Two-dose COVID-19 vaccination and possible arthritis flare among patients with rheumatoid arthritis in Hong Kong

Abstract

ObjectivesTo investigate the relationship between COVID-19 full vaccination (two completed doses) and possible arthritis flare.MethodsPatients with rheumatoid arthritis (RA) were identified from population-based electronic medical records with vaccination linkage and categorised into BNT162b2 (mRNA vaccine), CoronaVac (inactive virus vaccine) and non-vaccinated groups. The risk of possible arthritis flare after vaccination was compared using a propensity-weighted cohort study design. We defined possible arthritis flare as hospitalisation and outpatient consultation related to RA or reactive arthritis, based on diagnosis records during the episode. Weekly prescriptions of rheumatic drugs since the launch of COVID-19 vaccination programme were compared to complement the findings from a diagnosis-based analysis.ResultsAmong 5493 patients with RA (BNT162b2: 653; CoronaVac: 671; non-vaccinated: 4169), propensity-scored weighted Poisson regression showed no significant association between arthritis flare and COVID-19 vaccination ((BNT162b2: adjusted incidence rate ratio 0.86, 95% Confidence Interval 0.73 to 1.01); CoronaVac: 0.87 (0.74 to 1.02)). The distribution of weekly rheumatic drug prescriptions showed no significant differences among the three groups since the launch of the mass vaccination programme (all p values >0.1 from Kruskal-Wallis test).ConclusionsCurrent evidence does not support that full vaccination of mRNA or inactivated virus COVID-19 vaccines is associated with possible arthritis flare.

Adverse events of special interest following the use of BNT162b2 in adolescents: a population-based retrospective cohort study

“…Despite the increased risk of myocarditis and the marginally increased risk of sleeping disturbance/disorder the other AESIs recorded among the vaccinated group were similar to the unvaccinated group. Such observation was consistent with local studies conducted in the adult population [ 16 , 17 ]. Narcolepsy, one of the conditions covered by our definition of sleeping disturbance/disorder, has not been reported in other studies on COVID-19 vaccine-related AESI so far, but reported previously to be possibly associated with influenza vaccination [ 33 ].…”

“…Accordingly, we removed those who died before the index date, were hospitalized on the index date (in the unvaccinated group) or had any AESI records before the index date. This approach has been used in previous large-scale pharmacovigilance studies as well [ 17 , 20 , 21 ].…”

Lack of inflammatory bowel disease flare-up following two-dose BNT162b2 vaccine: a population-based cohort study

“…However, the effects of COVID-19 vaccine on IBD activity, particularly severe flare resulting in hospitalisation and the interplay with the use of immunotherapy remain unknown. To address these questions, we analysed the territory-wide electronic medical records with vaccination linkage database in Hong Kong2–7 to examine the association between BNT162b2 vaccination and IBD flare.…”

DMARD disruption, disease flare, and prolonged symptom duration after acute COVID-19 among participants with rheumatic disease: A prospective study

“…Prior studies have focused mainly on DMARD changes early in the pandemic related to concerns about drug supply or immunosuppression (32)(33)(34). Other studies have focused on temporary medication changes after COVID-19 vaccination and have found little evidence of increased risk of flare (35)(36)(37)(38). Compared to those studies, participants in our study may have had longer disruption of DMARDs while acutely ill, particularly those who required hospitalization, which may have increased their risk of flare.…”