Does COVID-19 vaccination affect rheumatic and musculoskeletal disease flares?

In a study of 1,377 patients with rheumatic and musculoskeletal diseases—such as inflammatory arthritis and lupus—flares of their conditions were uncommon following two-dose COVID-19 mRNA vaccination. In a study of 1,377 patients with rheumatic and musculoskeletal diseases—such as inflammatory arthritis and lupus—flares of their conditions were uncommon following two-dose COVID-19 mRNA vaccination.

In the Arthritis & Rheumatology study, 11% of patients reported flares after vaccination that required treatment, and there were no reports of severe flares. Flares were associated with prior SARS-CoV-2 infection, flares in the six months preceding vaccination, and use of combination immunomodulatory therapy.

"'Our findings demonstrate that the vaccines are safe and should alleviate the safety concerns of any hesitant patients," said first author Caoilfhionn Connolly, MD, MSc, of Johns Hopkins University School of Medicine. "This study highlights that most of our rheumatic patients tolerated the vaccine well with mostly having local reactions such as injection site pain, which was quite reassuring, but most importantly, we did not observe any severe flares of their underlying autoimmune disease," added co–senior author Julie J. Paik, MD, MHS, also of Johns Hopkins University School of Medicine.