COVID-19 vaccines safe for patients with rheumatic, musculoskeletal disease

Vaccines against SARS-CoV-2 has a safety profile that is similar in patients with inflammatory/autoimmune rheumatic and musculoskeletal disease (I-RMD) and those with noninflammatory RMD (NI-RMD), according to a study. The vaccines are well tolerated with rare reports of I-RMD flare and serious adverse events (AEs).

The study included 5,121 patients (mean age 61.6 years, 70 percent female), 4,604 with I-RMD (mean age 60.5 years, 68 percent female), and 517 with NI-RMD (mean age 71.4 years, 77 percent female), who were vaccinated against SARS-CoV-2. The mean time between first vaccine dose and case reporting was 66 days overall, 66 days in the I-RMD group, and 64 days in the NI-RMD group.

The most frequent diagnoses were inflammatory joint diseases (58 percent), connective tissue diseases (18 percent), and vasculitis (12 percent). More than half of the population (54 percent) received conventional synthetic disease-modifying antirheumatic drugs (DMARDs), while 42 percent and 35 percent were given biological DMARDs and immunosuppressants, respectively.

Most patients received the Pfizer/BioNTech vaccine (70 percent), 17 percent AstraZeneca/Oxford, and 8 percent Moderna. Among fully vaccinated patients, breakthrough infections occurred in 0.7 percent of I-RMD patients and 1.1 percent of NI-RMD patients.

There were 4.4 percent of patients who developed I-RMD flares (0.6 percent severe), of whom 1.5 percent required changes in their medication. AEs were documented in 37 percent of patients (37 percent I-RMD, 40 percent NI-RMD), while serious AEs occurred in 0.5 percent (0.4 percent I-RMD, 1.9 percent NI-RMD).

The present data should provide reassurance to rheumatologists and vaccine recipients and promote the safety of SARS-CoV-2 vaccines in I-RMD patients.