Luigi Mario","family":"Castello","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"Division of Internal Medicine, Azienda Ospedaliera \u201cSS. Antonio e Biagio e Cesare Arrigo\u201d, 15100 Alessandria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0581-245X","authenticated-orcid":false,"given":"Francesco","family":"Gavelli","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"COVID-19 Sub-Intensive Unit, Division of Emergency Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7611-8345","authenticated-orcid":false,"given":"Gian Carlo","family":"Avanzi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"COVID-19 Sub-Intensive Unit, Division of Emergency Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Patrucco","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"Medical Department, Division of Respiratory Diseases, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4349-1087","authenticated-orcid":false,"given":"Annalisa","family":"Chiocchetti","sequence":"additional","affiliation":[{"name":"Center for Autoimmune and Allergic Diseases (CAAD), Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"Department of Health Sciences, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9740-0155","authenticated-orcid":false,"given":"Mario","family":"Pirisi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"COVID-19 Unit, Department of Internal Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"COVID-19 Sub-Intensive Unit, Division of Emergency Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"Internal Medicine and Rheumatology Unit, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"Center for Autoimmune and Allergic Diseases (CAAD), Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2089-4139","authenticated-orcid":false,"given":"Cristina","family":"Rigamonti","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"Internal Medicine and Rheumatology Unit, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7747-7622","authenticated-orcid":false,"given":"Daniele","family":"Lilleri","sequence":"additional","affiliation":[{"name":"Unit of Microbiology and Virology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7863-8192","authenticated-orcid":false,"given":"Daniele","family":"Sola","sequence":"additional","affiliation":[{"name":"Internal Medicine and Rheumatology Unit, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8322-9158","authenticated-orcid":false,"given":"Pier Paolo","family":"Sainaghi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"},{"name":"COVID-19 Unit, Department of Internal Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"COVID-19 Sub-Intensive Unit, Division of Emergency Medicine, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"Internal Medicine and Rheumatology Unit, AOU \u201cMaggiore della Carit\u00e0\u201d, 28100 Novara, Italy"},{"name":"Center for Autoimmune and Allergic Diseases (CAAD), Universit\u00e0 del Piemonte Orientale (UPO), 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"118","DOI":"10.23736\/S0026-4806.20.07074-3","article-title":"Clinical stability and in-hospital mortality prediction in COVID-19 patients presenting to the emergency department","volume":"112","author":"Gavelli","year":"2021","journal-title":"Minerva Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"20731","DOI":"10.1038\/s41598-020-77698-4","article-title":"Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients","volume":"10","author":"Bellan","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Pinato, D.J., Lee, A.J.X., Biello, F., Segu\u00ed, E., Aguilar-Company, J., Carb\u00f3, A., Bruna, R., Bower, M., Rizzo, G., and Benafif, S. (2020). Presenting features and early mortality from SAARS-CoV-2 infection in cancer patients during the initial stage of the COVID-19 pandemic in Europe. Cancers, 12.","DOI":"10.3390\/cancers12071841"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"585866","DOI":"10.3389\/fcvm.2020.585866","article-title":"Comorbidities, cardiovascular therapies and COVID-19 mortality: A nationwide Italian observational study (ItaliC)","volume":"7","author":"Polverino","year":"2020","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_5","first-page":"20","article-title":"Risque thrombotique de la COVID-19","volume":"629\u2013630","year":"2021","journal-title":"OptionBio"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1186\/s13054-020-03060-9","article-title":"\u201cWar to the knife\u201d against thromboinflammation to protect endothelial function of COVID-19 patients","volume":"24","author":"Guglielmetti","year":"2020","journal-title":"Crit. Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1007\/s00134-020-06062-x","article-title":"High risk of thrombosis in patients with severe SARS-CoV-2 infection: A multicenter prospective cohort study","volume":"46","author":"Helms","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.healun.2020.12.009","article-title":"COVID-19 vaccination in our transplant recipients: The time is now","volume":"40","author":"Aslam","year":"2021","journal-title":"J. Heart Lung Transplant."