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  1. K. Kunalchandwar@gmail.Com1,
  2. K. Kishor1,
  3. J. Dixit1,
  4. P. Dogga1,
  5. D. Ekbote1,
  6. P. Kumar1,
  7. U. Dhakad1
  1. 1King George’s Medical University, Clinical Immunology and Rheumatology, Lucknow, India


Background Vaccination is one of the most significant public health achievements; however, the success has been marred with vaccine hesitancy. The reasons for vaccine hesitancy are neither singular nor straightforward and arise from a complex interplay between scientific, religious and political beliefs. This study aims to understand the possible reasons for vaccine hesitancy in patients with autoimmune rheumatic diseases and the effectiveness of Specialist counselling on vaccine-hesitant patients willingness to take the vaccine.

Objectives 1. To assess causes of Vaccine hesitancy against COVID-19 vaccines in patients with autoimmune rheumatic diseases.

2. To study the effect of specialist counselling on vaccine-hesitant patients willingness to take vaccine.

Methods Study design: We conducted an observational survey-based in person cross-sectional study. Patients attending a tertiary care hospital’s outpatient department were asked about their vaccination status. Those unvaccinated were asked reasons for vaccine hesitancy The vaccine-hesitant patients were counselled by the treating rheumatologist and asked regarding their willingness to take the vaccine after the counselling. The patient responses were recorded.

Sample: Convenience sampling was used, so the sample size was not calculated.

Inclusion and exclusion criteria: All adults(>18yrs) with AIRD coming to the rheumatology OPD. Those vaccinated, recently infected(within 6 weeks), and non-AIRD patients were excluded.

Data collection: The questionnaire included patients’ demographic details, Diagnosis, medication details, and response to the reason for vaccine hesitancy.

Statistical analysis: Descriptive statistics were performed by calculating measures of central tendency for quantitative variables and using counts and percentages for qualitative and nominal variables.

Results A total of 322 patients participated in the study with a mean age of 40 years(18-76), with 73%(234) females and 27%(88) males. Most patients had Rheumatoid Arthritis(40%) followed by SPA (27%), SLE(13%) and others and may were on immunosuppressive medications(95%). A significant proportion of patients(60%) had more than one reason for vaccine hesitancy. Almost 60% of the respondents feared their disease might flare post-vaccination, while almost half(44.4%) were hesitant to take the vaccine due to the fear of vaccine side effects and more than one third (35%) feared vaccine may not be effective on them as they were on immunosuppressive medications. Other major causes of vaccine hesitancy were the inability to get a chance to get vaccinated (18%), doubts about vaccine efficacy (15%), and fear of injections (10%).Most patients(91%) were willing to take the vaccine after specialist counselling and only 28 of the 322 (9%) were unwilling even after specialist counselling.

Conclusion Vaccine hesitancy can be multifactorial. Major reasons for vaccine hesitancy in patients with autoimmune rheumatic diseases were fear of flare of disease post-vaccination, fear of vaccine side effects and doubts whether the vaccine would work in patients taking immunosuppressive medications. Most patients were willing to take vaccine after counselling by a rheumatologist.

Disclosure of Interests None declared

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