Receipt of an mRNA COVID-19 vaccine is not associated with severe disease flares in patients with rheumatic diseases, according to a study presented at the annual meeting of the American College of Rheumatology, held virtually from Nov. 3 to 9.
Ines Colmegna, M.D., from the McGill University Health Centre in Montreal, and colleagues assessed the safety and immunogenicity of the mRNA-1273 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine following a two-dose regimen in patients with rheumatic diseases. The analysis included 220 participants (131 with rheumatoid arthritis [RA], 23 with systemic lupus erythematosus [SLE], eight with other rheumatic diseases, and 58 controls).
The researchers found that local and systemic solicited adverse events were more frequently reported after the second dose in all participants, with pain at the injection site being the most common. RA patients more often reported swollen joints (solicited adverse event) following both vaccine doses versus controls (22.9 versus 3.4 percent), although there was no clear increase in disease activity scores after vaccination. There were no serious adverse events attributed to the vaccine. Seropositivity for both the immunoglobulin (IgG) antibody against SARS-CoV-2 spike protein (IgG-S) and IgG receptor binding domain (IgG-RBD) after the first dose was 100 percent in controls but 67.7 percent in RA patients, 34.8 percent in SLE patients, and 87.5 percent in patients with other rheumatic diseases. Seropositivity for both IgG-S and IgG-RBD remained 100 percent in controls after the second dose and increased to 88.5 percent in RA patients and 78.3 percent in SLE patients and remained at 87.5 percent in patients with other rheumatic diseases. Among people with RA, seropositivity after the second dose was similar in older (>65 years) versus younger age groups. After both doses, people receiving rituximab or mycophenolate mofetil had lower humoral responses than patients not receiving those drugs.
“These findings help to reassure patients with rheumatic diseases and their providers who are concerned that COVID-19 vaccines could lead to an increase in disease activity,” Colmegna said in a statement. “It highlights the importance of having a complete vaccine scheme in order to enhance vaccine responses.”
Several authors disclosed financial ties to the pharmaceutical industry.