SHINE Study (Severe astHma COVID vacciNe rEsponse study)

Jun 25, 2024

There is abundant evidence that COVID vaccines helped to reduce the risk of becoming infected with COVID and the severity of COVID infection during the COVID-19 pandemic.  However, concern remained about the extent of protection in people with immunological diseases, such as asthma. The SHINE study, funded by the AAIR Charity in Southampton, was set up during the peak of the pandemic and involved asthma experts from Southampton, London and Glasgow and was led by Dr Hitasha Rupani, Lead of the Severe Asthma Service at University Hospital Southampton. The team investigated whether people with severe asthma developed the same level of protection (also known as immune response) after vaccination as people without asthma. In particular, the study looked at whether treatments used in severe asthma affected the immune response, focusing on biologics for asthma (omalizumab, mepolizumab and benralizumab) and steroids, whether given orally (prednisolone tablets) or via inhalers.


The study looked at the ability of the immune system to produce protective antibodies (proteins that help protect from infection) after vaccination using a finger-prick blood test developed by Virtus Respiratory Research Ltd from London. People with severe asthma and healthy people without asthma had these tests in the comfort and safety of their home and then posted the tests to the laboratory in London.


During the COVID vaccination program, people were initially given 2 doses of the vaccine and then a third (booster) dose was introduced. Since then, many people have had regular boosters. In this study, levels of antibodies were measured after 2 doses of the vaccine and after the third dose. A total of 129 people with severe asthma and 57 people without asthma participated in our study.


The results of the study showed that after the first 2 doses of the vaccine, people with severe asthma had lower antibody levels compared to people without asthma. However, after the third vaccine dose (the booster vaccine) was given, people with severe asthma had similar and good levels of antibodies as people without asthma. In particular, biologics or steroid inhalers did not affect the immune response to COVID vaccines.


This is an important finding that will help reassure people with severe asthma and teams who care for people with severe asthma that asthma biologics or steroid inhalers do not affect the immune protection after COVID vaccines. The study results also reinforce the need for booster vaccines.