{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:45:03Z","timestamp":1761061503835,"version":"build-2065373602"},"reference-count":91,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T00:00:00Z","timestamp":1633651200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Aberrant deployment of the immune response is a hallmark pathogenic feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease (COVID-19), possibly accounting for high morbidity and mortality, especially in patients with comorbidities, including immune-mediated disorders. Immunisation with SARS-COV-2 vaccines successfully instructs the immune system to limit viral spread into tissues, mitigate COVID-19 manifestations and prevent its most detrimental inflammatory complications in the general population. Patients with immune-mediated diseases have been excluded from vaccine registration trials, foreclosing the acquisition of specific efficacy and safety data. In this review, we aimed to summarise and critically discuss evidence from real-world studies addressing this issue to provide a comprehensive view of the impact of vaccination practices in patients with allergy, autoimmunity or immunodeficiency. We analysed clinical and laboratory data from 34 studies involving more than 13,000 subjects with various immune disorders who were vaccinated with mRNA- DNA- or inactivated viral particle-based vaccines. These data globally support the safe and effective use of SARS-CoV-2 vaccines in patients with immune-mediated diseases, although patient-tailored strategies to determine vaccination timing, vaccine choice and background therapy management are warranted to optimise vaccination outcomes. More data are needed regarding patients with primary immunodeficiencies.<\/jats:p>","DOI":"10.3390\/vaccines9101147","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T01:59:47Z","timestamp":1633917587000},"page":"1147","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Challenges to Vaccination against SARS-CoV-2 in Patients with Immune-Mediated Diseases"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2889-366X","authenticated-orcid":false,"given":"Giuseppe A.","family":"Ramirez","sequence":"first","affiliation":[{"name":"Division of Immunology, Transplants and Infectious Diseases, Universit\u00e0 Vita-Salute San Raffaele, 20132 Milan, Italy"},{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Asperti","sequence":"additional","affiliation":[{"name":"Division of Immunology, Transplants and Infectious Diseases, Universit\u00e0 Vita-Salute San Raffaele, 20132 Milan, Italy"},{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Cucca","sequence":"additional","affiliation":[{"name":"Division of Immunology, Transplants and Infectious Diseases, Universit\u00e0 Vita-Salute San Raffaele, 20132 Milan, Italy"},{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona-Rita","family":"Yacoub","sequence":"additional","affiliation":[{"name":"Division of Immunology, Transplants and Infectious Diseases, Universit\u00e0 Vita-Salute San Raffaele, 20132 Milan, Italy"},{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,8]]},"reference":[{"key":"ref_1","unstructured":"Jowett, B. (1881). Thucydides. History of the Peloponnesian War. Early Fourth Century BC, Clarendon Press. Chapter 47\u201354."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/j.1365-2249.2006.03304.x","article-title":"Translational mini-review series on vaccines: The Edward Jenner Museum and the history of vaccination","volume":"147","author":"Morgan","year":"2007","journal-title":"Clin. Exp. Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/nrd.2017.243","article-title":"mRNA vaccines\u2014A new era in vaccinology","volume":"17","author":"Pardi","year":"2018","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0140-6736(19)32686-8","article-title":"Lower trust in national government links to no history of vaccination","volume":"395","author":"Miyachi","year":"2020","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1007\/s00296-021-04941-0","article-title":"Rheumatology university faculty opinion on coronavirus disease-19 (COVID-19) vaccines: The vaXurvey study from Egypt","volume":"41","author":"Hammam","year":"2021","journal-title":"Rheumatol. