부산대학교 도서관

INTRODUCTION:: Studies suggest that the generation of durable T-cell immunity following coronavirus disease 2019 (COVID-19) vaccination protects against severe disease. The aim of this study was to measure cell-mediated immune response (CMIR) 1–2 months and 6 months after a third dose of a COVID-19 mRNA vaccine. METHODS:: This prospective study (HumoRal and CellULar initial and Sustained immunogenicity in patients with inflammatory bowel disease [IBD]) evaluated CMIR at 28–65 days (t1) after dose 2, 28–65 days (t2) (n = 183) and 6 months (±45 days) (t3) (n = 167) after a third dose of an mRNA COVID-19 vaccine. A small cohort had blood sample available 28–65 days (t4) (n = 55) after a fourth dose. Primary outcomes were CMIR at (t2) and (t3). Secondary outcomes included the effect of immunosuppressing IBD medications on CMIR and response at (t4). RESULTS:: All patients had measurable CMIR at all time points. CMIR increased at t2 compared with that at t1 (median 1,467 responding cells per million (interquartile range [IQR] 410–5,971) vs 313 (94–960) P < 0.001). There was no significant waning in t2 vs t3 or significant boosting at t4. Those on anti–tumor necrosis factor monotherapy had a higher CMIR compared with those not on this therapy at t2 (4,132 [IQR 1,136–8,795] vs 869 [IQR 343–3,221] P < 0.001) and t3 (2,843 [IQR 596–6,459] vs 654 [IQR 143–2,067] P < 0.001). In univariable analysis, anti–tumor necrosis factor monotherapy was associated with a higher CMIR at t2 (P < 0.001) and t3 (P < 0.001) and confirmed in a multivariable model (P < 0.001). DISCUSSION:: A third dose of a COVID-19 vaccine boosts CMIR, and the response is sustained in patients with IBD.