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Chen C, Huang S, Geng L, Lai P, Dou H, Zhang H, Chen H, Liang J, Sun L. COVID-19 vaccination and infection status: a cross-sectional survey of patients with rheumatic diseases in China. Rheumatol Int 2024; 44:703-713. [PMID: 37897662 DOI: 10.1007/s00296-023-05438-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/16/2023] [Indexed: 10/30/2023]
Abstract
To evaluate the vaccination status and clinical practice of patients with rheumatic diseases (RD) during the COVID-19 pandemic in China and to explore the impact of vaccination on infection severity in patients with RD. A cross-sectional survey was conducted among RD patients in outpatient and inpatient settings of the Rheumatology and Immunology Department in our hospital. Participants' characteristics, vaccination status, COVID-19 infection status, and medication for acute COVID-19 were collected. A total of 749 valid surveys were included in the study. A total of 271 (36.2%) patients were not vaccinated, and 478 (63.8%) patients received at least one dose of COVID-19 vaccine. 83.3% of patients were vaccinated with inactivated vaccines. Several patients with RD experienced the disease flare (57, 11.9%) and some adverse reactions (31, 6.5%) after COVID-19 vaccination. The COVID-19 infection rate was 84.1% in our study, which was not reduced by vaccination. However, vaccinated patients with RD showed decreased frequencies of pneumonia and hospitalization, compared with those of unvaccinated patients. Independent factors associated with hospitalization were COVID-19 vaccination (OR = 0.422, 95% CI 0.227-0.783), advanced age (OR = 1.070, 95% CI 1.046-1.095), ILD (OR = 1.245, 95% CI 1.082-1.432), and glucocorticoid (OR = 4.977, 95% CI 2.326-10.647). Adverse reactions to vaccines and disease flare are not common in RD patients. Although COVID-19 vaccination could not reduce the risk of COVID-19 infection in RD patients, it may effectively decrease the frequencies of pneumonia and hospitalization after infection. It is recommended that patients with RD should receive COVID-19 vaccination if there are no contraindications because the benefits outweigh the risks.
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Affiliation(s)
- Chen Chen
- Department of Clinical Nutrition, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
| | - Saisai Huang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
| | - Linyu Geng
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Peng Lai
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
| | - Huan Dou
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, 210093, China
| | - Huayong Zhang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
| | - Haifeng Chen
- Department of Rheumatology and Immunology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, 299 Qingyang Road, Wuxi, 214000, Jiangsu, China.
| | - Jun Liang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
| | - Lingyun Sun
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
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Wroński J, Palej K, Stańczyk S, Łosoś M, Werońska-Tatara J, Stasiek M, Wysmołek M, Olech A, Felis-Giemza A. Do Not Leave Your Patients in the Dark-Using American College of Rheumatology and European Alliance of Associations for Rheumatology Recommendations for Vaccination in Polish Adult Patients with Autoimmune Inflammatory Rheumatic Diseases. Vaccines (Basel) 2023; 11:1854. [PMID: 38140256 PMCID: PMC10748174 DOI: 10.3390/vaccines11121854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/12/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Introduction: Patients with autoimmune inflammatory rheumatic diseases (AIIRD) face a higher infectious risk compared to the general population. As per the ACR and EULAR recommendations, vaccinations against influenza, COVID-19, pneumococci, and tetanus are recommended for most patients with AIIRD. (2) Objectives: This study aimed to assess vaccination coverage among Polish AIIRD patients and identify factors influencing it. (3) Patients and Methods: This study was conducted at the reference rheumatological center in Poland between May 2023 and October 2023. The study participants completed a questionnaire covering their knowledge of vaccination recommendations, actual vaccination status, factors affecting their decision to vaccinate, and their perspectives on immunization. (4) Results: This study involved 300 AIIRD patients and 60 controls. Both groups exhibited comparably low vaccination rates for all diseases (the highest for COVID-19-52% in both groups and the lowest for pneumococci-7.7% and 10%, respectively). Knowledge about recommended vaccinations was limited among patients in both groups. AIIRD patients were also not aware that they should avoid live vaccines. The primary motivators for vaccination among AIIRD patients were fear of infection (up to 75%) and medical advice (up to 74.6%). Conversely, the predominant reasons for non-vaccination were a lack of knowledge that vaccination is recommended (up to 74.7%) and concerns about potential adverse effects (up to 48.6%). Many patients reported not receiving vaccination recommendations from either primary care physicians or rheumatologists. (5) Conclusions: To enhance vaccination coverage among AIIRD patients in Poland, it is essential to educate them about vaccinations during routine medical consultations, emphasizing the increased risk of infection, informing them about recommended vaccinations, and clarifying doubts about adverse effects.
