The COVID‐19 vaccine: Attitudes and vaccination in patients with autoimmune inflammatory rheumatic diseases

Abstract

Background We examined attitudes toward the COVID‐19 vaccine, potential factors underlying these attitudes, and ways to increase vaccination willingness in autoimmune inflammatory rheumatic diseases (AIIRD) patients. Methods A multicenter, web‐based, observational survey using an online questionnaire was conducted among AIIRD patients aged ≥18 years from May 24, 2021, to June 3, 2021. Participants were 3104 AIIRD patients (2921 unvaccinated and 183 vaccinated). Results Of the unvaccinated patients, 32.9% were willing to receive the COVID‐19 vaccine, 45.0% were uncertain, and 14.8% were unwilling. When vaccination was recommended by physicians, patients' willingness increased to 93.8%. Participants' main concerns were that the vaccine may aggravate AIIRD disease (63.0%) and may cause vaccine‐related adverse events (19.9%). Female patients were less likely to be vaccinated. However, patients who had children aged ≤18 years were more willing to be vaccinated. In addition, vaccination willingness was higher in patients with trust in the safety and efficacy of the COVID‐19 vaccine. Notably, 183 (5.9%) patients were vaccinated. The major vaccination side effects were injection reaction, myalgia, and fatigue. At a median follow‐up of 88 (38, 131) days, patients' disease activities were stable. Conclusions The findings show that AIIRD patients were unwilling to receive the COVID‐19 vaccine because of fears of potential disease exacerbation and additional adverse events. Sociodemographic characteristics and concerns about COVID‐19 disease and vaccines had a significant effect on vaccination willingness.

Varicella zoster virus reactivation following COVID‐19 vaccination in patients with autoimmune inflammatory rheumatic diseases: A cross‐sectional Chinese study of 318 cases

“…In our previous study, the results demonstrated that 32.9% of AIIRD patients were willing to receive the COVID‐19 vaccine, and the others (67.1%) were uncertain or unwilling, and the main hesitation was that the vaccine may aggravate AIIRD disease (63.0%) and may cause vaccine‐related AEs (19.9%). 7 Overall, although there was some mild AEs after getting the SARS‐CoV‐2 vaccines, the inactivated vaccination is safe, and disease aggravation is needed to pay attention in AIIRDs patients.…”

“…More patients in the AIIRD group took Pregabalin and Gabapentin because of the post-herpetic neuralgia with an insignificant difference (83.3%, 5/6 vs. 40.0%, 2/5, p = 0.242). Similarly, there was no statistical difference for the rash duration (18[12−30] vs. 7[7][8][9][10][11][12][13][14][15][16][17][18][19][20], p = 0.157) and vaccine brand (p = 0.567) between the AIIRD and HCs group. In addition, there was no significant difference in gender, age, comorbidities, time to onset of VZV reactivation and dose of COVID-19 vaccine between AIIRD patients and HCs cohort (p = 0.182, p = 0.314, p = 0.455, p = 0.462, p = 1.000, respectively) (Supporting Information: Table…”

“…By the end of June 2022, roughly 1 billion inactivated vaccine doses have been administered with effectiveness against severe infections ranging from 70% to 95% 5,6 . Although the mechanisms of all vaccines were different, they have several commonly reported adverse events (AEs) including, injection site pain and swelling, fatigue, fever, headache, nausea, and dermatological complications, all of which can develop after the first, second, and/or third dose 7 . More recently, varicella‐zoster virus (VZV) reactivation has been reported following vaccination against SARS‐CoV‐2 in case reports, case series and cross‐sectional studies with the prevalence ranging from 0.02% to 10.1% 8–11 .…”

“… 5 , 6 Although the mechanisms of all vaccines were different, they have several commonly reported adverse events (AEs) including, injection site pain and swelling, fatigue, fever, headache, nausea, and dermatological complications, all of which can develop after the first, second, and/or third dose. 7 More recently, varicella‐zoster virus (VZV) reactivation has been reported following vaccination against SARS‐CoV‐2 in case reports, case series and cross‐sectional studies with the prevalence ranging from 0.02% to 10.1%. 8 , 9 , 10 , 11 Among these references, the Israel study has revealed that patients with vaccination had higher risk of herpes zoster (HZ) infection (risk ratio, 1.43; 95% CI, 1.20−1.73).…”

Interplay of diabetes mellitus and rheumatic diseases amidst the COVID-19 pandemic: influence on the risk of infection, outcomes, and immune responses

“…The association with DM did not persist on multivariate analysis [58]. Other web-based surveys from China and Egypt did not find an influence of DM on the attitude of patients towards vaccination [62,63]. A Turkish survey of 229 patients with spondyloarthritis and 48 patients with RA found that 36% changed their treatment during the pandemic and that DM was a significant factor for deviation from prescribed drugs [64].…”