Baseline factors associated with self-reported disease flares following COVID-19 vaccination among adults with systemic rheumatic disease: results from the COVID-19 global rheumatology alliance vaccine survey. Issue Volume 61:Issue S12(2020) (23rd April 2022)

• Record Type: Journal Article
• Authors: Rider, Lisa G; Parks, Christine G; Wilkerson, Jesse; Schiffenbauer, Adam I; Kwok, Richard K; Noroozi Farhadi, Payam; Nazir, Sarvar; Ritter, Rebecca; Sirotich, Emily; Kennedy, Kevin; Larche, Maggie J; Levine, Mitchell; Sattui, Sebastian E; Liew, Jean W; Harrison, Carly O; Moni, Tarin T; Miller, Aubrey K; Putman, Michael; Hausmann, Jonathan; Simard, Julia F; Sparks, Jeffrey A; Miller, Frederick W
• Is Part Of: Rheumatology. Volume 61:Issue S12(2020)
• Page Start: SI143
• Page End: SI150
• Publication Date: 2022-04-23
• Subjects: COVID-19 -- vaccine -- disease flare -- systemic rheumatic diseases; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/keac249
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objective: To examine the frequency of, and risk factors for, disease flare following COVID-19 vaccination in patients with systemic rheumatic disease (SRD). Methods: An international study was conducted from 2 April to 16 August 2021, using an online survey of 5619 adults with SRD for adverse events following COVID-19 vaccination, including flares of disease requiring a change in treatment. We examined risk factors identified a priori based on published associations with SRD activity and SARS-CoV-2 severity, including demographics, SRD type, comorbidities, vaccine type, cessation of immunosuppressive medications around vaccination and history of reactions to non-COVID-19 vaccines, using multivariable logistic regression. Results: Flares requiring a change in treatment following COVID-19 vaccination were reported by 4.9% of patients. Compared with rheumatoid arthritis, certain SRD, including systemic lupus erythematosus (OR 1.51, 95% CI 1.03, 2.20), psoriatic arthritis (OR 1.95, 95% CI 1.20, 3.18) and polymyalgia rheumatica (OR 1.94, 95% CI 1.08, 2.48) were associated with higher odds of flare, while idiopathic inflammatory myopathies were associated with lower odds for flare (OR 0.54, 95% CI 0.31–0.96). The Oxford-AstraZeneca vaccine was associated with higher odds of flare relative to the Pfizer-BioNTech vaccine (OR 1.44, 95% CI 1.07, 1.95), as were a prior reaction to a non-COVID-19 vaccine (OR 2.50, 95% CI 1.76, 3.54) and female sex (OR 2.71, 95% CI 1.55, 4.72). Conclusion: SRD flares requiring changes in treatment following COVID-19 vaccination were uncommon in this large international study. Several potential risk factors, as well as differences by disease type, warrant further examination in prospective cohorts.