Adverse events after first COVID-19 vaccination in patients with autoimmune diseases

Boekel, Laura; Kummer, Laura; Dam, Koos P J van; Hooijberg, Femke; Kempen, Zoé van; Vogelzang, Erik H; Wieske, Luuk; Eftimov, Filip; Vollenhoven, Ronald van; Kuijpers, Taco W.; Ham, S. Marieke van; Tas, Sander W.; Killestein, Joep; Boers, Maarten; Nurmohamed, Michael T.; Rispens, Theo; Wolbink, Gertjan

doi:10.1016/s2665-9913(21)00181-8

Cited by 66 publications

(69 citation statements)

References 10 publications

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“… 2 A rheumatoid arthritis flare was also reported recently in a patient who received the COVID‐19 vaccine. 3 The articular complications caused by the different SARS‐CoV‐2 vaccines were compared, 4 but the Gam‐COVID‐Vac vaccine was not included. There have been no English reports describing arthritis after SPUTNIK‐V vaccination.…”

Section: Discussionmentioning

confidence: 99%

Arthritis of the left elbow joint after vaccination against SARS‐CoV‐2 infection

Baimukhamedov

2021

Int J of Rheum Dis

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Section: Discussionmentioning

confidence: 99%

Arthritis of the left elbow joint after vaccination against SARS‐CoV‐2 infection

Baimukhamedov

2021

Int J of Rheum Dis

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“…15 Although the prospective randomized studies for the currently available mRNA and adenovirus COVID-19 vaccines excluded patients on immunomodulatory medications, several groups have published case series of patients with IMID who have been vaccinated (Tables I and II). [16][17][18][19][20][21][22][23][24][25][26][27][28] These data suggest that patients receiving biologics for the treatment of inflammatory and autoimmune disease can safely receive, and are able to mount a detectable immune response to, the COVID-19 vaccines, with a few notable exceptions.…”

Section: Safety Of Covid-19 Vaccines In Patients With Imidmentioning

confidence: 91%

COVID-19 vaccine safety and efficacy in patients with immune-mediated inflammatory disease: Review of available evidence

Wack

Patton

Ferris

2021

Journal of the American Academy of Dermatology

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Dermatologists diagnose and treat many immune-mediated inflammatory diseases (IMID). Understanding the inherent immune dysregulation of these diseases as well as the additional disruption that comes as a result of IMID treatments has been important during the COVID-19 pandemic. With vaccines becoming widely available, dermatologists need to be familiar with the risks and benefits of vaccination in these patients, particularly those taking biologics, in order to have informed discussions with their patients. In this review, we present the current evidence related to COVID-19 vaccine safety and efficacy in patients with IMID and review existing recommendations for vaccination against SARS-CoV-2. Given the current evidence, there is minimal concern that these patients are at any greater risk of harm from COVID-19 vaccination compared to healthy controls. For most, the benefit of avoiding severe COVID-19 through vaccination will outweigh the theoretical risk of these vaccines. A question that is still outstanding is whether patients on biologics will generate a sufficient immune response to the vaccine, which may be dependent on the specific biologic therapy and indication being treated. This underscores the importance of following patients with IMID after vaccination to determine the safety, efficacy, and duration of the vaccine in this population.

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“…Most studies (33/34) included patients vaccinated with the BNT162b2 (Pfizer, n = 33) or the m-1372 (Moderna, n = 12) mRNA vaccines. Only 731 patients receiving recombinant adenoviral vector vaccines ( n = 711 ChAdOx1-nCoV-19, Astrazeneca, n = 20 Ad26.COV2.S, Janssen) and 51 receiving inactivated virus vaccines (BBV152, Bharat) have been described in 7/34 studies [ 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. One study reported disaggregated safety data by vaccine type, although limited to the first half of the vaccination cycle [ 36 ].…”

Section: Literature Reviewmentioning

confidence: 99%

“…In 12 out of 24 studies with available data (57%), the average patient age ranged between 40 and 55 years. Few, methodologically heterogeneous studies reported on comorbidities, suggesting that 34–69% of vaccinated patients with autoimmune/rheumatic diseases had one or more coexisting diseases [ 36 , 38 , 51 , 55 ]. Treatment data were instead reported in most studies: more than 75% of described patients were steroid-free at the time of vaccination.…”

Section: Autoimmune/rheumatic Disordersmentioning

confidence: 99%

“…Five studies (three with data from subjects who completed the vaccination schedule) compared the rates of vaccination-related adverse events between patients and healthy controls, yielding conflicting results. Specifically, one study reported higher frequencies of post-vaccination symptoms in patients than in controls after the first vaccination dose [ 36 ], while two small [ 43 , 66 ] and two larger other studies [ 50 , 60 ] showed comparable or even reduced adverse event rates in patients compared to controls.…”

Section: Autoimmune/rheumatic Disordersmentioning

confidence: 99%

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Challenges to Vaccination against SARS-CoV-2 in Patients with Immune-Mediated Diseases

et al. 2021

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Aberrant deployment of the immune response is a hallmark pathogenic feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease (COVID-19), possibly accounting for high morbidity and mortality, especially in patients with comorbidities, including immune-mediated disorders. Immunisation with SARS-COV-2 vaccines successfully instructs the immune system to limit viral spread into tissues, mitigate COVID-19 manifestations and prevent its most detrimental inflammatory complications in the general population. Patients with immune-mediated diseases have been excluded from vaccine registration trials, foreclosing the acquisition of specific efficacy and safety data. In this review, we aimed to summarise and critically discuss evidence from real-world studies addressing this issue to provide a comprehensive view of the impact of vaccination practices in patients with allergy, autoimmunity or immunodeficiency. We analysed clinical and laboratory data from 34 studies involving more than 13,000 subjects with various immune disorders who were vaccinated with mRNA- DNA- or inactivated viral particle-based vaccines. These data globally support the safe and effective use of SARS-CoV-2 vaccines in patients with immune-mediated diseases, although patient-tailored strategies to determine vaccination timing, vaccine choice and background therapy management are warranted to optimise vaccination outcomes. More data are needed regarding patients with primary immunodeficiencies.

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Adverse events after first COVID-19 vaccination in patients with autoimmune diseases

Cited by 66 publications

References 10 publications

Arthritis of the left elbow joint after vaccination against SARS‐CoV‐2 infection

Arthritis of the left elbow joint after vaccination against SARS‐CoV‐2 infection

COVID-19 vaccine safety and efficacy in patients with immune-mediated inflammatory disease: Review of available evidence

Challenges to Vaccination against SARS-CoV-2 in Patients with Immune-Mediated Diseases

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