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Herpes zoster reactivation after mRNA-1273 vaccination in patients with rheumatic diseases
  1. Tai-Ju Lee,
  2. Cheng-Hsun Lu,
  3. Song-Chou Hsieh
  1. Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  1. Correspondence to Professor Song-Chou Hsieh, Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan; hsiehsc{at}

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The SARS-CoV-2 vaccination is one of the major strategies against the COVID-19 pandemic. The novel platforms of vaccines were developed to replace the time-consuming traditional vaccine manufacturing process, but this worldwide campaign raises new safety issues. A new panel of adverse events was recently reported at nation-wide registry levels.1 However, the information is very limited in patients with rheumatic diseases, who potentially have increased risks of adverse events due to immune dysregulation or concomitant therapies.

We retrospectively collected the diseases, immunomodulators, types of vaccines and adverse events from patients receiving at least one dose of primary SARS-CoV-2 vaccine at rheumatology clinics of a tertiary referral centre in Taiwan. The data were analysed using the Fisher’s exact test for dichotomous variables and Wilcoxon rank sum test for continuous variables. Between July 2021 and September 2021, 265 patients were enrolled, including patients with Sjogren’s syndrome (n=49), rheumatoid arthritis (n=34), systemic lupus erythematosus (n=33), spondyloarthritis (n=21) and other rheumatic diseases (online supplemental table S1). Eighty-nine (33.7%) patients received ChAdOx1 nCoV-19 (AZD1222) vaccine (AstraZeneca/Oxford) and 176 (66.3%) received mRNA-1273 (Moderna) vaccines. The median (IQR) ages were 50 years (39, 60) in AZD1222 and 58 years …

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  • Handling editor Josef S Smolen

  • Contributors All authors were involved in collecting patients' data and executing the study. S-CH and T-JL drafted the manuscript. T-JL performed the statistical analysis. C-HL gave critical inputs.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.