More than 7 million Canadians suffer from immune-mediated inflammatory diseases (IMID) such as rheumatoid arthritis, inflammatory bowel disease, psoriasis, and related conditions. It is important that they too be protected from COVID-19, yet the effectiveness and safety of vaccines for Canadians with these health issues has not been thoroughly investigated. The COVID-19 Immunity Task Force (CITF) and Vaccine Surveillance Reference Group (VSRG) are supporting a nationwide study that will assess COVID-19 vaccine effectiveness, safety and vaccine hesitancy in this potentially vulnerable group of people.
“These diseases involve chronic inflammation and require immunosuppressive drugs. These drugs can control symptoms and prevent organ damage but can also lessen immune responses to vaccination,” explains Dr. Sasha Bernatsky, study lead and Senior Scientist in the Centre for Outcomes Research and Evaluation at the Research Institute of the McGill University Health Centre (RI-MUHC). “Patients, doctors and decision-makers also need to know if the drugs people with IMID are on can affect their response to COVID vaccination. We also need estimates of adverse events, and other problems including triggering a flare of their disease.”
The project involves a multi-institutional, multidisciplinary research team, who are recruiting across Canada, which also includes Dr. Carol Hitchon from the University of Manitoba, Dr. Vinod Chandran from the University of Toronto, and Dr. Dawn Bowdish from McMaster University.
“The drugs patients are on may increase susceptibility to infection,” adds Dr. Bernatsky, who is also a professor in the Department of Medicine at McGill University. “By the same token, many patients have tried numerous drug treatments to achieve good disease control and regain function. The thought that a vaccination could trigger a disease flare is daunting, especially when so little evidence exists as to how high or low the risk of a flare may be.”
Patient concerns may therefore lead to lower confidence in vaccines, a phenomenon that has been studied by Dr. Ines Colmegna, a scientist in the Infectious Diseases and Immunity in Global Health Program at the RI-MUHC, who is also involved in this study. “Vaccine hesitancy is a complex issue and understanding it is particularly relevant among people with autoimmune disease and/or immunosuppression,” she says.
The research team is examining the immune response to COVID-19 vaccination in 2,500 IMID patients. Patients are being recruited from British Columbia, Alberta, Manitoba, Ontario, Quebec and Newfoundland. Patients provide blood samples using at home finger prick collection kits prior to and after their COVID vaccinations. Researchers will study patients’ antibody levels up to 12 months after their final COVID vaccine. Post-vaccine reactions and COVID infections following vaccination will also be measured.
“Our goal is to assist regulators, doctors and patients in making evidence-based decisions regarding COVID vaccination,” says Dr. Bernatsky. “We will address safety concerns contributing to vaccine hesitancy and help inform public health recommendations regarding COVID-19 vaccination in vulnerable patient populations.”
“It is imperative to study the immune response and safety of vaccines not only in the general population, but in populations with specific health issues, such as those with IMID,” says Dr. Caroline Quach, Co-Chair of the Vaccine Surveillance Reference Group. “Studies such as this one help to inform on whether a booster dose is needed in IMID patients. They will also allow to estimate the rate of occurrence of adverse events, such as flares, which is a major consideration for this particular population.”
About the Research Institute of the McGill University Health Centre (RI-MUHC)
The Research Institute of the McGill University Health Centre (RI-MUHC) is a world-renowned biomedical and healthcare research centre. The institute, which is affiliated with the Faculty of Medicine of McGill University, is the research arm of the McGill University Health Centre (MUHC) – an academic health centre located in Montreal, Canada, that has a mandate to focus on complex care within its community. The RI-MUHC supports over 450 researchers and around 1,200 research trainees devoted to a broad spectrum of fundamental, clinical and health outcomes research at the Glen and the Montreal General Hospital sites of the MUHC. Its research facilities offer a dynamic multidisciplinary environment that fosters collaboration and leverages discovery aimed at improving the health of individual patients across their lifespan. The RI-MUHC is supported in part by the Fonds de recherche du Québec – Santé (FRQS). rimuhc.ca
About the Vaccine Surveillance Reference Group
The Vaccine Surveillance Reference Group (VSRG) supports the monitoring of the safety and effectiveness of COVID-19 vaccines in Canada. It is a consortium of Canadian organizations—the Public Health Agency of Canada (PHAC), the Canadian Immunization Research Network (CIRN), the National Advisory Committee on Immunization (NACI), and the COVID-19 Immunity Task Force (CITF)—working collaboratively to pool expertise on vaccine surveillance. The VSRG reports to PHAC and is supported by the CITF Secretariat. It is co-chaired by the leader CIRN and the former chair of NACI. Among its responsibilities, the VSRG, through the CITF Executive Committee, makes recommendations to PHAC on funding research teams that can address important aspects of the immune response, safety, and effectiveness of COVID-19 vaccines with public health relevance and with attention to all priority groups.
About the COVID-19 Immunity Task Force
The Government of Canada established the COVID-19 Immunity Task Force in late April 2020. The Task Force is overseen by a Leadership Group of volunteers that includes leading Canadian scientists and experts from universities and healthcare facilities across Canada who are focused on understanding the nature of immunity arising from the novel coronavirus that causes COVID-19. To that end, the CITF is supporting numerous studies to determine the extent of SARS-CoV-2 infection in Canada (in the general population as well as in specific communities and priority populations), understand the nature of immunity following infection, develop improved antibody testing methods, and help monitor the effectiveness and safety of vaccines as they are rolled out across Canada. The Task Force and its Secretariat work closely with a range of partners, including governments, public health agencies, institutions, health organizations, research teams, other task forces, and engages communities and stakeholders. Most recently, the Task Force has been asked to support vaccine surveillance, including monitoring vaccine effectiveness and safety, as part of its overall objective to generate data and ideas that inform interventions aimed at slowing—and ultimately stopping—the spread of SARS-CoV-2 in Canada. For more information visit: www.covid19immunitytaskforce.ca
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