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Affiliation(s)
- Jakub Wroński
- Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637 Warsaw, Poland;
| | - Karolina Palej
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland; (K.P.); (S.S.); (M.Ł.); (J.W.-T.); (M.S.); (M.W.); (A.F.-G.)
| | - Sandra Stańczyk
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland; (K.P.); (S.S.); (M.Ł.); (J.W.-T.); (M.S.); (M.W.); (A.F.-G.)
| | - Marta Łosoś
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland; (K.P.); (S.S.); (M.Ł.); (J.W.-T.); (M.S.); (M.W.); (A.F.-G.)
| | - Joanna Werońska-Tatara
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland; (K.P.); (S.S.); (M.Ł.); (J.W.-T.); (M.S.); (M.W.); (A.F.-G.)
| | - Małgorzata Stasiek
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland; (K.P.); (S.S.); (M.Ł.); (J.W.-T.); (M.S.); (M.W.); (A.F.-G.)
| | - Marta Wysmołek
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland; (K.P.); (S.S.); (M.Ł.); (J.W.-T.); (M.S.); (M.W.); (A.F.-G.)
| | - Agnieszka Olech
- Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637 Warsaw, Poland;
| | - Anna Felis-Giemza
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland; (K.P.); (S.S.); (M.Ł.); (J.W.-T.); (M.S.); (M.W.); (A.F.-G.)
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3
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Mayer D, Barun B, Lazibat K, Lasić S, Adamec I, Gabelić T, Krbot Skorić M, Habek M. COVID-19 vaccination uptake in people with multiple sclerosis compared to the general population. Acta Neurol Belg 2023; 123:2269-2275. [PMID: 37261658 PMCID: PMC10233513 DOI: 10.1007/s13760-023-02296-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To determine the COVID-19 vaccine uptake among people with multiple sclerosis (pwMS) compared to the general population in Croatia. METHODS Data from all pwMS entered in the MS Base register until March 24th, 2022 were extracted including age, sex, MS phenotype, disease-modifying therapy (DMT), and date of COVID-19 vaccination. Data on the general population of Croatia were obtained from the vaccination register of the Croatian Institute of Public Health. RESULTS 64.4% pwMS were fully COVID-19 vaccinated which was comparable to 66.3% of the general population. More pwMS were fully vaccinated in the age group 20-24 (74.1% vs 51.7%), and fewer pwMS were fully vaccinated in the age group 65-69 (33.3% vs 80.4%) compared to the general population of the same age group, respectively. PwMS who received at least one dose of any COVID-19 vaccine were older (40.5 vs 37.6 years, p = 0.01), had higher EDSS (2.0 vs 1.0, p = 0.025), and had longer disease duration (6.39 vs 5.35 years, p = 0.02), were more likely to have progressive disease course (p = 0.049) and were on high efficacy DMTs (p = 0.045) compared to unvaccinated pwMS. Longer disease duration positively predicted vaccine uptake. CONCLUSION Croatia has suboptimal COVID-19 vaccination uptake without a significant difference between the general population and pwMS.
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Affiliation(s)
- Dijana Mayer
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Barbara Barun
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Karla Lazibat
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Slava Lasić
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivan Adamec
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tereza Gabelić
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Magdalena Krbot Skorić
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia
- Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia
| | - Mario Habek
- Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia.
- School of Medicine, University of Zagreb, Zagreb, Croatia.
