Studying the immune response to COVID-19 vaccines: OCTAVE study

28 July 2021

We’re aware there is concern about the effectiveness of COVID-19 vaccines in people with inflammatory arthritis and other immune conditions, and that many people still have questions about having the vaccine and the levels of protection they give.

The OCTAVE trial, which is funded by the Medical Research Council (MRC), is hoping to shed some light in these areas. It is a collaborative research project involving groups in the Universities of Glasgow, Birmingham, Oxford, Liverpool, Imperial College London and Leeds Teaching Hospitals NHS Trust.

Researchers are building on years of experience in understanding the immune system in the context of chronic conditions, to better determine the effectiveness of COVID-19 vaccines in these clinically at-risk patient groups.

The collaboration includes researchers close to Versus Arthritis, through historical or current funding.

Initial results from the OCTAVE study can be found on the NIHR website, who are funding the study. This research is ongoing to better understand the efficacy of vaccines in people with immune conditions.

We asked Professors Iain McInnes and Stefan Siebert some questions about COVID-19 vaccines and the OCTAVE study.

What’s does the OCTAVE study hope to tell us about the COVID-19 vaccines?

The OCTAVE trial is examining the immune system before and after vaccination in people with various forms of arthritis and other rheumatic inflammatory diseases to examine how well the vaccine works in raising immune responses against the SARS-CoV2 virus, compared to the immune responses seen in healthcare workers.

We are examining the effect of having arthritis itself, and also the effects of different kinds of medicines that are being taken by such patients, on the behaviour of the vaccines. In addition, we will be able to compare the vaccine effects in people with other kinds of immune disease e.g. of the gut, and also other forms of chronic disease e.g. kidney and liver disease, cancer and finally with responses in people with transplants.

This will give us a really clear idea of how COVID vaccines behave in people whose immune systems are not working normally.

What is already known about the immune response to the vaccines in people with inflammatory arthritis?

Several vaccines are well characterised in arthritis patients – we know that some of our existing medicines e.g. rituximab can reduce the effectiveness of flu vaccine, and pneumovax.

Does taking immunosuppressant drugs interfere with the effectiveness of the vaccines?

Immunosuppressant drugs can potentially reduce the effectiveness of vaccines by reducing immune activation by the vaccine (their immune system doesn't respond as strongly to the vaccine as people who don't take these drugs).

However, if you’re offered the vaccine and delay taking it, then you leave yourself at risk from COVID-19. Find out more on our vaccine pages.

Can antibody tests be used to identify people with inflammatory arthritis who are well (or not well) protected by the vaccines?

We do not yet know what level of protection is offered by a given level of antibody level – this is a work in progress.

Current antibody blood tests also only tells us about one aspect of the immune response to vaccines, so this type of test may not be sufficient to give a definitive answer regarding the level of protection.

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