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1136\/annrheumdis-2020-219498","article-title":"Factors associated with COVID-19-related death in people with rheumatic diseases: Results from the COVID-19 Global Rheumatology Alliance physician-reported registry","volume":"80","author":"Strangfeld","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.jaci.2020.12.620","article-title":"COVID-19 in patients with primary and secondary immunodeficiency: The United Kingdom experience","volume":"147","author":"Shields","year":"2021","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"676","DOI":"10.55563\/clinexprheumatol\/lekp1y","article-title":"SARS-CoV-2 infection in patients with systemic autoimmune diseases","volume":"39","author":"Retamozo","year":"2021","journal-title":"Clin Exp Rheumatol."},{"key":"ref_9","first-page":"95","article-title":"Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome (MicroCLOTS): An atypical acute respiratory distress syndrome working hypothesis","volume":"22","author":"Ciceri","year":"2020","journal-title":"Crit. Care Resusc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1186\/s12967-020-02524-4","article-title":"Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection","volume":"18","author":"Maguire","year":"2020","journal-title":"J. Transl. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1016\/j.cmi.2021.05.023","article-title":"Drug reaction with eosinophilia and systemic symptoms (DRESS) in patients with COVID-19","volume":"27","author":"Ramirez","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Ramirez, G.A., Calvisi, S.L., De Lorenzo, R., Da Pract, V., Borio, G., Gallina, G., Farolfi, F., Cavallo, L., Pascali, M., and Castellani, J. (2021). A novel evidence-based algorithm to predict thromboembolism in patients with COVID-19: Preliminary data from a single-centre cohort. Minerva Med.","DOI":"10.23736\/S0026-4806.21.07331-6"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Schioppo, T., Argolini, L.M., Sciascia, S., Pregnolato, F., Tamborini, F., Miraglia, P., Roccatello, D., Sinico, R.A., Caporali, R., and Moroni, G. (2021). Clinical and peculiar immunological manifestations of SARS-CoV-2 infection in systemic lupus erythematosus patients. Rheumatology.","DOI":"10.1093\/rheumatology\/keab611"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Giollo, A., Bixio, R., Gatti, D., Viapiana, O., Idolazzi, L., Dejaco, C., and Rossini, M. (2020). Challenge of diagnosing ANCA-associated vasculitis during COVID-19 pandemic: A missed \u2018window of opportunity\u2019. Ann. Rheum. Dis.","DOI":"10.1136\/annrheumdis-2020-218830"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1177\/0961203320962855","article-title":"Impact of the COVID-19 pandemic on patients with systemic lupus erythematosus: Observations from an Indian inception cohort","volume":"30","author":"Rathi","year":"2020","journal-title":"Lupus"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1182\/blood-2010-06-290171","article-title":"Myeloperoxidase is required for neutrophil extracellular trap formation: Implications for innate immunity","volume":"117","author":"Metzler","year":"2011","journal-title":"Blood"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1007\/s00281-013-0376-6","article-title":"Neutrophil extracellular chromatin traps connect innate immune response to autoimmunity","volume":"35","author":"Radic","year":"2013","journal-title":"Semin. Immunopathol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s12016-014-8416-0","article-title":"Re-visiting Hypersensitivity Reactions to Taxanes: A Comprehensive Review","volume":"49","author":"Picard","year":"2014","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/j.ymthe.2021.01.030","article-title":"Allergic Reactions and Anaphylaxis to LNP-Based COVID-19 Vaccines","volume":"29","author":"Moghimi","year":"2021","journal-title":"Mol. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1161\/CIRCULATIONAHA.121.055913","article-title":"Myocarditis After BNT162b2 and mRNA-1273 Vaccination","volume":"144","author":"Larson","year":"2021","journal-title":"Circulation"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1056\/NEJMoa2104840","article-title":"Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination","volume":"384","author":"Greinacher","year":"2021","journal-title":"New Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Tan, C.K., Wong, Y.J., Wang, L.M., Ang, T.L., and Kumar, R. (2021). Autoimmune hepatitis following COVID-19 Vaccination: True causality or mere association?. J. Hepatol.","DOI":"10.1016\/j.jhep.2021.06.009"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1001\/jama.2021.3976","article-title":"Acute Allergic Reactions to mRNA COVID-19 Vaccines","volume":"325","author":"Blumenthal","year":"2021","journal-title":"JAMA"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Watad, A., De Marco, G., Mahajna, H., Druyan, A., Eltity, M., Hijazi, N., Haddad, A., Elias, M., Zisman, D., and