Is vaccination against COVID-19 associated with autoimmune rheumatic disease flare? A self-controlled case series analysis
Main finding · AIRD flare, all vaccinationsResult — go to the resultAdjusted incidence rate ratio 0.89 95% CI 0.80–0.98Authors' conclusion
Vaccination against COVID-19 was not associated with increased AIRD flares regardless of prior COVID-19, AIRD type, and whether mRNA or DNA vaccination technology were used.
Study context
- Population
- Patients with autoimmune rheumatic disease (AIRDs) vaccinated against COVID-19 who consulted for disease flare, 1 December 2020–31 December 2021 (72% female, mean age 65 years, 68.3% with RA)
- Participants
- 3,554 AIRD cases
- Exposure
- 21-day vaccine-exposed period vs vaccine-unexposed periods
- Outcome
- AIRD flare (consultation for AIRD with CS prescription on the same or next day)
- Follow-up
- 21 days after vaccination
Methodological detailsseason-adjusted, Clinical Practice Research Datalink (Aurum)
- Season-adjusted
- Clinical Practice Research Datalink (Aurum)
Main finding
AIRD flare, all vaccinations · 21-day vaccine-exposed period
Adjusted incidence rate ratio
0.89
95% CI 0.80–0.98
Vaccine-exposedvs Vaccine-unexposed
aIRR 0.89 (95% CI 0.80–0.98)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aIRR (95% CI) | |
|---|---|---|
| AIRD flare by dose · 21 days after vaccinationVaccine-exposedvs Vaccine-unexposedFirst vaccination | 0.76 (0.66–0.89) | |
| AIRD flare by dose · 21 days after vaccinationVaccine-exposedvs Vaccine-unexposedSecond vaccination | 0.94 (0.79–1.11) | |
| AIRD flare by dose · 21 days after vaccinationVaccine-exposedvs Vaccine-unexposedThird vaccination | 1.01 (0.85–1.20) | |
| 0.512Adjusted incidence rate ratio (log scale) |
AIRD flare by AIRD type
- On AIRD-type stratified analyses, vaccination was not associated with disease flares
AIRD flare after first vaccination by prior SARS-CoV-2 infection and vaccine type · vaccine-exposed period after first vaccination
- Vaccination without or after SARS-CoV-2 infection, and with vectored DNA or mRNA vaccines, associated with comparable reduced risk of AIRD flares
Original publication
Is vaccination against COVID-19 associated with autoimmune rheumatic disease flare? A self-controlled case series analysis. Rheumatology (Oxford). Published 1 September 2022. doi:10.
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