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Marozoff S, Tan J, Lu N, Kirmani A, Loree JM, Xie H, Lacaille D, Kopec JA, Esdaile JM, Corradetti B, Malone P, Koehn CL, Mennell P, Hoens AM, Aviña-Zubieta JA. Effect of Immunosuppressive or Immunomodulatory Agents on Severe COVID-19 Outcomes: A Population-Based Cohort Study. ACR Open Rheumatol 2023. [PMID: 37818772 DOI: 10.1002/acr2.11620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE We estimated the association between immunosuppressive and immunomodulatory agent (IIA) exposure and severe COVID-19 outcomes in a population-based cohort study. METHODS Participants were 18 years or older, tested positive for SARS-CoV-2 between February 6, 2020, and August 15, 2021, and were from administrative health data for the entire province of British Columbia, Canada. IIA use within 3 months prior to positive SARS-CoV-2 test included conventional disease-modifying antirheumatic drugs (antimalarials, methotrexate, leflunomide, sulfasalazine, individually), immunosuppressants (azathioprine, mycophenolate mofetil/mycophenolate sodium [MMF], cyclophosphamide, cyclosporine, individually and collectively), tumor necrosis factor inhibitor (TNFi) biologics (adalimumab, certolizumab, etanercept, golimumab, infliximab, collectively), non-TNFi biologics or targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs) (rituximab separately from abatacept, anakinra, secukinumab, tocilizumab, tofacitinib and ustekinumab collectively), and glucocorticoids. Severe COVID-19 outcomes were hospitalizations for COVID-19, ICU admissions, and deaths within 60 days of a positive test. Exposure score-overlap weighting was used to balance baseline characteristics of participants with IIA use compared with nonuse of that IIA. Logistic regression measured the association between IIA use and severe COVID-19 outcomes. RESULTS From 147,301 participants, we identified 515 antimalarial, 573 methotrexate, 72 leflunomide, 180 sulfasalazine, 468 immunosuppressant, 378 TNFi biologic, 49 rituximab, 144 other non-TNFi biologic or tsDMARD, and 1348 glucocorticoid prescriptions. Risk of hospitalizations for COVID-19 was significantly greater for MMF (odds ratio [95% CI]): 2.82 [1.81-4.40], all immunosuppressants: 2.08 [1.51-2.87], and glucocorticoids: 1.63 [1.36-1.96], relative to nonuse. Similar outcomes were seen for ICU admission and MMF: 2.52 [1.34-4.74], immunosuppressants: 2.88 [1.73-4.78], and glucocorticoids: 1.86 [1.37-2.54]. Only glucocorticoids use was associated with a significant increase in 60-day mortality: 1.58 [1.21-2.06]. No other IIAs displayed statistically significant associations with severe COVID-19 outcomes. CONCLUSION Current use of MMF and glucocorticoids were associated with an increased risk of severe COVID-19 outcomes compared with nonuse. These results emphasize the variety of circumstances of patients taking IIAs.
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Affiliation(s)
- Shelby Marozoff
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Jeremiah Tan
- Arthritis Research Canada and University of British Columbia, Vancouver, Canada
| | - Na Lu
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Ayesha Kirmani
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | | | - Hui Xie
- Arthritis Research Canada, Vancouver, and Simon Fraser University, Burnaby, British Columbia, Canada
| | - Diane Lacaille
- Arthritis Research Canada and University of British Columbia, Vancouver, Canada
| | - Jacek A Kopec
- Arthritis Research Canada and University of British Columbia, Vancouver, Canada
| | - John M Esdaile
- Arthritis Research Canada and University of British Columbia, Vancouver, Canada
| | - Bonnie Corradetti
- Arthritis Research Canada, Vancouver, British Columbia, and Kidney Section of the Medicine Strategic Clinical Network, Alberta Health, Edmonton, Canada
| | - Peter Malone
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Cheryl L Koehn
- Arthritis Research Canada and Arthritis Consumer Experts, Vancouver, British Columbia, Canada
| | | | - Alison M Hoens
- Arthritis Research Canada and University of British Columbia, Vancouver, Canada
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Bianchi FP, Donghia R, Tatoli R, Bonfiglio C. COVID-19 Immunization Rates in Patients with Inflammatory Bowel Disease Worldwide: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:1523. [PMID: 37896927 PMCID: PMC10611173 DOI: 10.3390/vaccines11101523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
Individuals with Inflammatory Bowel Disease (IBD) are characterized by an increased vulnerability to complications stemming from infectious diseases. While these patients do not inherently face a heightened risk of SARS-CoV-2 infection compared to the general population, their vulnerability to severe COVID-19 complications and subsequent hospitalization is notably increased. The objective of our study is to quantitatively assess the global coverage of COVID-19 vaccination among individuals with IBD, achieved through a comprehensive meta-analysis and systematic review. Thirteen studies were systematically selected from scientific articles available in the MEDLINE/PubMed, ISI Web of Knowledge, and Scopus databases, spanning from 1 January 2021 to 25 July 2023. The pooled prevalence of COVID-19 vaccine uptake was estimated at 72% (95%CI = 59-83%) for at least one dose, 81% (95%CI = 68-91%) for the complete vaccination regimen, and 71% (95%CI = 46-91%) for the third dose. Analysis of the determinants influencing vaccination uptake revealed several significant associations. These encompassed Caucasian ethnicity, female sex, absence of immunosuppressive therapy, advanced age, prior receipt of the anti-influenza vaccine, absence of a history of COVID-19 infection, and the provision of advice from gastroenterologists, all linked to improved compliance. Our study underscores a noteworthy yet not entirely optimal COVID-19 vaccination coverage among individuals with IBD. A multifaceted approach is warranted to enhance vaccination rates. Within this context, the role of gastroenterologists extends beyond direct patient care, encompassing a pivotal responsibility in preventing complications stemming from post-infectious diseases.
