Safety of vaccination against SARS-CoV-2 in people with rheumatic and musculoskeletal diseases: results from the EULAR Coronavirus Vaccine (COVAX) physician-reported registry.

Machado, Pedro M;Lawson-Tovey, Saskia;Strangfeld, Anja;Mateus, Elsa F;Mariette, Xavier;et.al.
(2022) Annals of the rheumatic diseases — Vol. 81, n° 5, p. 695-709 (2022)

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  • Machado, Pedro Morcid-logo
    Author
  • Lawson-Tovey, Saskiaorcid-logo
    Author
  • Strangfeld, Anjaorcid-logo
    Author
  • Mateus, Elsa Forcid-logo
    Author
  • Durez, Patrickorcid-logoUCLouvain
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  • Mariette, Xavierorcid-logo
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Abstract
(en) OBJECTIVES: To describe the safety of vaccines against SARS-CoV-2 in people with inflammatory/autoimmune rheumatic and musculoskeletal disease (I-RMD). METHODS: Physician-reported registry of I-RMD and non-inflammatory RMD (NI-RMDs) patients vaccinated against SARS-CoV-2. From 5 February 2021 to 27 July 2021, we collected data on demographics, vaccination, RMD diagnosis, disease activity, immunomodulatory/immunosuppressive treatments, flares, adverse events (AEs) and SARS-CoV-2 breakthrough infections. Data were analysed descriptively. RESULTS: The study included 5121 participants from 30 countries, 90% with I-RMDs (n=4604, 68% female, mean age 60.5 years) and 10% with NI-RMDs (n=517, 77% female, mean age 71.4). Inflammatory joint diseases (58%), connective tissue diseases (18%) and vasculitis (12%) were the most frequent diagnostic groups; 54% received conventional synthetic disease-modifying antirheumatic drugs (DMARDs), 42% biological DMARDs and 35% immunosuppressants. Most patients received the Pfizer/BioNTech vaccine (70%), 17% AstraZeneca/Oxford and 8% Moderna. In fully vaccinated cases, breakthrough infections were reported in 0.7% of I-RMD patients and 1.1% of NI-RMD patients. I-RMD flares were reported in 4.4% of cases (0.6% severe), 1.5% resulting in medication changes. AEs were reported in 37% of cases (37% I-RMD, 40% NI-RMD), serious AEs in 0.5% (0.4% I-RMD, 1.9% NI-RMD). CONCLUSION: The safety profiles of SARS-CoV-2 vaccines in patients with I-RMD was reassuring and comparable with patients with NI-RMDs. The majority of patients tolerated their vaccination well with rare reports of I-RMD flare and very rare reports of serious AEs. These findings should provide reassurance to rheumatologists and vaccine recipients and promote confidence in SARS-CoV-2 vaccine safety in I-RMD patients.
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Machado, P. M., Lawson-Tovey, S., Strangfeld, A., Mateus, E. F., Hyrich, K. L., Gossec, L., Carmona, L., Rodrigues, A., Raffeiner, B., Duarte, C., Hachulla, E., Veillard, E., Strakova, E., Burmester, G. R., Yardımcı, G. K., Gomez-Puerta, J. A., Zepa, J., Kearsley-Fleet, L., Trefond, L., et al. (2022). Safety of vaccination against SARS-CoV-2 in people with rheumatic and musculoskeletal diseases: results from the EULAR Coronavirus Vaccine (COVAX) physician-reported registry. Annals of the rheumatic diseases, 81(5), 695-709. https://doi.org/10.1136/annrheumdis-2021-221490 (Original work published 2022)