Early experience of COVID-19 vaccination in adults with systemic rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

Sebastian Eduardo Sattui; Jean W Liew; Kevin Kennedy; Emily Sirotich; Michael Putman; Tarin T Moni; Akpabio Akpabio; Deshiré Alpízar-Rodríguez; Francis Berenbaum; Inita Bulina; Richard Conway; Aman Dev Singh; Eimear Duff; Karen L Durrant; Tamer A Gheita; Catherine L Hill; Richard A Howard; Bimba F Hoyer; Evelyn Hsieh; Lina El Kibbi; Adam Kilian; Alfred Hyoungju Kim; David F L Liew; Chieh Lo; Bruce Miller; Serena Mingolla; Michal Nudel; Candace A Palmerlee; Jasvinder A Singh; Namrata Singh; Manuel Francisco Ugarte-Gil; John Wallace; Kristen J Young; Suleman Bhana; Wendy Costello; Rebecca Grainger; Pedro M Machado; Philip C Robinson; Paul Sufka; Zachary S Wallace; Jinoos Yazdany; Carly Harrison; Maggie Larché; Mitchell Levine; Gary Foster; Lehana Thabane; Lisa G Rider; Jonathan S Hausmann; Julia F Simard; Jeffrey A Sparks

doi:10.1136/rmdopen-2021-001814

Early experience of COVID-19 vaccination in adults with systemic rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey

RMD Open. 2021 Sep;7(3):e001814. doi: 10.1136/rmdopen-2021-001814.

Authors

Sebastian Eduardo Sattui^#¹, Jean W Liew^#², Kevin Kennedy³, Emily Sirotich⁴, Michael Putman⁵, Tarin T Moni⁶, Akpabio Akpabio⁷, Deshiré Alpízar-Rodríguez⁸, Francis Berenbaum⁹, Inita Bulina¹⁰, Richard Conway¹¹, Aman Dev Singh¹², Eimear Duff¹³, Karen L Durrant¹⁴, Tamer A Gheita¹⁵, Catherine L Hill^{16

17}, Richard A Howard¹⁸, Bimba F Hoyer¹⁹, Evelyn Hsieh^{20

21}, Lina El Kibbi²², Adam Kilian²³, Alfred Hyoungju Kim²⁴, David F L Liew^{25

26}, Chieh Lo²⁷, Bruce Miller²⁸, Serena Mingolla²⁹, Michal Nudel³⁰, Candace A Palmerlee³¹, Jasvinder A Singh^{32

33}, Namrata Singh³⁴, Manuel Francisco Ugarte-Gil^{35

36}, John Wallace³⁷, Kristen J Young³⁸, Suleman Bhana³⁹, Wendy Costello⁴⁰, Rebecca Grainger⁴¹, Pedro M Machado^{42

43}, Philip C Robinson^{44

45}, Paul Sufka⁴⁶, Zachary S Wallace^{47

48}, Jinoos Yazdany⁴⁹, Carly Harrison⁵⁰, Maggie Larché⁵¹, Mitchell Levine⁵², Gary Foster⁵³, Lehana Thabane⁵², Lisa G Rider⁵⁴, Jonathan S Hausmann^#^{48

