Covid‐19 vaccination in autoimmune rheumatic diseases: A multi‐center survey from southern India

Abstract

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.

Perceived Risks and Perceptions of Covid–19 Vaccination in Patients with Autoimmune Skin Diseases Attending a Tertiary Care Centre in South India – A Questionnaire Based Study

“…In our study the rst dose, coverage was more compared to the second dose. First dose completion was noted in 35.27% of the study participants whereas second dose vaccine completion was noted in 64.73% [9] Most of the study participants had covishield and only few had covaxin .This was similar to mohansundaram et al study where 77.6% vaccinated with covishield whereas 21.57% had covaxin. Vaccine hesitancy was noted in the 14(28%) of our study participants because of ignorance regarding vaccine safety and e cacy in 64.3% and due to personal beliefs in 57.1% of our study participants.…”

“…Majority of the study participants were in the age category of 45-60 18(36%) .Similarly in the Mohanasundaram et al [9] most of the study participants were in 47-60 years of age. In our study,Male preponderance was observed to be 52% whereas in the study done by mohanasundaram et al female preponderance of 79.16% seen.…”

“…Vaccine hesitancy was noted in the 14(28%) of our study participants because of ignorance regarding vaccine safety and e cacy in 64.3% and due to personal beliefs in 57.1% of our study participants. Whereas in the study done in multicentre, the reason was fear of the side effects 52.69% followed by fear of worsening of their disease condition 24.40% [9] . Felton R et al [10] stated from an international study where he recruited 1561 study participants,38.9% of the study participants were found to have SLE and 54.2% of the study participants were willing for vaccination ,13.6% of the study participants were unwilling.…”

Genetic predisposition between coronavirus disease 2019 and rheumatic diseases: A 2‐sample Mendelian randomization study

“…In addition, protective responses produced by vaccination suggested sequential activations of various immune‐related factors and immune cells. Adverse events after vaccination raised concerns that fighting against COVID‐19 could influence the human immune system in some uncontrollable ways 28–31 . Thus, the morbidity of chronic rheumatic diseases could increase following the COVID‐19 pandemic, and healthcare professionals should pay more attention to identifying high‐risk cases and the early diagnosis and treatment of COVID‐19‐induced rheumatic diseases to improve patient outcomes.…”

“…Adverse events after vaccination raised concerns that fighting against COVID-19 could influence the human immune system in some uncontrollable ways. [28][29][30][31] Thus, the morbidity of chronic rheumatic diseases could increase following the PBC is an autoimmune chronic liver rheumatic disease with positive serological anti-mitochondrial antibodies (AMA). 32 Several case reports showed female patients had elevated liver enzymes with positive AMA after COVID-19 infection, and were diagnosed with the onset of PBC triggered by SARS-CoV-2.…”