Abstract

BackgroundRecent surveys in chronic inflammatory rheumatic diseases (CIRD) showed a high degree of vaccine hesitancy. Current knowledge about patients’ attitudes towards vaccination against SARS-CoV-2 is limited.ObjectivesTo assess the willingness of CIRD patients to be vaccinated against SARS-CoV-2 and to identify influencing factors compared to non-CIRD patients.MethodsIn this cross-sectional study, two cohorts of consecutively in parallel recruited patients with and without CIRD presenting to our tertiary hospital answered questions of a structured interview to assess vaccination willingness to SARS-CoV-2, experience with SARS-CoV2 in their environment and their personal history of infections and vaccinations. Vaccination willingness was assessed by a numerical rating scale (0: fully disagree; 10: fully agree). Arbitrarily defined cut-offs were used to define definite (score ≥7) and probable willingness (scores of 5 or 6) to be vaccinated. Statistical analyses were performed with appropriate tests such as Kendall-tau b.ResultsA total of 514 CIRD and 100 non-CIRD patients, mean age 54.7±12.8 and 55.6±9.8 years, were included. Definite and probable willingness to be vaccinated against SARS-CoV-2 was declared by 79.6% and 90.7% vs. 76.0% and 85.0% of CIRD and non-CIRD patients, respectively. Only 60% of CIRD patients believed that the vaccines against SARS-CoV-2 were safe, and 42% indicated to be afraid of side effects. Vaccination willingness correlated significantly with the degree of education, age, identification with a risk group for COVID-19 disease, hypertension, and the degree of information about preventable diseases. There was no correlation with the history of infections or with immunosuppressive therapy.ConclusionAlthough our results show a high willingness for vaccination against SARS-CoV-2 in both groups, there was quite some uncertainty regarding the safety and efficacy of the vaccines. Since major influencing factors were education and information about SARS-CoV-2 and COVID-19, patient education should be immediately improved.Table 1.Patient demographics, disease characteristics and infection historyCIRD patientsNon-CIRD patientsMissing values of CIRD and non-CIRD patients No. (%)Group differences p-valueAge (years), mean (SD)54.7 ± 12.855.6 ± 9.800Women, No. (%)315 (61.3)83 (83)00Body mass index (BMI, kg/m2), mean (SD)27.9 ± 5.930.4 ± 7.800CIRD, No. (%)192 (37.3)0Rheumatoid arthritis134 (26)Axial spondyloarthritis72 (14)Psoriatic arthritis116 (22.6) Connective tissue disease/vasculitisDisease duration (years), mean (SD)9.8 ± 8.94.0 ± 6.500Therapy, No. (%)316 (61.5)0 bDMARDs147 (28.6) csDMARDs33 (6.4) tsDMARDs18 (3.5) no DMARDsHistory of a positive SARS-CoV-2 PCR test No. (%)22 (4.3)5 (5.0)3 (0,6)5 (5)0.79History of recurrent infection No. (%)54 (10.5)16 (16.0)1 (0.2)00.12History of severe infection No. (%)23 (4.5)13 (13.0)3 (0.6)00.004Educational level, No. (%)9 (9.3)35 (6.8)3 (3)0.13 low (< 8 years)50 (10.4)67 (69.1) moderate (8 to 12 years)275 (57.4)21 (21.6) high (> 12 years)154 (32.2)BMI body mass index, SD standard deviation, no number, DMRD Disease Modifying Anti-Rheumatic Drugs, b biological, ts targeted synthetic, cs conventional syntheticFigure 1.Vaccination willingness of CIRD patientsAcknowledgementsWe wish to thank all persons who participated in the current study.Furthermore, we thank Dr. Styliani Tsiami, Tanja Kobylinski and the clinical departments for assisting with recruitment of participants.Disclosure of InterestsNone declared

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