Naffaa, M.E. (2021). Immune-Mediated Disease Flares or New-Onset Disease in 27 Subjects Following mRNA\/DNA SARS-CoV-2 Vaccination. Vaccines, 9.","DOI":"10.3390\/vaccines9050435"},{"key":"ref_25","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_26","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1056\/NEJMoa2035389","article-title":"Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine","volume":"384","author":"Baden","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/S0140-6736(21)00432-3","article-title":"Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine: A pooled analysis of four randomised trials","volume":"397","author":"Voysey","year":"2021","journal-title":"Lancet"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1136\/annrheumdis-2021-220059","article-title":"SARS-CoV-2 vaccine hesitancy among patients with rheumatic and musculoskeletal diseases: A message for rheumatologists","volume":"80","author":"Priori","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_29","unstructured":"Lupus_Research_Alliance (2021, January 31). Two Thirds of People with Lupus Would Take COVID-19 Vaccine, Shows LRA Survey. Available online: https:\/\/www.lupusresearch.org\/two-thirds-of-people-with-lupus-would-take-covid-19-vaccine-shows-lra-survey\/."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1136\/annrheumdis-2020-219811","article-title":"Potential acceptance of COVID-19 vaccine in rheumatological patients: A monocentric comparative survey","volume":"80","author":"Campochiaro","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Ramirez, G.A., Argolini, L.M., Bellocchi, C., Moroni, L., Della-Torre, E., Farina, N., Caporali, R.F., Beretta, L., Gerosa, M., and Bozzolo, E.P. (2021). Impact of the COVID-19 pandemic in patients with systemic lupus erythematosus throughout one year. Clin. Immunol., ahead of print.","DOI":"10.1016\/j.clim.2021.108845"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Wack, S., Patton, T., and Ferris, L.K. (2021). COVID-19 vaccine safety and efficacy in patients with Immune-Mediated Inflammatory Disease: Review of available evidence. J. Am. Acad. Dermatol.","DOI":"10.1016\/j.jaad.2021.07.054"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"103028","DOI":"10.1016\/j.msard.2021.103028","article-title":"Experience with the COVID-19 AstraZeneca vaccination in people with multiple sclerosis","volume":"52","author":"Stennett","year":"2021","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1016\/j.jaip.2020.12.047","article-title":"mRNA Vaccines to Prevent COVID-19 Disease and Reported Allergic Reactions: Current Evidence and Suggested Approach","volume":"9","author":"Banerji","year":"2020","journal-title":"J. Allergy Clin. Immunol. Pr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1136\/annrheumdis-2021-220732","article-title":"Systemic rheumatic disease flares after SARS-CoV-2 vaccination among rheumatology outpatients in New York City","volume":"80","author":"Barbhaiya","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e542","DOI":"10.1016\/S2665-9913(21)00181-8","article-title":"Adverse events after first COVID-19 vaccination in patients with autoimmune diseases","volume":"3","author":"Boekel","year":"2021","journal-title":"Lancet Rheumatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"102983","DOI":"10.1016\/j.msard.2021.102983","article-title":"COVID-19 vaccines in multiple sclerosis treated with cladribine or ocrelizumab","volume":"52","author":"Buttari","year":"2021","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1007\/s00296-021-04917-0","article-title":"Safety of the ChAdOx1 nCoV-19 and the BBV152 vaccines in 724 patients with rheumatic diseases: A post-vaccination cross-sectional survey","volume":"41","author":"Cherian","year":"2021","journal-title":"Rheumatol. Int."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3198","DOI":"10.1016\/j.jaip.2021.05.010","article-title":"Safety of COVID-19 vaccination in patients with mastocytosis and monoclonal mast cell activation syndrome","volume":"9","author":"Kaakati","year":"2021","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/j.jaci.2021.01.004","article-title":"mRNA COVID-19 vaccine is well tolerated in patients with cutaneous and systemic mastocytosis with mast cell activation symptoms and anaphylaxis","volume":"147","author":"Rama","year":"2021","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"180","DOI":"10.18176\/jiaci.0683","article-title":"Safety of New mRNA Vaccines Against COVID-19 in Severely Allergic Patients","volume":"31","year":"2021","journal-title":"J. Investig. Allergol. Clin. Immunol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Connolly, C.M., Ruddy, J.A., Boyarsky, B.J., Avery, R.K., Werbel, W.A., Segev, D.L., Garonzik-Wang, J., and Paik, J.J. (2021). Safety of the first dose of mRNA SARS-CoV-2 vaccines in patients with rheumatic and musculoskeletal diseases. Ann. Rheum. Dis.","DOI":"10.1136\/annrheumdis-2021-220231"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Geisen, U.M., Berner, D.K., Tran, F., Sumbul, M., Vullriede, L., Ciripoi, M., Reid, H.M., Schaffarzyk, A., Longardt, A.C., and Franzenburg, J. (2021). Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort. Ann. Rheum. Dis.","DOI":"10.1136\/annrheumdis-2021-220272"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1111\/ced.14631","article-title":"COVID-19 vaccination and patients with psoriasis under biologics: Real-life evidence on safety and effectiveness from Italian vaccinated healthcare workers","volume":"46","author":"Damiani","year":"2021","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"100541","DOI":"10.1016\/j.waojou.2021.100541","article-title":"Successful SARS-CoV-2 vaccine allergy risk-management: The experience of a large Italian University Hospital","volume":"14","author":"Paoletti","year":"2021","journal-title":"World Allergy Organ J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1053\/j.gastro.2021.04.025","article-title":"Serologic Response to Messenger RNA Coronavirus Disease 2019 Vaccines in Inflammatory Bowel Disease Patients Receiving Biologic Therapies","volume":"161","author":"Wong","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Achiron, A., Mandel, M., Dreyer-Alster, S., Harari, G., Magalashvili, D., Sonis, P., Dolev, M., Menascu, S., Flechter, S., and Falb, R. (2021). Humoral immune response to COVID-19 mRNA vaccine in patients with multiple sclerosis treated with high-efficacy disease-modifying therapies. Ther. Adv. Neurol. Disord., 14.","DOI":"10.1177\/17562864211012835"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.anai.2021.04.024","article-title":"Risk of allergic reaction in patients with atopic disease and recent coronavirus disease 2019 vaccination","volume":"127","author":"Dages","year":"2021","journal-title":"Ann. Allergy, Asthma Immunol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1136\/annrheumdis-2021-220408","article-title":"SARS-CoV-2 vaccination in rituximab-treated patients: Evidence for impaired humoral but inducible cellular immune response","volume":"80","author":"Bonelli","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Simon, D., Tascilar, K., Fagni, F., Kronke, G., Kleyer, A., Meder, C., Atreya, R., Leppkes, M., Kremer, A.E., and Ramming, A. (2021). SARS-CoV-2 vaccination responses in untreated, conventionally treated and anticytokine-treated patients with immune-mediated inflammatory diseases. Ann. Rheum. Dis., 80.","DOI":"10.1136\/annrheumdis-2021-220461"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Ramirez, G.A., Della-Torre, E., Moroni, L., Yacoub, M.R., and Dagna, L. (2021). Correspondence on \u2018Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort\u2019. Ann. Rheum. Dis.","DOI":"10.1136\/annrheumdis-2021-220539"},{"key":"ref_52","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 with rheumatic and musculoskeletal diseases","volume":"80","author":"Ruddy","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_53","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_54","doi-asserted-by":"crossref","unstructured":"Nittner-Marszalska, M., Rosiek-Biegus, M., Kopec, A., Pawlowicz, R., Kosinska, M., Lata, A., and Szenborn, L. (2021). Pfizer-BioNTech COVID-19 Vaccine Tolerance in Allergic versus Non-Allergic Individuals. Vaccines, 9.","DOI":"10.3390\/vaccines9060553"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1053\/j.gastro.2021.05.044","article-title":"Effectiveness of SARS-CoV-2 Vaccination in a Veterans Affairs Cohort of Patients With Inflammatory Bowel Disease With Diverse Exposure to Immunosuppressive Medications","volume":"161","author":"Khan","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Callejas Rubio, J.L., Rios Fernandez, R., and De la Hera Fernandez, J. (2021). Efficacy and safety of SARS-CoV-2 vaccine in patients with giant cell arteritis. Med. Clin.","DOI":"10.1016\/j.medcle.2021.05.009"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e158","DOI":"10.1136\/annrheumdis-2021-220496","article-title":"Correspondence on \u2018Immunogenicity and safety of anti-SARS-Cov-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort\u2019","volume":"80","author":"Salviani","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.jaci.2021.05.029","article-title":"Immunogenicity