Abstract

Background:Over 2 million deaths from the COVID-19 disease have been reported in the world. Since no antiviral treatment is available, the vaccination is the most important option to fight the SARS-CoV-2 infection. Patients living with rheumatoid arthritis (RA) affecting the immune system or under immunosuppressive agent will be considered as a high risk population and will start the vaccination shortly. But many patients could decline the vaccine for several reasons including safety concerns.Objectives:The aim of this study is to evaluate the proportion of patients with RA who are favourable to COVID-19 vaccination, to know the reasons to decline and to analyse the characteristics of these patients.Methods:We included patients with RA from the UCLouvain Brussels cohort who met the ACR/EULAR 2010 classification criteria. A simple and standard questionnaire was distributed to patients who attended rheumatology out patient and day care clinic from 14 december 20 to 14 januari 21. All patient and RA characteristics (Age, gender, education, smoking habits, disease duration, ACPA, RF, DAS28-CRP, HAQ and therapies) were collected at the same time.Results:Data from 460 eligible RA patients were analyzed. The average age of the population is 58.21 years. 72% of the patients are women. 21% are smokers and 65% are positive for anti-citrullinated protein antibody (ACPA) with a mean DAS28-CRP of 2.39 and a mean HAQ of 0.821.281 patients (61%) indicated they would receive the vaccine as soon as it is available. For the 179 patients (39%) who decline, the reasons for not having vaccine were no trust in the vaccine at this time (53%), fear of side effects (28%), opposition to vaccine (4%), previous SARS-CoV-2 infection (2%) and unknown (5%),Interestingly, there were differences among RA patients not willing to receive the vaccine. Patient under the age of 50, women, low education grade, smokers, presence of RF/ACPA and treatment with a bioDMARD were less willing to receive the vaccine. No differences were observed for RA disease duration, HAQ and DAS28-CRP (see Table 1).Table 1.Characteristics of RA population and correlation between groups.TOTALn=460VACCIN-YESn=281 (61%)VACCIN-NOn=179 (39%)Age, mn58,21 +/-0,7160,37 ± 0,900454,82 ± 1,090p=0.0001*Group Age <30 yrs25 (5%)15 (5%)10 (6%)Group Age =31-50 yrs112 (24%)53 (19%)59 (33%)Group Age =51-70 yrs209 (45%)127 (45%)82 (46%)Group Age > 70 yrs114 (25%)86 (31%)28 (16%)p=0.0003**Gender, F/M, %-F332/128(F-72%)193/88(F-69%)139/40(F-78%)p=0.043**Educ0-163 (15%)27 (11%)36 (22%)Educ2-3349 (85%)222 (89%)127 (78%)p=0.003**RA Disease duration yrs, mn14,77 +/-0,5115,24 +/-0,6914,04 +/-0,73Smokers: YES/NO/Ex-Smokers, %-YES85/248/79 (21%)42/156/52 (17%)43/92/27 (27%)p=0.018**RF YES/NO, %243/137 (64%)133/94 (59%)110/43 (72%)p=0.009**ACPA YES/NO, %244/132 (65%)127/93 (58%)117/39 (75%)p=0.001**HAQ, mn0,814+/-0,0390,797+/-0,0510,838+/-0,061DAS28-CRP, mn2,39+/-0,052,35+/-0,072,44+/-0,09GC, YES/NO, %360/86 (19%)217/55 (20%)143/31 (18%)csDMARDs (MTX), YES/NO, %124/322 (72%)72/200 (74%)52/122 (70%)BioDMARDs, NO/YES, %151/295 (66%)107/165 (61%)44/130 (75%)p=0.003**(*) - Unpaired t Test; (**) - Fisher’s exact testConclusion:In our RA cohort, the rates of willingness to receive the vaccine are promising. Dedicated education and outreach efforts should be developed, especially in some RA subpopulation.Disclosure of Interests:None declared.

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