Safety and Health Care Use Following COVID-19 Vaccination Among Adults With Rheumatoid Arthritis: A Population-Based...

Area of Science:

• Immunology
• Rheumatology
• Vaccinology

Background:

• Rheumatoid arthritis (RA) is an autoimmune disease impacting joints.
• COVID-19 vaccines are crucial for protecting vulnerable populations.
• Understanding vaccine safety in RA patients is essential.

Purpose of the Study:

• To assess the association between COVID-19 vaccination and adverse events of special interest (AESIs) in adults with RA.
• To evaluate healthcare utilization, including emergency department visits and hospitalizations, following COVID-19 vaccination in RA patients.

Main Methods:

• A self-controlled case series (SCCS) analysis was performed on adults with RA who received at least one COVID-19 vaccine.
• Relative incidence (RI) rates of AESIs and healthcare use were calculated in 21-day periods post-vaccination compared to control periods.
• A matched non-RA comparator group was used to compare AESI risk between RA and non-RA populations.

Main Results:

• No increased risk of AESIs was observed in RA patients following COVID-19 vaccination compared to control periods.
• Emergency department visits increased after the second dose but decreased after the third dose in RA patients.
• Hospitalizations were lower across all doses, and rheumatology visits increased after the first dose but decreased after subsequent doses.
• RA patients showed a higher AESI risk after dose 3 compared to non-RA comparators, but experienced fewer ED visits and hospitalizations after dose 4.

Conclusions:

• COVID-19 vaccination in RA patients is not associated with an increased risk of AESIs.
• Healthcare utilization patterns varied by dose, with an overall trend towards reduced hospitalizations and ED visits in RA patients post-vaccination.
• While a slight increase in AESI risk was noted after dose 3 compared to controls, the overall safety profile remains favorable.