COVID-19 VACCINE: HESITANCY, ACCEPTANCE AND TOLERANCE AMONG PATIENTS WITH RHEUMATOID ARTHRITIS

BackgroundPatients with rheumatoid arthritis (RA) are considered a high-risk population to develop severe COVID-19 [1] and therefore vaccination is strongly recommended. Previous reports have shown a high hesitancy rate to receive a COVID-19 vaccine among RA.ObjectivesThis study aimed to evaluate the attitude of patients with RA to vaccination against SARS-CoV-2, explore the factors which may influence it, and assess adverse events of SARS-CoV-2 vaccines.MethodsThis is a cross-sectional study including 106 patients with RA diagnosed according to the ACR/EULAR 2010 classification criteria and followed in the Rheumatology Department, over a period of 10 months from March to December 2021.Demographic and disease parameters were collected: age, gender, educational status, disease duration, erythrocyte sedimentation rate (ESR), disease activity score (DAS28), and treatments being used. All patients responded to a questionnaire on their perceptions and concerns about the covid-19 vaccine, and the adverse effects for those who got vaccinated.ResultsAmong the 106 patients, 90 (84,9%) were females and 16 (15,1%) were males. Themean age was 54 ±13 years old [23-77]. Sixty-four percent were from urban areas and 36 %were from rural areas. Thirty-three percent of patients were illiterate. The mean diseaseduration was 9.54 ±5.76 years [2-22]. The mean DAS28 ESR was 3,88 ±1.34 [1.2-7.58]. All ofour patients were taking conventional synthetic DMARDs. Seventeen percent of patientswere on biological DMARDs. The majority of the patients (90%) reported that they respectedthe preventive measures. Twenty-two percent of patients had stopped their treatmentbecause they were afraid of the covid-19. Twenty-eight patients had contracted the SARS-CoV-2. Seventeen percent of the patients reported that they didn’t get vaccinated againstcovid-19. The reasons given by these patients were: presumed adverse events (53,3%),presumed inefficiency (25%), no recommendation from their doctor (46,7%), fear that thevaccine would make RA worse (64,7%). For the vaccinated patients, the vaccinesadministered were: 63,6 % Pfizer BioNTech, 6,8% Oxford/AstraZeneca, 5,7% Moderna, 4,5%Janssen/Johnson & Johnson, 2,3% Sinovac-CoronaVac and 17% unspecified. The majority ofthe patients (72,7 %) received two doses,14,8 % one dose and 12,5% 3 doses. Aftervaccination, 73,9% of patients reported adverse events, such as pain at the site of injection(88,1%), fatigue (35,8%), headache (14,9%), fever (13,4%) and muscle/joint pains (4,5%).Only 1 patient had experienced rheumatic disease flare. Hesitancy about the COVID-19vaccination was associated with low intellectual level (p=0.004) and rural origin (p=0.001).RAdisease duration, DAS28-ESR, and treatments have no influence on the attitude of patientstowards COVID-19 Vaccination (p > 0,05).ConclusionThe acceptance of COVID-19 vaccination by RA patients in our study is quite promising. Themajority of patients tolerated their vaccination well, with rare RA flares up. These resultsshould reassure rheumatologists and patients. Education and outreach efforts need to becontinued, especially for illiterate people and those who live in rural areas.References[1]HABERMAN, Rebecca H., CASTILLO, Rochelle, CHEN, Alan, et al. COVID-19 in patients with inflammatory arthritis: a prospective study on the effects of comorbidities and disease-modifying antirheumatic drugs on clinical outcomes. Arthritis & Rheumatology, 2020, vol. 72, no 12, p. 1981-1989.Disclosure of InterestsNone declared