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Letter
Systemic rheumatic disease flares after SARS-CoV-2 vaccination among rheumatology outpatients in New York City
  1. Medha Barbhaiya1,2,
  2. Jonah M. Levine3,
  3. Vivian P. Bykerk1,4,
  4. Deanna Jannat-Khah1,4,
  5. Lisa A. Mandl1,2
  1. 1 Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA
  2. 2 Department of Medicine and Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
  3. 3 Hospital for Special Surgery, New York, New York, USA
  4. 4 Department of Medicine, Weill Cornell Medical College, New York, New York, USA
  1. Correspondence to Dr Medha Barbhaiya, Division of Rheumatology, Hospital for Special Surgery, New York, NY 10021-4898, USA; barbhaiyam{at}hss.edu

https://doi.org/10.1136/annrheumdis-2021-220732

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    Vaccination against SARS-CoV-2 is crucial for patients with systemic rheumatic diseases (SRDs), who may be at increased risk of severe outcomes post-COVID-19.1 However, as patients with SRDs were not included in the mRNA vaccine trials (ie, Pfizer/BioNTech (BNT162b2) and Moderna (mRNA-1273)), no data exist regarding whether these vaccines might trigger SRD flares. Sparse data suggest that other vaccines may be associated with SRD flares,2 3 possibly from molecular mimicry triggering immune activation or non-specific adjuvant effects. As SRD flares are associated with disease deterioration, increased flares could have serious clinical implications.4

    We report the interim results of a web-based survey evaluating SRD flare incidence post-SARS-CoV-2 vaccine. The survey was e-mailed 5 March 2021 to 3545 outpatients with SRDs seen at a large rheumatology division in New York City. ICD-10 algorithms were used to identify SRDs (online supplemental material). A self-reported disease flare was defined as ‘a sudden worsening of your rheumatology condition or arthritis’ within 2 weeks of the vaccine.

    Supplemental material

    [annrheumdis-2021-220732supp001.pdf]

    As of 12 April 2021, out of 1483 respondents (41.8% response rate), 1101 patients (74.2%) with SRDs reported receiving at least one dose of a SARS-CoV-2 vaccine and provided flare data (mean age: 60.8 years (14.2 years); 80.6% female; …

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