COVID-19 Vaccination in Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: Safety Profile and Reasons for Opting against Vaccination

Abstract

The incidence of COVID-19 infection in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is similar to that in the general population, but the mortality rate is much higher. COVID-19 vaccination is strongly recommended for PAH/CTEPH patients. The aim of our cross-sectional study was to identify reasons why PAH/CTEPH patients refused vaccination against COVID-19. Moreover, we assessed the safety profile of approved COVID-19 vaccines in PAH/CTEPH patients. We examined 261 patients (164 PAH patients and 97CTEPH patients) with a median age of 60 (18–92) years, 62% of which were female. Sixty-one patients (23%) refused to be vaccinated. The main reason for unwillingness to be vaccinated was anxiety about adverse events (AEs, 61%). Age and fear of COVID-19 in the univariate analysis and age ≥60 years in the multivariate regression analysis were factors that impacted willingness to be vaccinated (OR = 2.5; p = 0.005). AEs were reported in 61% of vaccinated patients after the first dose and in 40.5% after the second dose (p = 0.01). The most common reported AEs were pain at the injection site (54.5%), fever (22%), fatigue (21%), myalgia (10.5%), and headache (10%). A lower percentage of AEs was reported in older patients (OR = 0.3; p = 0.001). The COVID-19 vaccines are safe for PAH/CTEPH patients. The results obtained in this study may encourage patients of these rare but severe cardio-pulmonary diseases to get vaccinated against COVID-19.

The impact of COVID‐19 pandemic on pulmonary hypertension: What have we learned?

“…It has proven to be safe in PAH and CTEPH patients. 26 During the last pandemic wave due to the Omicron variant, we reported the highest incidence of all the pandemic period with 17 cases over one single month. Two of these patients were unvaccinated and only one of them required hospital admission.…”

The COVID-19 Vaccination Behavior and Correlates in Diabetic Patients: A Health Belief Model Theory-Based Cross-Sectional Study in China, 2021

“…Previous studies had demonstrated a significant positive correlation between COVID-19 vaccination willingness and vaccination uptake behavior in patients with T2DM [ 19 ]. Groups of chronically ill patients, including those with diabetes, have lower COVID-19 vaccination rates, such as 8.3% in the U.S. and 18% in France [ 20 , 21 ]. However, the general population of patients with chronic diseases varies greatly by disease type, resulting in a limited representation of the behaviors of the massive number of diabetic patients.…”

Outcomes of COVID-19 in patients vaccinated and unvaccinated against SARS-CoV-2 and suffering from pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension

“…In Poland, there was no vaccination prioritization for PAH/CTEPH patients, even if they were seriously ill, except for patients waiting for a lung transplant. At the end of our study, 85% of PAH/CTEPH patients had been vaccinated, but in mid-June 2021 the figure was only 43% [22]. Some of the previously unvaccinated patients changed their minds after they caught COVID-19, while some changed their minds after attending informative campaigns organized at study centers.…”