A new study published in the journal Rheumatology found that disease flares occurred in 1 in 10 individuals with autoimmune rheumatic diseases (AIRDs) following COVID-19 vaccination, particularly those with comorbidities and mental health disorders.1 Characterized by chronic inflammation, rheumatoid arthritis (RA) and systemic lupus erythematosis (SLE) are among the most well-known AIRDs.2
Following up on concerns among AIRDs patients about potential flares following COVID shots, the study’s researchers investigated the incidence, predictors and patterns of flares following administration of the shots in individuals diagnosed with AIRDs They used the global COVID-19 Vaccination in Autoimmune Diseases (COVAD) surveys to conduct the study.3 Symptoms of flares included the appearance of new clinical signs such as rash, muscle weakness, joint pain or swelling, digital ulcers, shortness of breath, chest pain, dysphagia (speech difficulty), fever, fatigue, and active kidney disease.
In a joint statement, researchers Kshitij Jagtap, MD, Parikshit Sen, MBBS, and Latika Gupta, MD, said:
Disease flares are one of the prominent concerns that patients with rheumatic diseases have, as these episodes are often accompanied by disabling symptoms that affect their day-to-day activities and quality of life. This has been one of the reasons why many of these patients are reluctant to get vaccinated against COVID-19, as there is a lingering fear that vaccines may precipitate these flares. Unfortunately, there were very few studies that had investigated this relationship between COVID-19 vaccines and disease flares and thus there was no credible data to alleviate these concerns.4
An earlier study conducted in 2022 to examine the association between COVID shots and AIRD flares had showed no link between the two.5 6
Moderna’s mRNA COVID Shot Caused More Disease Flare Ups
Surveys for participants in the most recent study included 36 questions regarding COVID shots and the AIRD state of each patient. Participants were asked to identify their demographic information, type of disease they had, length of disease, clinical symptoms and their current medications.
There were a total of 15,165 responses, out of which 3,453 patients reported an incidence of disease flares. The findings showed that the incidence of disease flares was 11.3 percent, with arthritis (61.6 percent) and fatigue (58.8 percent) being the most common symptoms reported by patients.
The risk factors for the development of flares were the presence of multiple comorbidities and underlying mental health disorders. The findings also showed that patients who received Moderna/NIAID’s Spikevax messenger RNA (mRNA) COVID shot flared up more than patients who received COVID shots from other vaccine manufacturers.7
The overall incidence of flares in this study was higher than that found in previous studies. In one study, an online survey of 5,619 adults with systemic rheumatic diseases reported 4.9 percent flares that required a modification in their treatment.8 Another study from the EULAR-COVAX registry had 4.4 percent physician-reported flares in 5,121 patients with rheumatic disorders.9