The Flare-up of Rheumatic Autoimmune Diseases Following COVID-19 Vaccination

Maryam  Sahebari; Fahimeh  Otani; Zahra  Rezaieyazdi; Masoumeh  Salari; Zahra  Mirfeizi; Rozita  Khodashahi; Moeid Reza  Alipour; Muhammed  Joghatayi; Hassan  Mehrad Majd; Mandana   Khodashahi

doi:10.18502/jimc.v8i1.17059

Maryam Sahebari Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Fahimeh Otani Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Zahra Rezaieyazdi Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Masoumeh Salari Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Zahra Mirfeizi Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Rozita Khodashahi Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Moeid Reza Alipour Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Muhammed Joghatayi Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Hassan Mehrad Majd Clinical Research Development Unit, Faculty of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Mandana Khodashahi Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

DOI: https://doi.org/10.18502/jimc.v8i1.17059

Keywords: COVID-19 vaccines, Iran, Rheumatology, Rheumatic diseases, Vaccination

Abstract

Background: Individuals with Autoimmune Rheumatic Disease (AIRD) are vulnerability to severe SARS-CoV-2 outcomes and vaccination. The present study aimed to determine the incidence of AIRDs flares following COVID-19 vaccination and its risk factors.

Methods: The study was retrospective cross-sectional focused on patients with AIRD who experienced a flare-up at least during 30 days after receiving the COVID-19 vaccine. These patients were seen at Rheumatology Clinics at Imam Reza and Ghaem Hospitals, affiliated with Mashhad University of Medical Sciences, as well as private clinics in Mashhad, Iran, over a period of 1 years.

Results: The rate of recurrence following COVID-19 vaccination was estimated to be 3.16%. Rheumatoid arthritis (18.9%), systemic lupus erythematosus (12.9%), and cutaneous vasculitis (10.6%) were the most frequent AIRDs among patients who experienced a flare-up following COVID-19 vaccination. More than 85% of patients who were vaccinated with AstraZeneca experienced a flare-up after the first dose of vaccination. In the majority of patients, the flare-up occurred after the first dosage of COVID-19 vaccination.

Conclusion: In Mashhad, Iran, the incidence of flare-ups in autoimmune and inflammatory rheumatic diseases following COVID-19 vaccination is estimated to be a mere 3%. Despite their rarity, flare-ups in autoimmune and inflammatory rheumatic diseases post-COVID-19 vaccination can still pose a public health issue, potentially undermining public confidence in vaccinations.