Safety and Healthcare Use Following COVID-19 Vaccination Among Adults With Rheumatoid Arthritis: A Population-Based Self-Controlled Case Series Analysis
Main finding · AESIs in RA, relative to control periodsResult — go to the resultRIR 1.28 95% CI 1.05–1.56Authors' conclusion
COVID-19 vaccines in patients with RA were not associated with an increase in AESI risk or healthcare use after every dose.
Study context
- Population
- Adults with rheumatoid arthritis (RA) who received at least 1 COVID-19 vaccine (majority mRNA vaccines)
- Participants
- 123,466 vs 493,864
- Exposure
- 21-day periods after COVID-19 vaccination vs control periods, in RA and in matched non-RA comparators
- RAn = 123,466
- Comparatorsn = 493,864reference
- Outcome
- Relative incidence of AESIs (Bell palsy, idiopathic thrombocytopenia, acute disseminated encephalomyelitis, pericarditis/myocarditis, Guillain-Barré syndrome, transverse myelitis, MI, anaphylaxis, stroke, DVT, PE, narcolepsy, appendicitis, disseminated intravascular coagulation) in any 21-day period after vaccination vs control periods
- Follow-up
- 21 days after each dose
Methodological detailsmatched non-RA comparator group
- Matched non-RA comparator group
Main finding
AESIs in RA, relative to control periods
RIR
1.28
95% CI 1.05–1.56
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Estimate |
|---|---|
| ED visits and hospitalisations after dose 4, RA vs comparatorsRA vs Comparators · fewer ED visits | RIR (ED visits) 0.73 (95% CI 0.58–0.90) |
| ED visits and hospitalisations after dose 4, RA vs comparatorsRA vs Comparators · fewer hospitalisations | RIR (hospitalisations) 0.52 (95% CI 0.36–0.75) |
Emergency department (ED) visits in RA vs control periods
- Relative incidence (RI) after dose 2 (95% CI 1.03-1.10), increased
- 1.06
- RI after dose 3 (95% CI 0.89-0.96), decreased
- 0.93
Hospitalisations in RA vs control periods
- RI after dose 1
- 0.83 (95% CI 0.78-0.88)
- RI after dose 2
- 0.86 (95% CI 0.81-0.92)
- RI after dose 3
- 0.89 (95% CI 0.83-0.95)
Rheumatology visits in RA vs control periods
- RI after dose 1 (95% CI 1.07-1.10), increased
- 1.08
- Decreased after doses 2 and 3
Original publication
Safety and Healthcare Use Following COVID-19 Vaccination Among Adults With Rheumatoid Arthritis: A Population-Based Self-Controlled Case Series Analysis. J Rheumatol. Published 1 October 2023. doi:10.
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