COVID-19 Vaccine Tolerance in Patients with Rheumatoid Arthritis

January 26, 2023

Researchers from around the world collaborated to create an online survey for rheumatoid arthritis (RA) and other autoimmune rheumatic disease (AIRD) patients (excluding inflammatory myositis) to self-report COVID-19 vaccine-related adverse events occurring within 7 days post-vaccination (1).

1,347 RA patients participated in the survey between March and December 2021. The most common coexisting autoimmune diseases were thyroid disorders, systemic lupus erythematosus (SLE) and Sjogren’s syndrome (10.0%, 2.6%, and 2.5%, respectively). 76.9% of RA patients reported minor adverse effects, including pain at the injection site, fatigue, headache, and body aches. Major adverse effects were reported by 4.2% of patients; these included anaphylaxis, difficulty breathing, throat closure, and severe rashes. Three of these patients were hospitalized (.2%). The frequency of adverse effects and hospitalizations was mostly similar among patients with both active and inactive RA. Patients with RA experienced similar total adverse events and hospitalizations when compared to healthy controls.

Data reported by patients pointed to different outcomes between vaccines, as minor adverse effects were most frequently reported by people who received Pfizer-BioNTech and Moderna, and less frequently reported by Covaxin (Bharat Biotech) recipients. However, hospitalizations and major adverse effects were similar among RA patients regardless of the vaccine type, except for Johnson & Johnson recipients, who reported a higher frequency of any major adverse effects. Other COVID-19 vaccines included in the study were AstraZeneca and Sinopharm.

In regard to receiving immunosuppressive therapies, RA patients receiving methotrexate and hydroxychloroquine experienced a smaller number of minor adverse effects compared to patients who were not taking these medications. Hospitalization rates were similar among patients receiving different immunosuppressants.

In all, this study adds to the growing body of scientific literature showing COVID-19 vaccines are generally well tolerated amongst RA patients when compared to those without RA.