Inactivated vaccines may not provide adequate protection in immunosuppressed patients with rheumatic diseases.

Patients with autoimmune rheumatic diseases (AIRDs) are vulnerable to COVID-19 due to the presence of multiple comorbidities.1 Moreover, patients on immunosuppressants have blunted responses to vaccination as compared with healthy people.2 3 Persistence of the virus in such people may lead to the selection of more virulent mutants of SARS-CoV-2.4 It is crucial that they are prioritised for the best possible vaccine. India has crossed 650 million vaccinations with predominantly two vaccines: the adenoviral vector-borne AZD1222 (ChAdOx1 nCoV-19) and the indigenous whole-virion β-propiolactone-inactivated BBV152. In our cohort of around 1500 patients with AIRD who are being followed up to assess the immunogenicity of COVID-19 vaccines, we identified 475 patients who have completed two doses of either vaccine. Serum was collected on median 30th (range 28–35) day after the second dose of vaccine with informed consent after ethics clearance. Titres of IgG antibodies to spike protein were estimated with the Elecsys kit (Roche, Switzerland). To check the neutralisation potential of the sera, age, sex and disease matched 80 BBV152 and 85 AZD1222 recipients …