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Affiliation(s)
| | - Rossella Donghia
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy; (R.D.); (R.T.); (C.B.)
| | - Rossella Tatoli
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy; (R.D.); (R.T.); (C.B.)
| | - Caterina Bonfiglio
- National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy; (R.D.); (R.T.); (C.B.)
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Tabesh E, Soheilipour M, Rezaeisadrabadi M, Zare-Farashbandi E, Mousavi-Roknabadi RS. Comparison the effects and side effects of Covid-19 vaccination in patients with inflammatory bowel disease (IBD): a systematic scoping review. BMC Gastroenterol 2022; 22:393. [PMID: 35987619 PMCID: PMC9392501 DOI: 10.1186/s12876-022-02460-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
Covid-19 is a pandemic disease that is more severe and mortal in people with immunodeficiency, such as those with inflammatory bowel disease (IBD). On the other hand, no definitive treatment has been identified for it and the best way to control it is wide spread vaccination. The aim of this study was to evaluate the benefits and side effects of different vaccines in patients with IBD. Three Electronic databases [Medline (accessed from PubMed), Scopus, Science Direct, and Cochrane] were searched systematically without time limit, using MESH terms and the related keywords in English language. We focused on the research studies on the effect and side effects of Covid-19 vaccination in patients with IBD. Articles were excluded if they were not relevant, or were performed on other patients excerpt patients with IBD. Considering the titles and abstracts, unrelated studies were excluded. The full texts of the remained studies were evaluated by authors, independently. Then, the studies' findings were assessed and reported. Finally, after reading the full text of the remained articles, 15 ones included in data extraction. All included studied were research study, and most of them (12/15) had prospective design. Totally, 8/15 studies were performed in single-center settings. In 8/15 studies, patients with IBD were compared with a control group. The results were summarized the in two categories: (1) the effect of vaccination, and (2) side effects. The effect of vaccination were assessed in 13/15 studies. Side effects of Covid-19 vaccination in patients with IBD were reported in 7/15 studies. Patients with IBD can be advised that vaccination may have limited minor side effects, but it can protect them from the serious complications of Covid-19 and its resulting mortality with a high success rate. They should be also mentioned in booster doses. Studies showed that the risk of developing Covid-19 is more worrying in people with immunocompromised conditions, such as inflammatory bowel disease (IBD). On the other hand, no definitive treatment has been identified for it and the best way to control it is wide spread vaccination. The results of this systematic scoping review revealed that patients with IBD can be advised that vaccination may have limited minor side effects, but it can protect these patients from the serious complications of Covid-19. Also, they should be also mentioned in booster doses.
