SARS-CoV-2 vaccine hesitancy among patients with rheumatic and musculoskeletal diseases: a message for rheumatologists

Priori, Roberta; Pellegrino, Greta; Colafrancesco, Serena; Alessandri, Cristiano; Ceccarelli, Fulvia; Franco, Manuela Di; Riccieri, Valeria; Scrivo, Rossana; Scavalli, A. Sili; Spinelli, Francesca Romana; Conti, Fabrizio

doi:10.1136/annrheumdis-2021-220059

Cited by 66 publications

(96 citation statements)

References 6 publications

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“…The patients above 45-years of age and having higher education were more willing to take the vaccine. These observations were similar to the previous survey reports [8][9][10][11][12]. Additionally, few studies observed that males were more willing to get vaccinated than females [9,10,12].…”

Section: Discussionsupporting

confidence: 91%

“…The total willingness to take the COVID vaccine was 57.5% and was lesser among the AIRD patients than the controls. Similar observations were seen in another study from Rome with a low acceptance in AIRD-patients (54.9%) compared to controls (82.3%) [8]. While studies from Turkey and Amsterdam showed no difference between the patients and control groups for vaccination willingness [9,10].…”

Section: Discussionsupporting

confidence: 84%

“…These studies also reported that willingness to get vaccinated could be increased if recommended by a specialist physician [9,10,12]. The other reasons for refusal were fear of adverse events, a flare-up of underlying AIRD, and doubt related to the vaccine efficacy, similar to those reported in previous studies [8,9,11]. These points show that the AIRD patients still lack clarity about the pros and cons of the vaccination.…”

Section: Discussionsupporting

confidence: 72%

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COVID-19 vaccine hesitancy in patients with systemic autoimmune rheumatic disease: an interview-based survey

Gaur¹,

Agrawat²,

Shukla³

2021

Rheumatol Int

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Patients with a systemic autoimmune rheumatic disease (AIRD) are vulnerable to SARS Cov-2 infection. Vaccination against this infection can prevent the patients from developing severe disease. But vaccine hesitancy in this group can emerge as a hurdle. So there is a need to understand the perception regarding vaccination in AIRD patients. The study is an interviewbased survey done in AIRD patients and a control group from the general population. The questionnaire included the subject's demographic details, duration, diagnosis, the activity of AIRD, and questions regarding the perception of the vaccination. The survey included 280 patients with AIRD and 102 control subjects. 54% (152/280) of the patients and 67% (68/102) of the controls were willing to get vaccinated (p = 0.03). Patients > 45-years of age were more willing to vaccinate than those with age ≤ 45-years (61.9% vs. 44.8%; p = 0.001). Patients with lower education had more vaccine hesitancy than those with graduation and above (38% vs. 69%; p < 0.001). The common reason for vaccine hesitancy was not-yet-decided, fear related to vaccine side-effects, and disease worsening. 29% (82/280) patients were already vaccinated, out of which 35% (35/82) had mild events (fever/myalgia/headache). AIRD patients had fewer side effects than controls, and disease flare was seen in only one patient. Thus, educating AIRD patients regarding the pros and cons of vaccination, particularly concerning immunological disease, can help us overcome vaccine hesitancy. The message should clearly penetrate that there is a negligible risk of AIRD-flares with the COVID-19 immunization and the side effects are mild and manageable.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 72%

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COVID-19 vaccine hesitancy in patients with systemic autoimmune rheumatic disease: an interview-based survey

Gaur¹,

Agrawat²,

Shukla³

2021

Rheumatol Int

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“…As real-world experience accumulates, it is not surprising that the spontaneous acceptance of COVID-19 vaccination found here is higher compared with previous studies. [5][6][7][8] However, active involvement of rheumatologists may further engage hesitant patients, allowing coverage of nearly 90% of those receiving several immunomodulatory drugs in combination. In this perspective, the constitution of dedicated task forces, such as those promoted by EULAR 1 as well as by other national and international societies, 9 10 is fundamental to assist rheumatology providers with updated guidelines on the optimal use of COVID-19 vaccines for patients with RMD.…”

Section: Correspondencementioning

confidence: 99%

“…A number of independent surveys have however alarmingly reported that, among patients with RMD, potential acceptance of COVID-19 vaccines may not exceed 60%, without apparent differences in relation to specific diseases, comorbidities and type of medication. [5][6][7][8] Strategies to effectively engage high-risk patients with RMD into vaccination programmes are therefore urgently needed.…”

mentioning

confidence: 99%

Correspondence on ‘EULAR December 2020 viewpoints on SARS-CoV-2 vaccination in patients with RMDs’

et al. 2021

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Reactogenicity of the Messenger RNA SARS–CoV‐2 Vaccines Associated With Immunogenicity in Patients With Autoimmune and Inflammatory Disease

Yang

Taylor

Paez

et al. 2022

Arthritis Care & Research

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Objective. Little is known regarding the reactogenicity and related SARS-CoV-2 vaccine response in patients with chronic inflammatory disease (CID). Our objective was to characterize the adverse event profile of CID patients following SARS-CoV-2 vaccination and understand the relationship between reactogenicity and immunogenicity of SARS-CoV-2 vaccines.Methods. CID patients and healthy controls eligible to receive messenger RNA (mRNA) SARS-CoV-2 vaccines participated in 3 study visits (pre-vaccine, after dose 1, and after dose 2) in which blood and clinical data were collected. Assessment of adverse events were solicited within 7 days of receiving each dose. Serum anti-SARS-CoV-2 spike IgG ± antibody titers were quantified following vaccination. Statistical analysis was performed utilizing mixed models and tobit regressions, with adjustment for covariates.Results. The present study included 441 participants (322 CID patients and 119 control subjects). Compared to controls, CID patients reported greater symptom severity after dose 1 (P = 0.0001), including more myalgia and fatigue (P < 0.05). For immunogenicity, a higher symptom severity after dose 1 and a higher number of symptoms after dose 2 was associated with higher antibody titers (P ≤ 0.05). Each increase of 1 symptom was associated with a 15.1% increase in antibody titer. Symptom association was strongest with site pain after dose 1 (105%; P = 0.03) and fatigue after dose 2 (113%; P = 0.004).Conclusion. Patients with CID have a distinct reactogenicity profile following SARS-CoV-2 vaccination compared to controls. Furthermore, there is an association between increased reactogenicity and increased vaccine response. This finding may speak to the more variable immunogenicity in CID patients and may be an important indicator of vaccine response to the novel SARS-CoV-2 vaccines.

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SARS-CoV-2 vaccine hesitancy among patients with rheumatic and musculoskeletal diseases: a message for rheumatologists

Cited by 66 publications

References 6 publications

COVID-19 vaccine hesitancy in patients with systemic autoimmune rheumatic disease: an interview-based survey

COVID-19 vaccine hesitancy in patients with systemic autoimmune rheumatic disease: an interview-based survey

Correspondence on ‘EULAR December 2020 viewpoints on SARS-CoV-2 vaccination in patients with RMDs’

Reactogenicity of the Messenger RNA SARS–CoV‐2 Vaccines Associated With Immunogenicity in Patients With Autoimmune and Inflammatory Disease

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