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. 2023 Oct 3;62(10):3291-3301.
doi: 10.1093/rheumatology/kead057.

Vaccine hesitancy decreases in rheumatic diseases, long-term concerns remain in myositis: a comparative analysis of the COVAD surveys

Parikshit Sen  1 , Naveen R  2 , Nazanin Houshmand  3 , Siamak Moghadam Kia  4 , Mrudula Joshi  5 , Sreoshy Saha  6 , Kshitij Jagtap  7 , Vishwesh Agarwal  8 , Arvind Nune  9 , Elena Nikiphorou  10   11 , Ai Lyn Tan  12   13 , Samuel Katsuyuki Shinjo  14 , Nelly Ziade  15   16 , Tsvetelina Velikova  17 , Marcin Milchert  18 , Ioannis Parodis  19   20 , Abraham Edgar Gracia-Ramos  21 , Lorenzo Cavagna  22 , Masataka Kuwana  23 , Johannes Knitza  24 , Ashima Makol  25 , Aarat Patel  26 , John D Pauling  27   28 , Chris Wincup  29   30 , Bhupen Barman  31 , Erick Adrian Zamora Tehozol  32 , Jorge Rojas Serrano  33 , Ignacio García-De La Torre  34 , Iris J Colunga-Pedraza  35 , Javier Merayo-Chalico  36 , Okwara Celestine Chibuzo  37 , Wanruchada Katchamart  38 , Phonpen Akawatcharangura Goo  39 , Russka Shumnalieva  40 , Yi-Ming Chen  41   42 , Leonardo Santos Hoff  43 , Lina El Kibbi  44 , Hussein Halabi  45 , Binit Vaidya  46 , Syahrul Sazliyana Shaharir  47 , A T M Tanveer Hasan  48 , Dzifa Dey  49 , Carlos Enrique Toro Gutiérrez  50 , Carlo Vinicio Caballero-Uribe  51 , James B Lilleker  52   53 , Babur Salim  54 , Tamer Gheita  55 , Tulika Chatterjee  56 , Oliver Distler  57 , Miguel A Saavedra  58 , Jessica Day  59   60   61 , Hector Chinoy  52   62   63 ; COVAD Study Group; Vikas Agarwal  2 , Rohit Aggarwal  64 , Latika Gupta  52   65   66
Collaborators, Affiliations
Free article

Vaccine hesitancy decreases in rheumatic diseases, long-term concerns remain in myositis: a comparative analysis of the COVAD surveys

Parikshit Sen et al. Rheumatology (Oxford). .
Free article

Abstract

Objective: COVID-19 vaccines have a favorable safety profile in patients with autoimmune rheumatic diseases (AIRDs) such as idiopathic inflammatory myopathies (IIMs); however, hesitancy continues to persist among these patients. Therefore, we studied the prevalence, predictors and reasons for hesitancy in patients with IIMs, other AIRDs, non-rheumatic autoimmune diseases (nrAIDs) and healthy controls (HCs), using data from the two international COVID-19 Vaccination in Autoimmune Diseases (COVAD) e-surveys.

Methods: The first and second COVAD patient self-reported e-surveys were circulated from March to December 2021, and February to June 2022 (ongoing). We collected data on demographics, comorbidities, COVID-19 infection and vaccination history, reasons for hesitancy, and patient reported outcomes. Predictors of hesitancy were analysed using regression models in different groups.

Results: We analysed data from 18 882 (COVAD-1) and 7666 (COVAD-2) respondents. Reassuringly, hesitancy decreased from 2021 (16.5%) to 2022 (5.1%) (OR: 0.26; 95% CI: 0.24, 0.30, P < 0.001). However, concerns/fear over long-term safety had increased (OR: 3.6; 95% CI: 2.9, 4.6, P < 0.01). We noted with concern greater skepticism over vaccine science among patients with IIMs than AIRDs (OR: 1.8; 95% CI: 1.08, 3.2, P = 0.023) and HCs (OR: 4; 95% CI: 1.9, 8.1, P < 0.001), as well as more long-term safety concerns/fear (IIMs vs AIRDs - OR: 1.9; 95% CI: 1.2, 2.9, P = 0.001; IIMs vs HCs - OR: 5.4 95% CI: 3, 9.6, P < 0.001). Caucasians [OR 4.2 (1.7-10.3)] were likely to be more hesitant, while those with better PROMIS physical health score were less hesitant [OR 0.9 (0.8-0.97)].

Conclusion: Vaccine hesitancy has decreased from 2021 to 2022, long-term safety concerns remain among patients with IIMs, particularly in Caucasians and those with poor physical function.

Keywords: COVID-19 vaccines; autoimmune disease; idiopathic inflammatory myopathies; registries; vaccine hesitancy.

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