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Roman I, Andreica I, Baraliakos X, Redeker I, Kiltz U, Braun J. SARS-CoV-2 vaccination willingness and predictors in patients with chronic inflammatory rheumatic diseases (CIRD) and without CIRD. Ther Adv Musculoskelet Dis 2022; 14:1759720X221093760. [PMID: 35707223 PMCID: PMC9189521 DOI: 10.1177/1759720x221093760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 03/24/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Recent surveys in chronic inflammatory rheumatic diseases (CIRD) showed a high degree of vaccine hesitancy. Current knowledge about patients’ attitudes toward vaccination against SARS-CoV-2 is limited. Objectives: To assess the willingness of CIRD patients to be vaccinated against SARS-CoV-2 and to identify the influencing factors compared with non-CIRD patients. Methods: In this cross-sectional study, two cohorts of consecutive patients with and without CIRD were recruited in parallel when presenting to our tertiary hospital and asked to answer questions of a structured interview to assess vaccination willingness to SARS-CoV-2 their experience with SARS-CoV-2 and their personal history of infections and vaccinations. Vaccination willingness was assessed using a numerical rating scale (0: fully disagree; 10: fully agree). Arbitrarily defined cut-offs were used to define definite (score ⩾7) and probable willingness (score of 5 or 6) to be vaccinated. Factors associated with willingness were assessed using Kendall’s tau-b correlation measure and linear regression analysis. Results: A total of 514 CIRD and 100 non-CIRD patients, mean age of 54.7 ± 12.8 and 55.6 ± 9.8 years, respectively, were included. Definite and probable willingness to be vaccinated against SARS-CoV-2 was declared by 79.6% and 90.7% versus 76.0% and 85.0% of CIRD and non-CIRD patients, respectively. Only 60% of CIRD patients believed that the vaccines against SARS-CoV-2 were safe, and 42% indicated to be afraid of side effects. Vaccination willingness was significantly correlated with being in a risk group for COVID-19 (tau-b = −0.149), hypertension (tau-b = 0.14), and information about disease prevention (tau-b = 0.19), while a history of infections or immunosuppressive therapy was not. Vaccination willingness was significantly associated with higher education (b = 0.65) and age (b = 0.06). Conclusion: This survey highlights several predictors of relevance for the vaccination willingness of patients with CIRD and controls including appropriate information about its relevance. The good news, however, is that the vast majority of CIRD patients indicated their willingness to be vaccinated. However, there was some uncertainty regarding the safety and efficacy of the vaccines. Since the major influencing factors were education and information about SARS-CoV-2 Vaccine and COVID-19 Disease, patient education should be improved soon.
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Affiliation(s)
| | | | - Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet, Herne, Germany
- Ruhr-University Bochum, Bochum, Germany
| | - Imke Redeker
- Rheumazentrum Ruhrgebiet, Herne, Germany
- Ruhr-University Bochum, Bochum, Germany
| | - Uta Kiltz
- Rheumazentrum Ruhrgebiet, Herne, Germany
- Ruhr-University Bochum, Bochum, Germany
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Widdifield J, Kwong JC, Chen S, Eder L, Benchimol EI, Kaplan GG, Hitchon C, Aviña-Zubieta JA, Lacaille D, Chung H, Bernatsky S. Vaccine effectiveness against SARS-CoV-2 infection and severe outcomes among individuals with immune-mediated inflammatory diseases tested between March 1 and Nov 22, 2021, in Ontario, Canada: a population-based analysis. THE LANCET RHEUMATOLOGY 2022; 4:e430-e440. [PMID: 35441151 PMCID: PMC9009845 DOI: 10.1016/s2665-9913(22)00096-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background We estimated COVID-19 vaccine effectiveness against SARS-CoV-2 infection and severe COVID-19 outcomes among individuals with immune-mediated inflammatory diseases in Ontario, Canada. Methods In this population-based analysis, we used a test-negative design across four immune-mediated inflammatory disease population-based cohorts, comprising individuals with rheumatoid arthritis, ankylosing spondylitis, psoriasis, and inflammatory bowel disease. We identified all SARS-CoV-2 tests done in these populations between March 1 and Nov 22, 2021 (a period in which there was rapid uptake of vaccines, and the alpha [B.1.1.7] and delta [B.1.617.2] SARS-CoV-2 variants were predominantly circulating in Canada) and separately assessed outcomes of SARS-CoV-2 infection and severe COVID-19 outcomes (hospitalisation due to COVID-19 and death due to COVID-19) for each disease group. We used multivariable logistic regression to estimate the effectiveness of one, two, and three doses of mRNA-based COVID-19 vaccine (BNT162b2 [Pfizer–BioNTech], or mRNA-1273 [Moderna]) among individuals at the time of SARS-CoV-2 testing. Findings Between March 1 and Nov 22, 2021, we identified 2127 (5·9%) test-positive cases among 36 145 individuals (26 476 [73·2%] were female and 9669 [26·8%] were male) with rheumatoid arthritis tested, 476 (6·1%) test-positive cases among 7863 individuals (4130 [52·5%] were female and 3733 [47·5%] were male) with ankylosing spondylitis tested, 