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Rider LG, Parks CG, Wilkerson J, Schiffenbauer AI, Kwok RK, Noroozi Farhadi P, Nazir S, Ritter R, Sirotich E, Kennedy K, Larche MJ, Levine M, Sattui SE, Liew JW, Harrison CO, Moni TT, Miller AK, Putman M, Hausmann J, Simard JF, Sparks JA, Miller FW. 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. Rheumatology (Oxford) 2022; 61:SI143-SI150. [PMID: 35460240 DOI: 10.1093/rheumatology/keac249] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/30/2022] [Indexed: 11/12/2022] Open
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 April 2 to August 16, 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.
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Affiliation(s)
- Lisa G Rider
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS, National Institutes of Health (NIH), Bethesda, MD, USA)
| | | | | | - Adam I Schiffenbauer
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS, National Institutes of Health (NIH), Bethesda, MD, USA)
| | - Richard K Kwok
- Office of the Director, NIEHS, NIH, Research Triangle Park, NC, USA
| | - Payam Noroozi Farhadi
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS, National Institutes of Health (NIH), Bethesda, MD, USA)
| | - Sarvar Nazir
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS, National Institutes of Health (NIH), Bethesda, MD, USA)
| | | | | | - Kevin Kennedy
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | | | - Mitchell Levine
- Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Sebastian E Sattui
- Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jean W Liew
- Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA
| | | | - Tarin T Moni
- Department of Biochemistry and Biomedical Sciences, McMaster University Faculty of Science, Hamilton, ON, Canada
| | - Aubrey K Miller
- Office of the Director, NIEHS, NIH, Research Triangle Park, NC, USA
| | | | - Jonathan Hausmann
- Program in Rheumatology, Boston Children's Hospital, Division of Rheumatology and Clinical Immunology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA
| | - Julia F Simard
- Department of Epidemiology and Population Health, and Immunology and Rheumatology (Department of Medicine), Stanford University School of Medicine, USA
| | - Jeffrey A Sparks
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Frederick W Miller
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS, National Institutes of Health (NIH), Bethesda, MD, USA)
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