Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Feb;51(1):75-92.
doi: 10.1016/j.rdc.2024.08.005. Epub 2024 Oct 15.

Flares of Systemic Autoimmune Rheumatic Disease Following Coronavirus Disease 2019 Vaccination: A Narrative Review

Genna Braverman  1 , Medha Barbhaiya  2 , Minerva Nong  3 , Lisa A Mandl  2
Affiliations
Review

Flares of Systemic Autoimmune Rheumatic Disease Following Coronavirus Disease 2019 Vaccination: A Narrative Review

Genna Braverman et al. Rheum Dis Clin North Am. 2025 Feb.

Abstract

This narrative review summarizes current evidence on the risk of systemic autoimmune rheumatic disease (SARD) flare following coronavirus disease 2019 vaccination. The authors detail key studies in the literature employing diverse methodologies, including cross-sectional surveys, prospective and retrospective cohorts, case-crossover designs, self-controlled case series, and systematic reviews. Data are reassuring, suggesting that vaccination is unlikely to increase the risk of flares across a range of SARD. When postvaccination flares do occur, individuals with high disease activity and frequent flares at baseline may be at higher risk. Rheumatologists may consider discussing these findings with patients during collaborative conversations about risks and benefits of vaccination.

Keywords: Coronavirus disease 2019 vaccination; Federal Drug Agency; Post-vaccination flare; Rheumatologists; Systemic autoimmune rheumatic disease; Systemic autoimmune rheumatic disease flare.

PubMed Disclaimer

Conflict of interest statement

Disclosure G. Braverman and M. Nong have no disclosures. M. Barbhaiya is supported by the Rheumatology Research Foundation, United States Investigator Award. L.A. Mandl receives research support from Regeneron Pharmaceuticals, United States and payments from UpToDate, unrelated to this work. L.A. Mandl works as an associate editor for Annals of Internal Medicine.

Similar articles

See all similar articles

References

    1. Jackson LA, Anderson EJ, Rouphael NG, et al. An mRNA vaccine against SARS-CoV-2 - preliminary report. N Engl J Med 2020;383(20):1920–31. - PMC - PubMed
    1. World Health Organization. WHO coronavirus (COVID-19) dashboard: COVID-19 vaccination, World Data. Available at: https://data.who.int/dashboards/covid19/vaccines. Accessed May 29, 2024.
    1. Baden LR, El Sahly HM, Essink B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 VACCINE. N Engl J Med 2021;384(5):403–16. - PMC - PubMed
    1. Polack FP, Thomas SJ, Kitchin N, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med 2020;383(27):2603–15. - PMC - PubMed
    1. Curtis JR, Johnson SR, Anthony DD, et al. American College of Rheumatology Guidance for COVID-19 vaccination in patients with rheumatic and musculoskeletal diseases: version 5. Arthritis Rheumatol 2023;75(1):E1–16. - PMC - PubMed

Publication types

MeSH terms

Substances