of Pfizer-BioNTech COVID-19 vaccine in patients with inborn errors of immunity","volume":"148","author":"Hagin","year":"2021","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e160","DOI":"10.1136\/annrheumdis-2021-220736","article-title":"Correspondence on \u2018Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort\u2019","volume":"80","author":"Veenstra","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_60","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_61","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1136\/annrheumdis-2021-220503","article-title":"Disease activity and humoral response in patients with inflammatory rheumatic diseases after two doses of the Pfizer mRNA vaccine against SARS-CoV-2","volume":"80","author":"Kaplan","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"4404","DOI":"10.1016\/j.vaccine.2021.06.061","article-title":"Specialist confirmed allergic reactions to COVID-19 mRNA vaccines at a mass vaccination site","volume":"39","author":"Myles","year":"2021","journal-title":"Vaccine"},{"key":"ref_63","unstructured":"Guerrieri, S., Lazzarin, S., Zanetta, C., Nozzolillo, A., Filippi, M., and Moiola, L. (2021). Serological response to SARS-CoV-2 vaccination in multiple sclerosis patients treated with fingolimod or ocrelizumab: An initial real-life experience. J. Neurol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e161","DOI":"10.1136\/annrheumdis-2021-220898","article-title":"Correspondence on \u2018Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort\u2019","volume":"80","author":"Tascilar","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Simon, D., Tascilar, K., Schmidt, K., Manger, B., Weckwerth, L., Sokolova, M., Bucci, L., Fagni, F., Manger, K., and Schuch, F. (2021). Brief Report: Humoral and cellular immune responses to SARS-CoV-2 infection and vaccination in B cell depleted autoimmune patients. Arthritis Rheumatol.","DOI":"10.1002\/art.41914"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e627","DOI":"10.1016\/S2665-9913(21)00212-5","article-title":"The effect of methotrexate and targeted immunosuppression on humoral and cellular immune responses to the COVID-19 vaccine BNT162b2: A cohort study","volume":"3","author":"Mahil","year":"2021","journal-title":"Lancet Rheumatol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e250","DOI":"10.1016\/S2665-9913(20)30095-3","article-title":"Rheumatic disease and COVID-19: Initial data from the COVID-19 Global Rheumatology Alliance provider registries","volume":"2","author":"Gianfrancesco","year":"2020","journal-title":"Lancet Rheumatol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1136\/annrheumdis-2020-217763","article-title":"Prevalence of hospital PCR-confirmed COVID-19 cases in patients with chronic inflammatory and autoimmune rheumatic diseases","volume":"79","author":"Pablos","year":"2020","journal-title":"Ann. Rheum. Dis."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1016\/j.semarthrit.2020.06.012","article-title":"COVID-19 in systemic lupus erythematosus: Data from a survey on 417 patients","volume":"50","author":"Ramirez","year":"2020","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1111\/all.14238","article-title":"Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China","volume":"75","author":"Zhang","year":"2020","journal-title":"Allergy"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"eabf3698","DOI":"10.1126\/sciimmunol.abf3698","article-title":"Discordant neutralizing antibody and T cell responses in asymptomatic and mild SARS-CoV-2 infection","volume":"5","author":"Reynolds","year":"2020","journal-title":"Sci. Immunol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"eabi6950","DOI":"10.1126\/sciimmunol.abi6950","article-title":"Distinct antibody and memory B cell responses in SARS-CoV-2 naive and recovered individuals following mRNA vaccination","volume":"6","author":"Goel","year":"2021","journal-title":"Sci. Immunol."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Bilich, T., Nelde, A., Heitmann, J.S., Maringer, Y., Roerden, M., Bauer, J., Rieth, J., Wacker, M., Peter, A., and Horber, S. (2021). T cell and antibody kinetics delineate SARS-CoV-2 peptides mediating long-term immune responses in COVID-19 convalescent individuals. Sci. Transl. Med., 13.","DOI":"10.1126\/scitranslmed.abf7517"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1177\/096120339300200311","article-title":"Allergic disorders in systemic lupus erythematosus","volume":"2","author":"Sequeira","year":"1993","journal-title":"Lupus"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1002\/art.40858","article-title":"Investigating Asthma, Allergic Disease, Passive Smoke Exposure, and Risk of Rheumatoid Arthritis","volume":"71","author":"Kronzer","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2405","DOI":"10.1001\/archinternmed.2008.513","article-title":"Half- vs. full-dose trivalent inactivated influenza vaccine (2004-2005): Age, dose, and sex effects on immune responses","volume":"168","author":"Engler","year":"2008","journal-title":"Arch. Intern. Med."