Do patients with diabetes have a different antibody response to COVID-19 vaccines compared to healthy individuals?

This study evaluated the antibody response and side effects associated with COVID-19 vaccines administration in patients with type 1 (T1D) and type 2 diabetes (T2D), people without diabetes. The data showed similar immune responses in patients with and without diabetes after the second COVID-19 vaccine, regardless of glucose control.

Patients with severe or fatal Coronavirus Disease (COVID-19) that have become hospitalized, frequently have other underlying conditions such as diabetes. COVID-19 vaccination is highly recommended and prioritized in patients with diabetes, as a result. Patients with diabetes have a compromised immune response to SARS-CoV-2, the virus that causes COVID-19.

However, it remains unclear whether there is a reduced immune response to SARS-CoV-2 in these patients. There is a need to evaluate the antibody response in patients with diabetes following COVID-19 vaccination and the impact of glucose control on antibody response.

This study included 161 adult patients with T1D or T2D and 86 healthy controls that received a COVID-19 vaccine (BioNTech/Pfizer, Moderna, or AstraZeneca). Patients belonged to one of four groups depending on the type of diabetes and HbA1c levels (average blood glucose over 2-3 months). Blood antibody levels were determined 7-14 days after the first vaccine and 14-21 days after the second vaccine.

Of 161 patients with diabetes, the results of 150 patients were analyzed. After the first vaccine, 52.7% of patients with T1D and 48% of patients with T2D had antibody levels above the cut-off for a positive result (0.8) using the Roche’s Elecsys anti-SARS-CoV-2 immunoassay. After the second vaccine, antibody levels were similar for patients with T1D, T2D, and healthy controls.

87.4% of study participants had injection site reactions after the first vaccine and 63.3% of participants after the second dose.

The study showed that patients with T1D and T2D had a similar antibody response to COVID-19 vaccines as healthy individuals.

The study only investigated one aspect of the vaccine immune response, antibody levels. Most participants received an mRNA-based (Pfizer and Moderna) vaccine compared to the adenovirus-based (AstraZeneca) COVID-19 vaccine.