Disease exacerbation and COVID-19 following mRNA COVID-19 vaccination in adolescents with Systemic Lupus Erythematosus
Authors' conclusion
COVID-19 vaccination is effective and safe in preventing severe COVID-19 among adoSLE patients, without increasing annual SLE flare rates.
Study context
- Population
- Adolescent systemic lupus erythematosus (SLE) patients aged 12–18 years without prior COVID-19, vaccinated with BNT162b2 (mean age 15.8 ± 1.6 years; 92.8% female)
- Participants
- 69 vaccinated adolescent SLE (adoSLE) patients
- Exposure
- Post- vs pre-COVID-19 vaccination
- Outcome
- SELENA-SLEDAI flare index disease flares, year-on-year flare rates before and after vaccination
- Follow-up
- 12 months
Methodological details12-month prospective, pre- vs post-vaccination comparison
- 12-month prospective
- Pre- vs post-vaccination comparison
Main finding
As reported in the abstract
Year-on-year flare rate
P = 0.371
Observational data: associations, not effects.
Further findings
Independent factors of disease flares
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Non-use of HCQ | 18.83 (1.97–179.60) | P = 0.011 | |
| SELENA-SLEDAI score ≥8 within 12 months prior to vaccination | 5.33 (1.38–20.55) | P = 0.015 | |
| 0.050.21520Adjusted odds ratio (log scale) |
COVID-19 within a year post-vaccination
- Patients who contracted COVID-19, all with mild to moderate symptoms
- Thirty-four (49.3%)
- COVID-19 among the 46 patients who received a booster
- 15 (32.6%)
Safety
Renal flare rate, pre- vs post-vaccine
- Increment in post-vaccine renal flare rate
- 6 (8.7%) versus 14 (20.3%), p = .046
- Renal flare patients with previous LN
- 13 (92.9%)
- New-onset or increased proteinuria (most common finding)
- 71.4%
Original publication
Disease exacerbation and COVID-19 following mRNA COVID-19 vaccination in adolescents with Systemic Lupus Erythematosus. Lupus. Published 29 March 2025. doi:10.
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