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6. COVID-19 mRNA vaccine immunogenicity decay and breakthrough illness in adolescents and young adults with childhood-onset rheumatic diseases.

Author

Yeo, Joo Guan, Teh, Kai Liang, Chia, Wan Ni, Book, Yun Xin, Hoh, Sook Fun, Gao, Xiaocong, Das, Lena, Zhang, Jinyan, Sutamam, Nursyuhadah, Poh, Su Li, Lim, Amanda Jin Mei, Tay, Shi Huan, Yaung, Katherine Nay, Ong, Xin Mei, Leong, Jing Yao, Wang, Lin-Fa, Albani, Salvatore, and Arkachaisri, Thaschawee

Subjects
*DRUG therapy for rheumatism, *COVID-19, *SCIENTIFIC observation, *CONFIDENCE intervals, *COVID-19 vaccines, *ANTI-inflammatory agents, *TIME, *VACCINE effectiveness, *DESCRIPTIVE statistics, *RESEARCH funding, *RHEUMATISM, *VIRAL antibodies, *ODDS ratio, *DISEASE complications, *EVALUATION, *ADULTS, *ADOLESCENCE
Abstract

Objectives To evaluate the humoral immunogenicity for 6 months after the two-dose coronavirus disease 2019 (COVID-19) mRNA vaccination in adolescents and young adults (AYAs) with childhood-onset rheumatic diseases (cRDs). Methods This monocentric observational study was conducted between August 2020 and March 2022. Humoral immunogenicity was assessed at 2–3 weeks after first vaccine dose and 1, 3 and 6 months after the second dose by the cPass™ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) neutralization antibody (nAb) assay. An inhibition signal of ≥30% defined the seroconversion threshold and the readings were calibrated against the World Health Organization International Standard for SARS-CoV-2 antibodies. Results. One hundred and sixty-nine AYAs with cRDs were recruited [median age 16.8 years (interquartile range, IQR 14.7–19.5), 52% female, 72% Chinese]. JIA (58%) and SLE (18%) comprised the major diagnoses. After second vaccine dose, 99% seroconverted with a median nAb titre of 1779.8 IU/ml (IQR 882.8–2541.9), declining to 935.6 IU/ml (IQR 261.0–1514.9) and 683.2 IU/ml (IQR 163.5–1400.5) at the 3- and 6-month timepoints, respectively. The diagnosis of JIA [odds ratio (OR) 10.1, 95% CI 1.8–58.4, P  = 0.010] and treatment with anti-TNF-α (aTNF) (OR 10.1, 95% CI 1.5–70.0, P  = 0.019) were independently associated with a >50% drop of nAb titres at 6 months. Withholding MTX or MMF did not affect the vaccine response or decay rate. The COVID-19 breakthrough infection was estimated at 18.2 cases/1000 patient-months with no clinical risk factors identified. Conclusion Over half of AYAs with cRDs had a significant drop in SARS-CoV-2 nAb at 6-month despite an initial robust humoral response. JIA and aTNF usage are predictors of a faster decay rate. [ABSTRACT FROM AUTHOR]

Published
2023
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7. Post-mRNA vaccine flares in autoimmune inflammatory rheumatic diseases: Results from the COronavirus National Vaccine registry for ImmuNe diseases SINGapore (CONVIN-SING)

Author

Ma, Margaret, primary, Santosa, Amelia, additional, Fong, Warren, additional, Chew, Li-Ching, additional, Low, Andrea HL, additional, Law, Annie, additional, Poh, Yih Jia, additional, Yeo, Siaw Ing, additional, Leung, Ying Ying, additional, Ng, Victoria WW, additional, Koh, Joshua ZE, additional, Tay, Sen Hee, additional, Mak, Anselm, additional, Teng, Gim Gee, additional, Xu, Chuanhui, additional, Tang, Johnston GX, additional, Kong, Kok Ooi, additional, Angkodjojo, Stanley, additional, Goh, Wei-Rui, additional, Chuah, Tyng Yu, additional, Roslan, Nur Emillia, additional, Arkachaisri, Thaschawee, additional, Teh, Kai Liang, additional, Sriranganathan, Melonie, additional, Tan, Teck Choon, additional, Phang, Kee Fong, additional, Yap, Qai Ven, additional, Chan, Yiong Huak, additional, Cheung, Peter PM, additional, and Lahiri, Manjari, additional

