Vaccine hesitancy decreases in rheumatic diseases, long-term concerns remain in myositis: a comparative analysis of the COVAD surveys

Abstract

Objective COVID-19 vaccines have a favorable safety profile in patients with autoimmune rheumatic diseases (AIRDs) such as idiopathic inflammatory myopathies (IIMs), however hesitancy continues to persist among these patients. Therefore, we studied the prevalence, predictors, and reasons for hesitancy in patients with IIMs, other AIRDs, non-rheumatic autoimmune diseases (nrAIDs) and healthy controls (HCs), using data from the two international COVID-19 Vaccination in Autoimmune Diseases (COVAD) e-surveys Methods The 1st and 2nd COVAD patient self-reported e-surveys were circulated from March to December 2021, and February to June 2022 (ongoing). We collected data on demographics, comorbidities, COVID-19 infection and vaccination history, reasons for hesitancy, and patient reported outcomes. Predictors of hesitancy were analyzed using regression models in different groups. Results We analyzed data from 18,882 (COVAD-1) and 7666 (COVAD-2) respondents. Reassuringly, hesitancy decreased from 2021 (16.5%) to 2022 (5.1%) [OR 0.26; 95%CI: 0.24-0.30, p < 0.001]. However, concerns/fear over long-term safety had increased [OR 3.6;95% CI:2.9-4.6, p < 0.01]. We noted with concern greater skepticism over vaccine science among patients with IIMs than AIRDs [OR:1.8; 95%CI: 1.08-3.2, p = 0.023] and HCs [OR: 4; 95%CI: 1.9-8.1, p < 0.001], as well as more long-term safety concerns/fear [IIMs vs AIRDs; OR: 1.9; 95%CI: 1.2-2.9, p = 0.001; IIMs vs HCs; OR: 5.4 95%CI: 3-9.6), p < 0.001]. Caucasians [OR 4.2 (1.7-10.3)] were likely to be more hesitant, while those with better PROMIS physical health score were less hesitant [OR 0.9 (0.8-0.97)]. Conclusion Vaccine hesitancy has decreased from 2021 to 2022, long-term safety concerns remain among patients with IIMs, particularly in Caucasians and those with poor physical function.

The COVID-19 epidemic curve and vaccine acceptance among patients with rheumatic diseases: an ecological study

“…These doubts may then become less pressing when risk perception is higher, leading to a change in attitude toward the need for a vaccine. Acceptance regardless of fear is consistent with other studies, which have reported a decrease in hesitancy from 2021 to 2022 despite increase in concerns over long-term safety of vaccines [29].…”

Attitudes towards COVID Vaccine and Vaccine Hesitancy in Dermatology: A Narrative Review

“…Rheumatology and dermatology are similar in that many conditions have an autoimmune basis in its pathogenesis. Similar concerns about vaccine safety and the potential exacerbation of underlying inflammatory conditions have been observed among patients with myositis, rheumatic diseases, including systemic lupus erythematosus, and rheumatoid arthritis [ 18 , 19 , 20 ].…”

Blood Coagulation and Thrombotic Disorders following SARS-CoV-2 Infection and COVID-19 Vaccination

“…The phenomenon of denial is significant, and reports of adverse effects, particularly thrombotic ones, have a bearing on it. A complicated phenomenon, vaccination hesitancy is influenced by people's opinions of the effectiveness and safety of immunizations; therefore, more studies should focus on the safety and more studies should investigate vaccine fear in people [178][179][180].…”