55

56}, Julia F Simard^#^{57

58}, Jeffrey A Sparks^#^{59

60}

Affiliations

¹ Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA.
² Section of Rheumatology, Boston University School of Medicine, Boston, Massachusetts, USA.
³ Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
⁴ Medicine, McMaster University, Hamilton, Ontario, Canada.
⁵ Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
⁶ Department of Biochemistry & Biomedical Sciences, McMaster University Faculty of Science, Hamilton, Ontario, Canada.
⁷ Rheumatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
⁸ Research Unit, Mexican College of Rheumatology, Coyoacan, Ciudad de México, Mexico.
⁹ Rheumatology, Sorbonne Université, Paris, France.
¹⁰ Department of Internal Diseases, Rheumatology Centre, Paul Stradins Clinical University Hospital, Riga, Latvia.
¹¹ Rheumatology, Saint James's Hospital, Dublin, Ireland.
¹² Community Medicine, GMC Patiala, Punjab, India.
¹³ Department of Rheumatology, Saint James's Hospital, Dublin, Ireland.
¹⁴ Autoinflammatory Alliance, San Francisco, California, USA.
¹⁵ Rheumatology and Clinical Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt.
¹⁶ Rheumatology Department, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
¹⁷ Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
¹⁸ Spondylitis Association of America, Van Nuys, California, USA.
¹⁹ Medical Department I, Department for Rheumatology and Clinical Immunology, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Schleswig-Holstein, Germany.
²⁰ Section of Rheumatology, Allergy & Immunology, Yale School of Medicine, New Haven, Connecticut, USA.
²¹ Section of Rheumatology, VA Connecticut Healthcare System-West Haven Campus, West Haven, Connecticut, USA.
²² Rheumatology, Specialized Medical Center Hospital, Riyadh, Saudi Arabia.
²³ Department of Internal Medicine, Division of Rheumatology, Saint Louis University, Saint Louis, Missouri, USA.
²⁴ Medicine/Rheumatology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA.
²⁵ Rheumatology, Austin Health, Heidelberg West, Victoria, Australia.
²⁶ Clinical Pharmacology and Therapeutics, Austin Health, Heidelberg, Victoria, Australia.
²⁷ I-Shou University College of Medicine, Yanchau Sheng, Taiwan.
²⁸ Medicine, University of California San Diego, La Jolla, California, USA.
²⁹ Italian National Patient Association for Rehumatoid and Rare Disease (APMARR), Rome, Italy.
³⁰ The Israeli Association for RMD Patients "Mifrakim Tz'eirim", Haifa, Israel.
³¹ Relapsing Polychondritis Foundation, International Relapsing Polychondritis Research Network, Walnut Creek, California, USA.
³² Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
³³ Medicine Service, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA.
³⁴ Medicine, Division of Rheumatology, University of Washington, Seattle, Washington, USA.
³⁵ Department of Rheumatology, Universidad Cientifica del Sur, Lima, Peru.
³⁶ Universidad Científica del Sur, Lima, Peru.
³⁷ Autoinflammatory UK, Edinburgh, UK.
³⁸ Division of Rheumatology, University of Texas Southwestern Medical School, Dallas, Texas, USA.
³⁹ Crystal Run Healthcare, Middletown, New York, USA.
⁴⁰ Irish Children's Arthritis Network (iCAN), Tipperary, Ireland.
⁴¹ Department of Medicine, Malaghan Institute of Medical Research, Wellington, New Zealand.
⁴² MRC Centre for Neuromuscular Diseases, University College London, London, UK.
⁴³ Rheumatology, University College London Centre for Rheumatology, London, UK.
⁴⁴ Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia.
⁴⁵ Metro North Hospital & Health Service, Royal Brisbane and Woman's Hospital Health Service District, Herston, Queensland, Australia.
⁴⁶ Healthpartners, St Paul, Minnesota, USA.
⁴⁷ Clinical Epidemiology Program and Rheumatology Unit, Division of Rheumatology,Allergy, and Immunology, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁴⁸ Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
⁴⁹ Medicine/Rheumatology, University of California, San Francisco, California, USA.
⁵⁰ LupusChat, New York, New York, USA.
⁵¹ Division of Clinical Immunology and Allergy, McMaster University Department of Medicine, Hamilton, Ontario, Canada.
⁵² Department of Health Research Methods, Evidence and Impact (HEI), McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.
⁵³ Department of Health Research Methods, Evidence, and Impact (HEI); Medicine, McMaster University, Hamilton, Ontario, Canada.
⁵⁴ Environmental Autoimmunity Group, NIEHS/NIH/DHHS, Bethesda, Maryland, USA.
⁵⁵ Rheumatology, Boston Children's Hospital, Boston, Massachusetts, USA.
⁵⁶ Division of Rheumatology and Clinical Immunology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
⁵⁷ Epidemiology and Population Health and Department of Medicine, Division of Immunology & Rheumatology, Stanford School of Medicine, Stanford, California, USA.
⁵⁸ Department of Medicine, Clinical Epidemiology Unit, Sweden.
⁵⁹ Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA [email protected].
⁶⁰ Department of Medicine, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA.

^# Contributed equally.

Abstract

Background: We describe the early experiences of adults with systemic rheumatic disease who received the COVID-19 vaccine.

Methods: From 2 April to 30 April 2021, we conducted an online, international survey of adults with systemic rheumatic disease who received COVID-19 vaccination. We collected patient-reported data on clinician communication, beliefs and intent about discontinuing disease-modifying antirheumatic drugs (DMARDs) around the time of vaccination, and patient-reported adverse events after vaccination.

Results: We analysed 2860 adults with systemic rheumatic diseases who received COVID-19 vaccination (mean age 55.3 years, 86.7% female, 86.3% white). Types of COVID-19 vaccines were Pfizer-BioNTech (53.2%), Oxford/AstraZeneca (22.6%), Moderna (21.3%), Janssen/Johnson & Johnson (1.7%) and others (1.2%). The most common rheumatic disease was rheumatoid arthritis (42.3%), and 81.2% of respondents were on a DMARD. The majority (81.9%) reported communicating with clinicians about vaccination. Most (66.9%) were willing to temporarily discontinue DMARDs to improve vaccine efficacy, although many (44.3%) were concerned about rheumatic disease flares. After vaccination, the most reported patient-reported adverse events were fatigue/somnolence (33.4%), headache (27.7%), muscle/joint pains (22.8%) and fever/chills (19.9%). Rheumatic disease flares that required medication changes occurred in 4.6%.

Conclusion: Among adults with systemic rheumatic disease who received COVID-19 vaccination, patient-reported adverse events were typical of those reported in the general population. Most patients were willing to temporarily discontinue DMARDs to improve vaccine efficacy. The relatively low frequency of rheumatic disease flare requiring medications was reassuring.

Keywords: COVID-19; autoimmune diseases; vaccination.

Publication types

Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19 Vaccines
COVID-19*
Female
Humans
Male
Middle Aged
Rheumatic Diseases* / drug therapy
Rheumatology*
SARS-CoV-2
Surveys and Questionnaires
Vaccination

Substances

COVID-19 Vaccines

Abstract

Publication types

MeSH terms

Substances

Grants and funding