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Vaccination against COVID-19 was performed according to the Swedish national vaccination program during 2021. Three different COVID-19 vaccines were used (one adenovirus vector vaccine (ChAdOx1 nCoV-19, AstraZeneca) and two mRNA vaccines (BNT162b2, Pfizer-BioNtech and CX-024414, Moderna). The second vaccination was performed using either the same vaccine type at the first vaccine dose or a combination of the two vaccine types according to recommendations from the Swedish authorities [20 ]. The second vaccine dose was administrated approximately 12 weeks after the first dose of the adenovirus vector vaccine and after 3 weeks after a dose of mRNA vaccine. Only mRNA vaccines were used as a third vaccine dose [20 ].

The T2B! cohort consists of IMID patients on and not on ISP treatment, and healthy controls. Participants were vaccinated either through the national vaccination campaign or as part of the ongoing study with one or two doses of any of the four different vaccines available in the Netherlands during 2021; BNT162b2 (Pfizer/BioNTech), CX-024414 (Moderna), ChAdOx1nCoV-19 (AstraZeneca) or Ad.26.COV2.S (Janssen) as primary immunization and CX-024414 or BNT162b2 as additional vaccinations (i.e. a third and/or booster vaccinations). In this cohort, primary immunizations ranged from March 1^st, 2021 to December 10^th, 2021, while additional vaccinations ranged from September 27^th, 2021 to July 6^th, 2022.
For this substudy, we selected IMID patients who received at least one vaccination as part of primary immunization, and who at least completed the survey at baseline and at 60 days follow-up after start of primary immunization.

This prospective observational cohort study was conducted at a single tertiary center in Brazil. Patients with SpA were paired by sex and age with a CG without ARD and both groups were vaccinated with inactivated SARS-CoV-2 vaccine (CoronaVac), which does not include recombinant mRNA technology, such as BNT162b2 (Pfizer-BioNtech) and CX-024414 (Moderna), or viral vectored platforms, such as ChAdOx1 nCoV-19 (AstraZeneca) or Ad.26.COV2.S (Janssen). Each dose consisted of 3 μg in 0.5 mL of β-propiolactone inactivated SARS-CoV-2 (derived from the CN02 strain of SARS-CoV-2 grown in African green monkey kidney cells—Vero 25 cells), with aluminum hydroxide as adjuvant.
The vaccination protocol consisted of a 28-day appart two-dose schedule of the inactivated SARS-CoV-2 vaccine CoronaVac (batch #20200412; Sinovac Life Sciences, Beijing, China). Both doses were applied at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Vaccinated subjects were assigned to blood collection at baseline (D0), immediately before the second dose (D28), and 69 days (D69) from baseline.
Participants were also invited to a study extended phase and received a third dose of CoronaVac at D210 (210 days from baseline) and had their humoral response re-evaluated 240 days from baseline (D240).
Patients were invited to participate after the review of their electronic records.