3089 (6·5%) test-positive cases among 47 199 individuals (26 062 [55·2%] were female and 21 137 [44·8%] were male) with psoriasis tested, and 1702 (5·4%) test-positive cases among 31 311 individuals (17 716 [56·6%] were female and 13 595 [43·4%] were male) with inflammatory bowel disease tested. Adjusted vaccine effectiveness of two doses against infection was 83% (95% CI 80–86) in those with rheumatoid arthritis, 89% (83–93) among those with ankylosing spondylitis, 84% (81–86) among those with psoriasis, and 79% (74–82) among those with inflammatory bowel disease. After two vaccine doses, effectiveness against infection generally peaked 31–60 days after vaccination and waned gradually with each additional month. Vaccine effectiveness against severe outcomes after two doses was 92% (95% CI 88–95) in those with rheumatoid arthritis, 97% (83–99) among those with ankylosing spondylitis, 92% (86–95) among those with psoriasis, and 94% (88–97) among those with inflammatory bowel disease. Vaccine effectiveness after a third dose against infection was similar to or higher than after the second dose (ranging from 76% [47–89] to 96% [72–99]), although due to a paucity of events, estimates could not be calculated for some subgroups for severe outcomes. Interpretation Two vaccine doses were found to be highly effective against both SARS-CoV-2 infection and severe COVID-19 outcomes in patients with rheumatoid arthritis, ankylosing spondylitis, psoriasis, and inflammatory bowel disease during the study period. Research is needed to determine the durability of effectiveness of three doses over time, particularly against emerging variants. Funding Public Health Agency of Canada
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Affiliation(s)
- Jessica Widdifield
- Holland Bone & Joint Program, Sunnybrook Research Institute, Toronto ON, Canada
- ICES, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Jeffrey C Kwong
- ICES, Toronto, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Public Health Ontario, Toronto, Canada
| | | | - Lihi Eder
- Division of Rheumatology, University of Toronto, Toronto, ON, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Eric I Benchimol
- ICES, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
- SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
| | - Gilaad G Kaplan
- Department of Medicine and Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Carol Hitchon
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - J Antonio Aviña-Zubieta
- Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Vancouver, BC, Canada
| | - Diane Lacaille
- Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Vancouver, BC, Canada
| | | | - Sasha Bernatsky
- Divisions of Rheumatology and Clinical Epidemiology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
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Marrie RA, Dolovich C, Cutter GR, Fox RJ, Salter A. Attitudes toward coronavirus disease 2019 vaccination in people with multiple sclerosis. Mult Scler J Exp Transl Clin 2022; 8:20552173221102067. [PMID: 35634013 PMCID: PMC9131385 DOI: 10.1177/20552173221102067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/04/2022] [Indexed: 11/16/2022] Open
Abstract
Objective We estimated coronavirus disease 2019 (COVID-19) vaccination rates in the North American Research Committee on Multiple Sclerosis (NARCOMS) population and investigated reasons for vaccine hesitancy. Methods In Spring 2021, we surveyed the NARCOMS participants about COVID-19 vaccinations. Participants reported whether they had received any COVID-19 vaccination; if not, they reported why not. They also reported whether they had received influenza vaccination. Using multivariable logistic regression, we assessed participant characteristics associated with uptake of COVID-19 and influenza vaccines. Results Of 4955 eligible respondents, 3998 (80.7%) were females with a mean (SD) age of 64.0 (9.7) years. Overall, 4165 (84.1%) reported that they had received a COVID-19 vaccine, most often Pfizer-BioNTech and Moderna, and 3723 (75.4%) received a seasonal influenza vaccine. Reasons for not getting the COVID-19 vaccine included possible adverse effects (47.73%), possible lack of efficacy (13.7%), and lack of perceived need (17.1%). Factors associated with receiving the COVID-19 vaccine included receipt of influenza vaccine, older age, higher socioeconomic status, any leisure physical activity, and use of disease-modifying therapy. Conclusion In this older cohort of people with multiple sclerosis, COVID-19 vaccine uptake was high, exceeding uptake of seasonal influenza vaccine. Concerns regarding safety, efficacy, and lack of perceived risk were associated with not obtaining the COVID-19 vaccine.
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Affiliation(s)
- Ruth Ann Marrie
- Rady Faculty of Health Sciences, Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Casandra Dolovich
- Rady Faculty of Health Sciences, Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Gary R Cutter
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Robert J. Fox
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Amber Salter
- Department of Neurology, Section on Statistical Planning and Analysis, UT Southwestern Medical Center, Dallas, Texas, USA
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