Pausing methotrexate improves response to the booster dose; Vaccination in the first trimester of pregnancy most beneficial

A pregnant woman receives a vaccine for the coronavirus disease (COVID-19) at the Skippack pharmacy in Schwenksville, Pennsylvania, U.S. February 11, 2021. REUTERS/Hannah Beier/File Photo

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June 30 (Reuters) – The following is a summary of some recent studies on COVID-19. This includes research results that warrant further studies to confirm the results and that have yet to be certified through peer review.

Pausing Immunosuppression Improves COVID-19 Booster Response

People taking a commonly used drug for inflammatory diseases like rheumatoid arthritis or psoriasis get below-average protection from COVID-19 vaccines, but stopping the drug for two weeks after a booster shot doubled patients’ antibody responses in a randomized study.

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British researchers studied 254 adults receiving methotrexate for their medical conditions who were about to receive their third dose of a Pfizer (PFE.N)/BioNTech (22UAy.DE), Moderna (MRNA.O) or AstraZeneca (AZN.L) vaccine receive. . Participants were randomly assigned to interrupt methotrexate treatment for two weeks after the booster dose or to continue taking methotrexate as usual. Blood tests one and three months later showed that antibody levels in patients who stopped taking methotrexate for two weeks were more than double those in patients who continued to take it. This was true regardless of the methotrexate dose, the type of inflammatory disease, the type of vaccine and whether or not the patients had ever been infected with SARS-CoV-2. Patient reports of flare-ups were slightly more common in the interruption group, but there was no difference between the groups when seeking medical help for flare-ups, and there was no impact on quality of life or overall health, the researchers reported Monday in The Lancet Respiratory Medicine.

“Further research is needed to assess whether interrupting treatment with other similarly acting immunosuppressive drugs will also improve vaccine-induced immunity,” the researchers said.

COVID-19 vaccine particularly beneficial in the first trimester

Pregnant women getting vaccinated against COVID-19 should consider the type and timing of vaccination, new research finds.

The 158 pregnant women in the study received Moderna or Pfizer/BioNTech mRNA vaccines or Johnson & Johnson’s (JNJ.N) adenovirus-based vaccine. As reported on Tuesday in nature communication, the Moderna shot offered subtle advantages over the Pfizer shot in terms of antibody levels and function, and both RNA vaccines induced stronger antibodies than the J&J shot. Immune responses to the vaccines were stronger when administered in the first or third trimester than in the second trimester, while transplacental transmission of protective COVID-19 antibodies to the fetus was most efficient after vaccination in the first and second trimesters.

If unvaccinated women become pregnant, the US Centers for Disease Control and Prevention recommends getting vaccinated as soon as possible to maximize the time mother and fetus are protected from COVID-19. The researchers say their results show that vaccination in the first trimester induces an immune response that is as good or better than later in pregnancy, along with a “high transfer efficiency” of antibodies to the fetus. In addition, “maternal and newborn immunity could be further enhanced by strengthening in the third trimester,” the researchers said.

Click for a Reuters chart on vaccines in development.

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Reporting by Nancy Lapid; Edited by Bill Berkrot

Our standards: The Thomson Reuters Trust Principles.

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