{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T21:40:13Z","timestamp":1784756413809,"version":"3.55.0"},"reference-count":20,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","award":["2122-HQ-000070"],"award-info":[{"award-number":["2122-HQ-000070"]}],"id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: The Safety and Immunogenicity of COVID-19 Vaccines in Systemic Autoimmune-Mediated Inflammatory Diseases (SUCCEED) study was created to better understand COVID-19 vaccination in immune-mediated inflammatory disease (IMID). Knowing the frequency of COVID-19 breakthrough infections is important, particularly in IMID. Our objective was to assess these events in IMID. Methods: We prospectively studied IMID participants who had received \u2265three COVID-19 vaccine doses. Individuals provided saliva samples monthly (September 2022 to August 2023). These were evaluated by polymerase chain reaction (PCR) for SARS-CoV-2. We also assessed antibodies against SARS-CoV-2 (anti-spike, SmT1, receptor binding domain, RBD, and nucleocapsid, NP) based on dried blood spots. Multivariable general estimating equation regression produced odd ratios (OR) for PCR SARS-CoV-2 positivity, related to demographics, immunosuppressives, and antibody levels. Results: Diagnoses included rheumatoid arthritis RA (N = 161, 44% of the total), systemic lupus, psoriatic arthritis, spondylarthritis, vasculitis, systemic sclerosis, and inflammatory bowel disease. Of the 366 participants, most were taking immunosuppressive medication. Of 1266 saliva samples, 56 (5.1%) were positive for SARS-CoV-2 on PCR. Higher anti-SmT1 antibodies were inversely associated with SARS-CoV-2 detection on PCR (adjusted OR 0.66, 95% confidence interval 0.45\u20130.97). Antibodies to SmT1, RBD, and NP were correlated and thus could not be included in a single model, but when anti-RBD was used in place of anti-SmT1, the results were similar. No other factor (including prior COVID-19 infection) was clearly associated with SARS-CoV-2 detection. Conclusions: This is the first study of SARS-CoV-2 in a large prospective cohort of triple (or more) vaccinated individuals with IMIDs. Anti-SmT1 antibodies appeared to be protective against later SARS-CoV-2 positivity, although recent past infection was not clearly related. This suggests the importance of maintaining robust vaccine-induced immunity through vaccination in IMID.<\/jats:p>","DOI":"10.3390\/vaccines13020104","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T03:40:17Z","timestamp":1737517217000},"page":"104","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["COVID-19 Breakthrough Infections in Immune-Mediated Inflammatory Diseases: Data from the SUCCEED (Safety and Immunogenicity of COVID-19 Vaccines in Systemic Autoimmune-Mediated Inflammatory Diseases) Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Jeremiah","family":"Tan","sequence":"first","affiliation":[{"name":"Arthritis Research Canada and Division of Rheumatology, University of British Columbia, Vancouver, BC V5Y 3P2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-2802","authenticated-orcid":false,"given":"Sasha","family":"Bernatsky","sequence":"additional","affiliation":[{"name":"The Research Institute of the McGill University Health Centre, Montreal, QC H3A 0E9, Canada"},{"name":"Division of Rheumatology, Department of Medicine, McGill University, Montreal, QC H3A 0E9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5501-0017","authenticated-orcid":false,"given":"Jennifer L. F.","family":"Lee","sequence":"additional","affiliation":[{"name":"The Research Institute of the McGill University Health Centre, Montreal, QC H3A 0E9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7278-2596","authenticated-orcid":false,"given":"Paul R.","family":"Fortin","sequence":"additional","affiliation":[{"name":"Centre de Recherche ARThrite\u2014UL, Division of Rheumatology, Department of Medicine, CHU de Qu\u00e9bec, Universit\u00e9 Laval, Qu\u00e9bec City, QC G1V 4G2, Canada"},{"name":"Axe Maladies Infectieuses et Immunitaires, Centre de Recherche du CHU de Qu\u00e9bec, Universit\u00e9 Laval, Qu\u00e9bec City, QC G1V 4G2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roya M.","family":"Dayam","sequence":"additional","affiliation":[{"name":"Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Claude","family":"Gingras","sequence":"additional","affiliation":[{"name":"Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, ON M5G 1X5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Colmegna","sequence":"additional","affiliation":[{"name":"The Research Institute of the McGill University Health Centre, Montreal, QC H3A 0E9, Canada"},{"name":"Division of Rheumatology, Department of Medicine, McGill University, Montreal, QC H3A 0E9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6823-2957","authenticated-orcid":false,"given":"Dawn M. E.","family":"Bowdish","sequence":"additional","affiliation":[{"name":"McMaster Immunology Research Centre, McMaster University, Hamilton, ON L8S 4L8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudie","family":"Berger","sequence":"additional","affiliation":[{"name":"The Research Institute of the McGill University Health Centre, Montreal, QC H3A 0E9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dora","family":"Chan","sequence":"additional","affiliation":[{"name":"Arthritis Research Canada and Division of Rheumatology, University of British Columbia, Vancouver, BC V5Y 3P2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie J.","family":"Larch\u00e9","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, McMaster University, Hamilton, ON L8N 3Z5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1151-0826","authenticated-orcid":false,"given":"Dawn P.","family":"Richards","sequence":"additional","affiliation":[{"name":"Canadian Arthritis Patient Alliance, Toronto, ON M6R 2J6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lourdes","family":"Gonzalez Arreola","sequence":"additional","affiliation":[{"name":"Arthritis Research Canada and Division of Rheumatology, University of British Columbia, Vancouver, BC V5Y 3P2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A.","family":"Hitchon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3A 1R9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Lalonde","sequence":"additional","affiliation":[{"name":"Canadian Arthritis Patient Alliance, Toronto, ON M6R 2J6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Antonio","family":"Avi\u00f1a-Zubieta","sequence":"additional","affiliation":[{"name":"Arthritis Research Canada and Division of Rheumatology, University of British Columbia, Vancouver, BC V5Y 3P2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"n1943","DOI":"10.1136\/bmj.n1943","article-title":"Effectiveness of BNT162b2 and mRNA-1273 COVID-19 vaccines against symptomatic SARS-CoV-2 infection and severe COVID-19 outcomes in Ontario, Canada: Test negative design study","volume":"374","author":"Chung","year":"2021","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1080\/13696998.2021.2002063","article-title":"Evaluation of COVID-19 vaccine breakthrough infections among immunocompromised patients fully vaccinated with BNT162b2","volume":"24","author":"Moran","year":"2021","journal-title":"J. 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