Aim This survey was conducted to evaluate COVID‐19 vaccination status in patients with autoimmune rheumatic diseases (AIRDs). Our objectives were to study vaccine hesitancy, adverse effects, breakthrough infections and flare of underlying disease in this population subgroup. Methods This was a multi‐center, cross‐sectional, interview‐based survey done at 6 tertiary care centers across Tamil Nadu, in the southern part of India from September 15, 2021 to October 14, 2021. The survey questionnaire was filled up by AIRD patients attending their clinics. The survey questionnaire comprised a set of 14 questions, distributed between patient characteristics, vaccines taken, their characteristics and COVID‐19 infection. Results There were 2092 participants, with a mean age of 47.5 ± 13.17 years. Among them, 1293 (61.81%) were vaccinated, of which 837 (64.73%) were fully vaccinated. Two‐thirds of our subjects were vaccinated with ChAdOx1 nCov‐19 (COVISHIELD) (77.64%) and 21.57% with BBV 152 (COVAXIN). Age, gender, education and comorbidities had no association with vaccine hesitancy. The commonest (421; 52.69%) reason for vaccine hesitancy was fear of side effects. The incidence (n = 72) of breakthrough infections was similar in both the vaccine groups, of which 58 (80.55%) were partially vaccinated and 14 (19.44%) were fully vaccinated. Thirty‐two patients had a flare of pre‐existing rheumatic disease. Conclusion ChAdOx1 nCov‐19 and BBV 152 were found to be safe in patients with rheumatic diseases. Fear of side effects was the major cause of vaccine hesitancy. All adverse effects were minor and self‐limiting. Breakthrough infections and disease flares occurred only in a small subset of our cohort.

A 58-year-old Caucasian woman was admitted for knee replacement but during the postoperative period she developed sepsis due to pneumonia, which was treated with coamoxiclav and then piperacillin (for 2 weeks). She had renal failure, which needed haemofiltration. During her recovery she had diarrhoea due to Clostridium difficile, which was not controlled with metronidazole. Vancomycin was therefore given, but she developed urticarial erythematous skin rash and hence it was stopped. She was not on any other new medications and a vasculitic screen was negative. A dermatologist reviewed her file as well. The skin rash subsided after 2 weeks with topical emollients and chlorphenamine tablets. Her diarrhoea eventually settled and she went home well. Though classically described in men, this "red man" syndrome (features of urticarial erythematous rash due to oral vancomycin) has been previously reported in case reports and in literature reviews.

requires the accurate input of data based on Office of Population, Censuses and Surveys classification, fourth revision (OPCS-4) and the International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10) to reflect clinical activity. Trusts have a financial incentive to ensure that coding is accurate, comprehensive and timely. Since 1990 OPCS-4 (with revisions) has been implemented across the NHS.

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