AB1331 COVID VACCINATION AND ADVERSE REACTIONS AMONG PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES: WHAT IS THE RHEUMATOLOGIST’S ROLE?

Abstract

BackgroundSince 2021, EULAR has advocated for the vaccination of patients with rheumatic and musculoskeletal diseases [1]. However, there is significant patient hesitancy, and it is often attributed to concern regarding vaccine adverse events (AEs) [2]. Idiopathic inflammatory myopathies (IIMs) are an example of rare rheumatic conditions in which population-specific data is limited and rheumatologists may play vital role in a vaccine discussion.ObjectivesOur aim was to evaluate COVID vaccination and AEs rates in patients with IIM and determine whether rheumatologist-initiated vaccine discussions correlated with patient vaccination rates.MethodsThe Montefiore Medical Center Myositis registry was created from patients that met 2017 EULAR/ACR classification criteria for IIM. Patients without a history of rheumatology care at our hospital or those who had died prior to COVID vaccines availability were excluded. Demographics and IIM subtype were documented. Vaccination details, including vaccination type and number, were recorded. Medical records were reviewed for minor and major vaccine AEs and documentation by a rheumatologist of COVID vaccine discussion. The presence of fever, headache, fatigue, or pain at injection site within 2 weeks of vaccine administration was considered a minor vaccine AE. The presence of anaphylaxis, Guillen Barre Syndrome, myocarditis, pericarditis, death or IIM flare within 3 months of vaccination administration was defined as a major AE. Statistical analyses included two-sample t-test, Chi-square tests or Fisher’s exact tests.ResultsOf 153 within the registry, 116 met inclusion criteria. 81 of 116 (70%) of patients had received at least one COVID vaccination. Demographics (age, sex, race, ethnicity) were similar between vaccinated and unvaccinated patients. Of the vaccinated patients, all had received the primary series, 69% (56/81) had received a booster, and only 7% had received the primary, booster, and bivalent series. Overall, the rates of minor and major AEs were 17% and 2%, respectively. There were no differences in AEs based on the vaccine type (Pfizer, Moderna, or Janssen). However, it was more likely for patients to have minor AEs after receiving a booster vaccine in comparison to the primary or bivalent series, regardless of vaccine type (p=0.02). 7% (6/81) patients experienced a flare within 3 months of vaccination.In total, 38/116 (33%) of IIM patients had a documented COVID vaccine discussion with their rheumatologist. Of those patients who discussed the vaccine, 34 (89%) received at least one COVID vaccine while only 60% (47/78) of the patients who had not discussed vaccination were vaccinated (Figure 1).ConclusionWhile majority of IIM patients have received the primary series, the booster and bivalent series are much less prevalent. IIM patients whose rheumatologist discussed vaccination were more likely to be vaccinated. This signifies the importance of rheumatologist-initiated vaccine discussions. We reported less minor AEs and the same frequency of major AEs as larger, self-reported IIM studies. The low prevalence of AEs and IIM flares may be a tool in the rheumatologist-led vaccination discussion.