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Klugar, M., Riad, A., Mekhemar, M., Conrad, J., Buchbender, M., Howaldt, H.P., and Attia, S. (2021). Side Effects of mRNA-Based and Viral Vector-Based COVID-19 Vaccines among German Healthcare Workers. Biology, 10.","DOI":"10.3390\/biology10080752"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Pormohammad, A., Zarei, M., Ghorbani, S., Mohammadi, M., Razizadeh, M., Turner, D., and Turner, R. (2021). Efficacy and Safety of COVID-19 Vaccines: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Vaccines, 9.","DOI":"10.2139\/ssrn.3812422"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.3899\/jrheum.090369","article-title":"Developing a standardized definition for disease \u201cflare\u201d in rheumatoid arthritis (OMERACT 9 Special Interest Group)","volume":"36","author":"Bingham","year":"2009","journal-title":"J. Rheumatol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e419","DOI":"10.1016\/S2665-9913(21)00059-X","article-title":"COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: A cohort study","volume":"3","author":"Avouac","year":"2021","journal-title":"Lancet Rheumatol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1136\/annrheumdis-2021-220604","article-title":"Rituximab, but not other antirheumatic therapies, is associated with impaired serological response to SARS-CoV-2 vaccination in patients with rheumatic diseases","volume":"80","author":"Spiera","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1177\/0961203313493032","article-title":"Infection risk in systemic lupus erythematosus patients: Susceptibility factors and preventive strategies","volume":"22","author":"Danza","year":"2013","journal-title":"Lupus"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1080\/09511920410001713501","article-title":"Effect of influenza vaccinations on immune response and serum eotaxin level in patients with allergic bronchial asthma","volume":"13","author":"Brydak","year":"2004","journal-title":"Mediat. Inflamm."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"2503","DOI":"10.1111\/all.14449","article-title":"A compendium answering 150 questions on COVID-19 and SARS-CoV-2","volume":"75","author":"Riggioni","year":"2020","journal-title":"Allergy"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1111\/all.14657","article-title":"Risk factors for severe and critically ill COVID-19 patients: A review","volume":"76","author":"Gao","year":"2020","journal-title":"Allergy"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1111\/all.14532","article-title":"COVID-19 in Severe Asthma Network in Italy (SANI) patients: Clinical features, impact of comorbidities and treatments","volume":"76","author":"Heffler","year":"2021","journal-title":"Allergy"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"21805","DOI":"10.1038\/s41598-020-77791-8","article-title":"Impact of comorbid asthma on severity of coronavirus disease (COVID-19)","volume":"10","author":"Lee","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1111\/all.13802","article-title":"Eosinophils capture viruses, a capacity that is defective in asthma","volume":"74","author":"Bal","year":"2019","journal-title":"Allergy"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1056\/NEJMc2102131","article-title":"Delayed Large Local Reactions to mRNA-1273 Vaccine against SARS-CoV-2","volume":"384","author":"Blumenthal","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Caminati, M., Guarnieri, G., Batani, V., Scarpieri, E., Finocchiaro, A., Chieco-Bianchi, F., Senna, G., and Vianello, A. (2021). COVID-19 Vaccination in Patients with Severe Asthma on Biologic Treatment: Safety, Tolerability, and Impact on Disease Control. Vaccines, 9.","DOI":"10.3390\/vaccines9080853"},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Simonetti, O., Rizzetto, G., Molinelli, E., Diotallevi, F., Radi, G., Cirioni, O., D\u2019Errico, M.M., and Offidani, A. (2021). Safety and Efficacy of Vaccines during COVID-19 Pandemic in Patients Treated with Biological Drugs in a Dermatological Setting. 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