Evidence map›Paper›PMID 40691289›Full record

Observational studyPediatric research2026

Immunogenicity of COVID-19 booster vaccines in children receiving immunosuppressive medications.

Janna R Shapiro, Florence Choi, Amy Xu, Trang T Duong, Anne-Claude Gingras, Karen Colwill, Sasha Bernatsky, Susanne M Benseler, Rae Sm Yeung, SUCCEED KIDS Team

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Janna R ShapiroCenter for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Florence ChoiDivision of Rheumatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Amy XuCell Biology Program, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
Trang T DuongCell Biology Program, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
Anne-Claude GingrasLunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Sinai Health, Toronto, ON, Canada.
Karen ColwillLunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Sinai Health, Toronto, ON, Canada.
Sasha BernatskyCentre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
Susanne M BenselerDivision of Rheumatology, Department of Paediatrics, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, AL, Canada.
Rae Sm YeungDepartment of Immunology, University of Toronto, Toronto, ON, Canada. rae.yeung@sickkids.ca.
SUCCEED KIDS Team

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs many jurisdictions move towards seasonal COVID-19 vaccines, there remains insufficient data on optimal vaccination strategies for children with immune-mediated inflammatory diseases (IMID) treated with immunomodulatory therapies.

methodsA prospective observational cohort study was performed, with clinical data and biosamples longitudinally collected to determine the effect of immunomodulatory therapies on the antibody response to four COVID-19 vaccine doses. Antibodies against the SARS-CoV-2 spike, receptor-binding domain, and nucleocapsid proteins were measured.

resultsFollowing doses two and three, antibody responses were lowest in participants treated with biologic or targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs), of which TNF inhibitors were the most common. Rates of antibody decay were similar between treatment groups, but weaker initial responses in the b/tsDMARD group led to antibody levels dipping to low values within four months of vaccination. The fourth vaccine dose significantly boosted antibody levels in the b/tsDMARD group, resulting in a sustained response. Among additional samples collected from children with hybrid immunity (i.e., vaccinated and prior SARS-CoV-2 infection), no differences in antibody levels were found between participants who were or were not treated with b/tsDMARDs.

conclusionsThese data support providers in counselling families regarding the importance of annual COVID-19 booster vaccines in children with IMID. IMPACT: There is conflicting evidence on the effect of immunosuppressive treatments on the antibody response to vaccination in paediatric populations. Long-term follow-up of children treated with various immunosuppressive therapies as they received booster COVID-19 vaccines demonstrated that antibody responses to the second and third vaccine dose were impaired in children treated with biologics (mainly TNF inhibitors). Deficits in the antibody response were largely corrected by a fourth vaccine dose or infection with SARS-CoV-2. Children treated with biologic therapies require a full suite of COVID-19 vaccines and should be strongly encouraged to receive seasonal COVID-19 vaccine boosters.

Indexed as

COVID-19COVID-19 VaccinesImmunization, SecondaryImmunogenicity, VaccineImmunosuppressive AgentsSARS-CoV-2AdolescentAntibodies, ViralChildChild, PreschoolFemaleHumansMaleProspective StudiesSpike Glycoprotein, CoronavirusAntibodies, ViralCOVID-19 VaccinesImmunosuppressive AgentsSpike Glycoprotein, Coronavirusspike protein, SARS-CoV-2

Identifiers

PMID40691289

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.