COVID Vaccination in Patients with SLE

July 22, 2021

Patients with systemic lupus erythematosus (SLE) were excluded from COVID-19 vaccine trials. To better understand the tolerability of COVID-19 vaccines amongst patients with SLE, the international vaccination against COVID in systemic lupus (VACOLUP) study was initiated via an online survey. Participants included those with a self-reported, medically confirmed diagnosis of SLE.

The study included 696 participants from 30 countries. All patients had received at least one dose by the time of the study, most commonly from Pfizer, Sinovac, AstraZeneca, and Moderna. 343 patients received a second dose.
316 participants reported side effects after the first dose; 181 of the 343 patients who received the second dose reported side effects. “Patients who received both vaccine doses and reported side-effects after the first dose were more likely to report side-effects after the second dose.”

3% of study participants reported a medically confirmed flare-up of SLE. “Having a flare during the past year before vaccination was associated with an increased risk of SLE flare after COVID-19 vaccination.” Approximately 50% of patients with SLE reported side effects that, more often than not, did not impair daily function. There was no difference in occurrence between those who received an mRNA vaccine versus a vaccine with a different method of delivery.

It is important to note that the short median time between vaccination and onset of flare-ups suggests that these side effects may parallel expected post-vaccine reactions and that the “3% figure could be an overestimation of the actual flare rate.”