Characteristics of emerging new autoimmune diseases after COVID-19 vaccination: A sub-study by the COVAD group

Russka Shumnalieva, Naveen Ravichandran, Jennifer Hannah, Mahnoor Javaid, Naitica Darooka, Debaditya Roy, Daniel e. Gonzalez, Tsvetelina Velikova, Marcin Milchert, Masataka Kuwana, Mrudula Joshi, Abraham edgar Gracia‐ramos, Peter Boyd, Praggya Yaadav, Karen Cheng, Linda Kobert, Lorenzo Cavagna, Parikshit Sen, Jessica Day, Ashima MakolCarlos enrique toro Gutiérrez, Carlo v. Caballero‐uribe, Sreoshy Saha, Ioannis Parodis, Dzifa Dey, Elena Nikiphorou, Oliver Distler, Esha Kadam, Ai lyn Tan, Samuel katsuyuki Shinjo, Nelly Ziade, Johannes Knitza, Hector Chinoy, Rohit Aggarwal, Vikas Agarwal, Latika Gupta

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Despite the overall safety and efficacy of COVID-19 vaccinations, rare cases of systemic autoimmune diseases (SAIDs) have been reported post-vaccination. This study used a global survey to analyze SAIDs in susceptible individuals' post-vaccination.

Methods
A cross-sectional study was conducted among participants with self-reported new-onset SAIDs using the COVID-19 Vaccination in Autoimmune Diseases (COVAD) 2 study dataset—a validated, patient-reported e-survey—to analyze the long-term safety of COVID-19 vaccines. Baseline characteristics of patients with new-onset SAIDs and vaccinated healthy controls (HCs) were compared after propensity score matching based on age and sex in a 1:4 ratio.

Results
Of 16 750 individuals, 74 (median age 52 years, 79.9% females, and 76.7% Caucasians) had new-onset SAID post-vaccination, mainly idiopathic inflammatory myopathies (IIMs) (n = 23, 31.51%), arthritis (n = 15; 20.53%), and polymyalgia rheumatica (PMR) (n = 12, 16.40%). Higher odds of new-onset SAIDs were noted among Caucasians (OR = 5.3; 95% CI = 2.9–9.7; p < .001) and Moderna vaccine recipients (OR = 2.7; 95% CI = 1.3–5.3; p = .004). New-onset SAIDs were associated with AID multimorbidity (OR = 1.4; 95% CI = 1.1–1.7; p < .001), mental health disorders (OR = 1.6; 95% CI = 1.3–1.9; p < .001), and mixed race (OR = 2.2; 95% CI = 1.2–4.2; p = .010), where those aged >60 years (OR = 0.6; 95% CI = 0.4–0.8; p = .007) and from high/medium human development index (HDI) countries (compared to very high HDI) reported fewer events than HCs.

Conclusion
This study reports a low occurrence of new-onset SAIDs following COVID-19 vaccination, primarily IIMs, PMR, and inflammatory arthritis. Identified risk factors included pre-existing AID multimorbidity, mental health diseases, and mixed race. Revaccination was well tolerated by most patients; therefore, we recommend continuing COVID-19 vaccination in the general population. However, long-term studies are needed to understand the autoimmune phenomena arising post-vaccination.
Original languageEnglish
Article numbere15178
JournalInternational Journal Of Rheumatic Diseases
Volume27
Issue number5
Early online date14 May 2024
DOIs
Publication statusPublished - May 2024

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