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6004","DOI":"10.1016\/j.vaccine.2020.10.059","article-title":"The public\u2019s role in COVID-19 vaccination: Human-centered recommendations to enhance pandemic vaccine awareness, access, and acceptance in the United States","volume":"39","author":"Brunson","year":"2021","journal-title":"Vaccine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1056\/NEJMoa2035389","article-title":"Efficacy and safety of the m-RNA-1273 SARS-CoV2 vaccine","volume":"384","author":"Baden","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3459","DOI":"10.2147\/IDR.S315727","article-title":"Overview of the main anti-SARS-CoV-2 vaccines: Mechanism of action, efficacy and safety","volume":"14","author":"Mascellino","year":"2021","journal-title":"Infect. Drug Resist."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"726960","DOI":"10.3389\/fimmu.2021.726960","article-title":"Induction of high levels of specific humoral and cellular responses to SARS-CoV-2 after the administration of Covid-19 mRNA vaccines requires several days","volume":"12","author":"Carbonell","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1038\/s41586-021-03324-6","article-title":"mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants","volume":"592","author":"Wang","year":"2021","journal-title":"Nature"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"744887","DOI":"10.3389\/fimmu.2021.744887","article-title":"The mucosal and serological immune responses to the novel coronavirus (SARS-CoV-2) vaccines","volume":"12","author":"Chan","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Guerrrieri, M., Francavilla, B., Fiorelli, D., Nuccetelli, M., Passali, F.M., Coppeta, L., Somma, G., Bernardini, S., Magrini, A., and Di Girolamo, S. (2021). Nasal and salivary mucosal humoral immune response elicited by mRNA BNT162b2 COVID-19 vaccine compared to SARS-CoV-2 natural infection. Vaccines, 9.","DOI":"10.3390\/vaccines9121499"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1086\/587063","article-title":"Vaccination in patients with chronic rheumatic or autoimmune diseases","volume":"46","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1136\/annrheumdis-2019-215882","article-title":"2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases","volume":"79","author":"Furer","year":"2020","journal-title":"Ann. Rheum. Dis."},{"key":"ref_19","first-page":"317","article-title":"Vaccination in adults with rheumatoid arthritis in an era of new disease-modifying anti-rheumatic drugs","volume":"36","author":"Meroni","year":"2018","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.autrev.2013.07.007","article-title":"Influenza and pneumococcal vaccinations of patients with systemic lupus erythematosus: Current views upon safety and immunogenicity","volume":"13","author":"Murdaca","year":"2014","journal-title":"Autoimmun. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1136\/ard.2005.036434","article-title":"Vaccination against influenza in rheumatoid arthritis: The effect of disease modifying drugs, including TNFa blockers","volume":"65","author":"Fomin","year":"2006","journal-title":"Ann. Rheum. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"D\u2019Amelio, R., Asero, R., Cassatella, M.A., Lagana, B., Lunardi, C., Migliorini, P., Nisini, R., Parronchi, P., Quinti, I., and Racanelli, V. (2021). Anti-COVID-19 vaccination in patients with autoimmune-autoinflammatory disorders and primary\/secondary immunodeficiencies: The position of the task force on behalf of the Italian immunological societies. Biomedicines, 9.","DOI":"10.3390\/biomedicines9091163"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"102744","DOI":"10.1016\/j.jaut.2021.102744","article-title":"Impaired immunogenicity to COVID-19 vaccines in autoimmune systemic diseases. High prevalence of non-response in different patients\u2019 subgroups","volume":"125","author":"Ferri","year":"2021","journal-title":"J. Autoimmun."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2852","DOI":"10.1080\/21645515.2015.1078043","article-title":"Immunizations in solid organ and hematopoietic stem cell transplant patients: A comprehensive review","volume":"11","author":"Kumar","year":"2015","journal-title":"Hum. Vacc. Immunother."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"104468","DOI":"10.1016\/j.jcv.2020.104468","article-title":"Evaluation of the EUROIMMUN anti-SARS-CoV-2 ELISA assay for detection of IgA and IgG antibodies","volume":"129","author":"Beavis","year":"2020","journal-title":"J. Clin. Virol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Schmidt, K.G., Harrer, E.G., Tascilar, K., K\u00fcbel, S., El Kenz, B., Hartmann, F., Simon, D., Schett, G., Nganou-Makamdop, K., and Harrer, T. (2022). Characterization of serum and mucosal SARS-CoV-2-antibodies in HIV-1-infected subjects after BNT162b2 mRNA vaccination or SARS-CoV-2 infection. Viruses, 14.","DOI":"10.3390\/v14030651"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1002\/jmv.27287","article-title":"Correlation between a quantitative anti-Sars-CoV-2 IgG ELISA and neutralization activity","volume":"94","author":"Bartok","year":"2022","journal-title":"J. Med. Virol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"104988","DOI":"10.1016\/j.jcv.2021.104988","article-title":"Neutralizing antibody responses following natural SARS-CoV-2 infection: Dynamics and correlation with commercial serologic tests","volume":"144","author":"Montesinos","year":"2021","journal-title":"J. Clin. Virol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1007\/s40121-021-00475-x","article-title":"In search of the SARS-CoV-2 protection correlate: Head-to-head comparison of two quantitative S1 assays in pre-characterized oligo-\/asymptomatic patients","volume":"10","author":"Castelletti","year":"2021","journal-title":"Infect. Dis. Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1038\/s41590-021-01122-w","article-title":"The T cell immune response against SARS-CoV-2","volume":"23","author":"Moss","year":"2022","journal-title":"Nat. Immunol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1136\/annrheumdis-2021-220647","article-title":"Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in adult patients with autoimmune inflammatory rheumatic diseases and in the general population: A multicentre study","volume":"80","author":"Furer","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3496","DOI":"10.1093\/rheumatology\/keab223","article-title":"COVID-19 vaccination and antirheumatic therapy","volume":"60","author":"Arnold","year":"2021","journal-title":"Rheumatology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1136\/annrheumdis-2021-219957","article-title":"Rheumatology and COVID-19 at 1 year: Facing the unknowns","volume":"80","author":"Calabrese","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1136\/annrheumdis-2021-221244","article-title":"Impact of disease-modifying antirheumatic drug on vaccine immunogenicity in patients with inflammatory rheumatic and musculoskeletal diseases","volume":"80","author":"Friedman","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e95","DOI":"10.3346\/jkms.2021.36.e95","article-title":"COVID-19 vaccination in patients with autoimmune inflammatory rheumatic diseases: Clinical guidance of the Korean College of Rheumatology","volume":"36","author":"Park","year":"2021","journal-title":"J. Korean Med. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1136\/annrheumdis-2021-220862","article-title":"Methotrexate and glucocorticoids, but not anticytokine thrapy, impair the immunogenicity of a single dose of the BNT162b2 mRNA COVID-19 vaccine in patients with chronic inflammatory arthritis","volume":"80","author":"Bugatti","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1136\/annrheumdis-2021-220597","article-title":"Methotrexate hampers immunogenicity to BNT162b2 mRNA COVID-19 vaccine in immune-mediated inflammatory disease","volume":"80","author":"Haberman","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1136\/annrheumdis-2021-220289","article-title":"Antibody response to a single dose of SARS-CoV-2 mRNA vaccine in patients with rheumatic and musculoskeletal diseases","volume":"80","author":"Boyarsky","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1136\/annrheumdis-2021-220656","article-title":"High antibody response to two-dose SARS-CoV-2 messenger RNA vaccination in patients whit rheumatic and musculoskeletal diseases","volume":"80","author":"Ruddy","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1007\/s00392-021-01880-5","article-title":"Poor humoral and T-cell response to two-dose SARS-CoV-2 messenger RNA vaccine BNT162b2 in cardiothoracic transplant recipients","volume":"110","author":"Schramm","year":"2021","journal-title":"Clin. Res. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1016\/j.kint.2021.03.014","article-title":"Low immunization rates among kidney transplant recipients who received 2 doses of the mRNA-1273 SARS-CoV-2 vaccine","volume":"99","author":"Benotmane","year":"2021","journal-title":"Kidney Int."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Korth, J., Jahn, M., Dorsch, O., Anastasiou, O.E., Sorge-H\u00e4dicke, B., Eisenberger, U., G\u00e4ckler, A., Dittmer, U., Witzke, O., and Wilde, B. (2021). Impaired humoral response in renal transplant recipients to SARS-CoV-2 vaccination with BNT162b2 (Pfizer-BioNTech). Viruses, 13.","DOI":"10.3390\/v13050756"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jhep.2021.04.020","article-title":"Low immunogenicity to SARS-CoV-2 vaccination among liver transplant recipients","volume":"75","author":"Rabinowich","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1038\/s41581-021-00491-7","article-title":"COVID-19 vaccination in kidney transplant recipients","volume":"17","author":"Caillard","year":"2021","journal-title":"Nature Rev. Nephrol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"7375","DOI":"10.1016\/j.vaccine.2021.10.068","article-title":"Absent antibody production following COVID19 vaccination with mRNA in patients under immunosuppressive treatments","volume":"39","author":"Wagner","year":"2021","journal-title":"Vaccine"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1111\/cei.12604","article-title":"Calcineurin inhibitors dampen humoral immunity by acting directly on na\u00efve B cells","volume":"180","author":"Bogaert","year":"2015","journal-title":"Clin. Experiment. Immunol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"s2","DOI":"10.1191\/0961203305LU2109OA","article-title":"Mechanisms of action of mycophenolate mofetil","volume":"14","author":"Allison","year":"2005","journal-title":"Lupus"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1097\/00007691-199512000-00007","article-title":"Mode of action of tacrolimus (FK506): Molecular and cellular mechanisms","volume":"17","author":"Thomson","year":"1995","journal-title":"Ther. Drug. Monit."