Vaccine hesitancy decreases in rheumatic diseases, long-term concerns remain in myositis: a comparative analysis of the COVAD surveys
Parikshit Sen, R Naveen, Nazanin Houshmand, Siamak Moghadam‐Kia, Mrudula Joshi, Sreoshy Saha, Kshitij Jagtap, Vishwesh Agarwal, Arvind Nune, Elena Nikiphorou, Ai Lyn Tan, Samuel Katsuyuki Shinjo, Nelly Ziadé, Tsvetelina Velikova, Marcin Milchert, Ioannis Parodis, Abraham Edgar Gracia‐Ramos, Lorenzo Cavagna, Masataka Kuwana, Johannes Knitza, Ashima Makol, Aarat Patel, John D Pauling, Chris Wincup, Bhupen Barman, Erick Adrian Zamora Tehozol, Jorge Rojas‐Serrano, Ignacio García-De La Torre, I. J. Colunga-Pedraza, Javier Merayo‐Chalico, Okwara Celestine Chibuzo, Wanruchada Katchamart, Phonpen Akawatcharangura Goo, Russka Shumnalieva, Yi‐Ming Chen, Leonardo Santos Hoff, Lina El Kibbi, Hussein Halabi, Binit Vaidya, Syahrul Sazliyana Shaharir, A T M Tanveer Hasan, Dzifa Dey, Carlos Enrique Toro Gutiérrez, Carlo V. Caballero‐Uribe, James B Lilleker, Babur Salim, Tamer A. Gheita, Tulika Chatterjee, Oliver Distler, Miguel Ángel Saavedra, Jessica Day, Hector Chinoy, COVAD Study Group, Sinan Kardeş, Laura Andréoli, Daniele Lini, Karen Screiber, Melinda Nagy Vince, Yogesh Preet Singh, Rajiv Ranjan, Avinash Jain, Sapan C Pandya, Rakesh Kumar Pilania, Aman Sharma, Manesh Manoj, Vikas Gupta, Chengappa Kavadichanda, Pradeepta Sekhar Patro, Sajal Ajmani, Sanat Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha Shenoy, Ajay Asranna, Keerthi Talari Bommakanti, Anuj Shukla, Arun K. Pande, Kunal Chandwar, Akanksha Ghodke, Hiya Boro, Zoha Zahid Fazal, Döndü Üsküdar Cansu, Reşit Yıldırım, Armen Yuri Gasparyan, Nicoletta Del Papa, Gianluca Sambataro, Fabiola Atzeni, Marcello Govoni, Simone Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico Fusaro, Marco Sebastiani, Luca Quartuccio, Franco Franceschini, Pier Paolo Sainaghi, Giovanni Orsolini, Rossella De Angelis, Maria Giovanna Danielli
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.