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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.

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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.

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