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"100283","DOI":"10.1016\/j.esmoop.2021.100283","article-title":"Serologic response to COVID-19 infection and\/or vaccine in cancer patients on active treatment","volume":"6","author":"Grinshpun","year":"2021","journal-title":"ESMO Open Cancer Horiz."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1001\/jamaoncol.2021.2155","article-title":"Evaluation of seropositivity following BNT162b2 messenger RNA vaccination for SARS-CoV-2 in patients undergoing treatment for cancer","volume":"7","author":"Massarweh","year":"2021","journal-title":"JAMA Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.ejca.2021.10.013","article-title":"Evaluation of COVID-19 vaccine response in patients with cancer: An interim analysis","volume":"159","author":"Tran","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e2211897","DOI":"10.1001\/jamanetworkopen.2022.11897","article-title":"Comparison of SARS-CoV-2 antibody response after 2-dose mRNA-1273 vs BNT162b2 vaccine in incrementally immunosuppressed patients","volume":"5","author":"Mitchell","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"839922","DOI":"10.3389\/fimmu.2022.839922","article-title":"Persistence of immune response in health care workers after two doses BNT162b2 in a longitudinal observational study","volume":"13","author":"Herzberg","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Ssentongo, P., Ssentongo, A.E., Voleti, N., Groff, D., Sun, A., Ba, D.M., Nunez, J., Parent, L.J., and Chinchilli VMPaules, C.I. (2022). SARS-CoV-2 vaccine effectiveness against infection, symptomatic and severe COVID-19: A systematic review and meta-analysis. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07418-y"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1080\/14760584.2022.2035222","article-title":"COVID-19 vaccine effectiveness among immunocompromised populations: A targeted literature review of real-world studies","volume":"21","author":"Lin","year":"2022","journal-title":"Expert Rev. Vaccines"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1016\/j.cmi.2022.02.002","article-title":"The effect of a third-dose BNT162b2 vaccine on anti-SARS-CoV-2 antibody levels in immunosuppressed patients","volume":"28","author":"Saiag","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2837","DOI":"10.1002\/jmv.27644","article-title":"Third dose of SARS-CoV-2 vaccine: A systematic review of 30 published studies","volume":"94","author":"Petrelli","year":"2022","journal-title":"J. Med. Virol."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Margioris, A.N. (2022). Immunosuppressed non-responders to two doses of mRNA SARS-CoV-2 vaccines achieve an immune response comparable to those of immunocompetent individuals after a third dose. Hormones, 1\u20135.","DOI":"10.1007\/s42000-022-00365-y"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1016\/j.jaci.2022.01.013","article-title":"Comparative analyses of IgG\/IgA neutralizing effects induced by three COVID-19 vaccines against variants of concern","volume":"149","author":"Lafon","year":"2022","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1126\/science.abg6105","article-title":"Neutralization of SARS-CoV-2 lineage B.1.1.7 pseudovirus by BNT162b2 vaccine-elicited human sera","volume":"371","author":"Muik","year":"2021","journal-title":"Science"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.chom.2021.03.002","article-title":"SARS-CoV-2 variant B.1.1.7 is susceptible to neutralizing antibodies elicited by ancestral spike vaccines","volume":"29","author":"Shen","year":"2021","journal-title":"Cell Host Microbe"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1038\/s41591-021-01270-4","article-title":"Neutralization of SARS-CoV-2 spike 69\/70 deletion, E484K and N501Y variants by BNT162b2 vaccine-elicited sera","volume":"27","author":"Xie","year":"2021","journal-title":"Nature Med."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/8\/1766\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:08:08Z","timestamp":1760141288000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/8\/1766"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,12]]},"references-count":62,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["v14081766"],"URL":"https:\/\/doi.org\/10.3390\/v14081766","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,12]]}}}