Published
2023
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8. Multisystem inflammatory syndrome in children in Singapore

Author

Nadua, Karen Donceras, primary, Chong, Chia Yin, additional, Kam, Kai-Qian, additional, Mok, Yee Hui, additional, Choo, Jonathan Tze Liang, additional, Lam, Joyce Ching Mei, additional, Li, Jiahui, additional, Tan, Natalie Woon Hui, additional, Yung, Chee Fu, additional, Chan, Su-Wan Bianca, additional, Teh, Kai Liang, additional, Das, Lena, additional, Arkachaisri, Thaschawee, additional, and Thoon, Koh Cheng, additional

Published
2022
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9. Robust neutralizing antibody response to SARS-CoV-2 mRNA vaccination in adolescents and young adults with childhood-onset rheumatic diseases

Author

Yeo, Joo Guan, primary, Chia, Wan Ni, additional, Teh, Kai Liang, additional, Book, Yun Xin, additional, Hoh, Sook Fun, additional, Gao, Xiaocong, additional, Das, Lena, additional, Zhang, Jinyan, additional, Sutamam, Nursyuhadah, additional, Lim, Amanda Jin Mei, additional, Poh, Su Li, additional, Tay, Shi Huan, additional, Nay Yaung, Katherine, additional, Ong, Xin Mei, additional, Hazirah, Sharifah Nur, additional, Chua, Camillus Jian Hui, additional, Leong, Jing Yao, additional, Wang, Lin-Fa, additional, Albani, Salvatore, additional, and Arkachaisri, Thaschawee, additional

Published
2022
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11. Implementation of Universal Newborn Screening for Severe Combined Immunodeficiency in Singapore While Continuing Routine Bacille-Calmette-Guerin Vaccination Given at Birth

Author

Chan, Su-Wan Bianca, primary, Zhong, Youjia, additional, Lim, Soon Chuan James, additional, Poh, Sherry, additional, Teh, Kai Liang, additional, Soh, Jian Yi, additional, Chong, Chia Yin, additional, Thoon, Koh Cheng, additional, Seng, Michaela, additional, Tan, Ee Shien, additional, Arkachaisri, Thaschawee, additional, and Liew, Woei Kang, additional

Published
2022
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16. Primary care approach to Kawasaki disease.

Author

Mui Ching Tan, Joanne, Keng Wein Tan, Jeanette, Choon How How, Kai Liang Teh, Tan, Joanne Mui Ching, Tan, Jeanette Keng Wein, How, Choon How, and Teh, Kai Liang

Subjects
MUCOCUTANEOUS lymph node syndrome, PRIMARY care, CONJUNCTIVITIS, MOTHERS, CELL phones, MUCOCUTANEOUS lymph node syndrome diagnosis, PRIMARY health care
Abstract

His mother took Tom, a one-year-old boy, to your clinic for a repeat consultation for persistent fever. Two days ago, he had presented with a three-day history of high fever and conjunctivitis. His mother mentioned that he had started attending a neighbourhood childcare centre one month before, and his teachers had said that a few of his classmates were down with flu. At that time, you prescribed antipyretics for viral fever and advised his mother to return if the fever persisted beyond Day 5 of the illness. During the repeat consultation, Tom's mother reported that he had developed a rash two days ago, but it had mostly faded. She showed you a photo she had taken with her mobile phone of a generalised maculopapular rash. Tom was extremely fretful and refused to lie down on the couch, but you managed to examine him on his mother's lap. On examination, his neck was supple, and a detailed head-to-toe examination revealed bilateral non-suppurative conjunctivitis, mild red lips and Bacille Calmette-Guérin vaccine site erythema. You were concerned that Tom had features of Kawasaki disease and referred him to a paediatric tertiary hospital for further evaluation. [ABSTRACT FROM AUTHOR]

Published
2021
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