Factors affecting the intention of COVID-19 vaccination in Korean patients with myasthenia gravis: A survey-based study

Abstract

ObjectiveTo investigate the intention of coronavirus disease 2019 (COVID-19) vaccination in Korean patients with myasthenia gravis (MG) and to determine the factors that influence their attitude toward COVID-19 vaccination.Materials and methodsWe conducted a questionnaire survey of 160 Korean patients with MG. The questionnaire consisted of five categories, including vaccination status, willingness to get vaccinated, general concerns over vaccination, impact of MG diagnosis on vaccination decision, and MG-specific concerns over vaccination. The responses were rated from 1 (no intention or influence) to 5 (significant intention or influence). We compared the clinical factors between patients willing to get vaccinated (willing group) and those who were neutral or unwilling (hesitant group).ResultsThe average score of willingness to get vaccinated was 4.1 ± 1.2 (Likert score, 1–5). The hesitant group demonstrated higher proportions of women, patients with MG Foundation of America (MGFA) classification ≥III at nadir, and those who had experienced myasthenic crisis than the willing group (women, p = 0.027; MGFA classification≥III, p = 0.018; myasthenic crisis, p = 0.027). Scores for the willingness to get vaccinated (Likert score, 1–5) were negatively correlated with the MGFA classification at nadir (r = −0.235, p = 0.003), degree of general concern about vaccination (r = −0.362, p < 0.001), and impact of MG diagnosis on vaccination decision (r = −0.365, p < 0.001). In the path analysis, the MGFA classification at nadir was negatively associated with the willingness to get vaccinated by increasing the impact of MG diagnosis on vaccination decision.ConclusionMG diagnosis, maximum disease severity, and general concerns about vaccination influenced the intention to get vaccinated.

Impact of COVID-19 Infection and Its Association With Previous Vaccination in Patients With Myasthenia Gravis in Korea: A Multicenter Retrospective Study

“…In a previous study, patients with a severe form of MG exhibited reluctance toward vaccination. 31 The principal reasons for vaccine hesitancy were fears of the adverse effects of vaccination, worries about interactions between MG medications and COVID-19 vaccination, and doubts that the patients’ own medical condition is not suitable for vaccination. These reasons may be related to the difference in the MG characteristics between vaccinated and unvaccinated patients in the present study.…”

Safety of SARS-CoV-2 vaccine in patients with autoimmune neurological conditions: a systematic review and meta-analysis

“…Whether COVID-19 vaccination leads to the exacerbation of underlying neuroimmune diseases has been a controversial topic and a significant cause of vaccine hesitation in patients with neuroimmune diseases. A questionnaire survey on vaccination willingness conducted on South Korean people with myasthenia gravis by researchers KIM et al reported that patients who had experienced myasthenic crises were more resistant to vaccination in 160 questionnaire results, which may be related to their greater concern about the exacerbation of underlying diseases [47] .Yap, S. M. et al surveyed COVID-19 vaccination willingness among people with multiple sclerosis in Northern Ireland, and the results showed that about 20% of MS patients are antipathy to vaccines [48] .Most of this antipathy stems from concerns that vaccination may trigger or aggravate the disease [49] . The association of vaccination with disease recurrence has been reported previously in several studies,A review incorporated 10 observational articles with a total of 1299 myasthenia gravis patients revealed that only 60 (4.26%) patients developed an acute exacerbation of MG after vaccination [9] ;In a study conducted in Kuwait, the probability of disease worsening and recurrence was carried out a 5.5% and 1.8% following Vaccination in MS patients, respectively [2] .…”

Safety of COVID-19 vaccine in patients with myasthenia gravis: a self-controlled case series study

“…Since the first mass vaccination program started in December 2020, approximately 64% of the population worldwide has received two doses of the COVID-19 vaccine (updated to 30 October 2022: Our World in Data: https://ourworldindata.org ). Although the safety of COVID-19 vaccines has also been clarified in clinical trials, vaccine hesitancy still exists in some immunocompromised patients, such as patients with myasthenia gravis (MG) ( 1 , 2 ). The main reason for vaccine hesitancy in these immunocompromised patients was fear of vaccine-related symptom exacerbation.…”