Table 1.
Summary of studies on a flare-up of RDs after COVID-19 vaccination.
| Author | Diseases | Vaccine Type | Flare Rate, % (n/N) | Common Flare Symptoms | Risk Factors | Protective Factors | Medication Change | Rate or Hospitalization for Flare | ||
|---|---|---|---|---|---|---|---|---|---|---|
| Total | After 1st dose | After 2nd dose | ||||||||
| Zavala-Flores | SLE | mRNA | 20% (20/100) | 9% (9/100) | 20% (18/90) | arthritis, dermal, leukopenia, myopericarditis, lupus pneumonitis |
history of renal involvement, HCQ, AZA, flare history within 6 months | / | / | 10% (2/20) |
| Cherian | RA (43.85%); SLE (10.13%); SpA (13.25%); Vasculitis (6.23%); inflammatory polyarthritis (15.59%); other (10.89%) | adenovirus-based, inactivated | 0.8% (4/523) | / | / | arthritis | / | / | / | / |
| Rotondo | arthritis (78%); CTD (18%); vasculitis (4%) | adenovirus-based, mRNA | 2.2% (3/137); mRNA:3/107 adenovirus-based:0/30 |
2.2% (3/137) | 0 | / | / | / | / | / |
| Fan | SLE (40.7%); RA (28.8%); BD (8.1%); PsA (5%);pSS (4.9%); AS (2.9%) |
inactivated | 10.5% (158/1507) |
/ | / | arthritis, skin rash, fever | elderly, allergic history | stable disease | 3.5% (53/1507) | / |
| Visentini | Vasculitis | mRNA | 9.5% (6/63) |
Purpura, peripheral neuropathy | ||||||
| Connolly | arthritis (47%); SLE (20%); SS (5%); vasculitis (3%); SSc (1%); overlap CTD (20%) | mRNA | 11% (151/1377) |
4.4% (61/1377) |
7% (90/1377) |
arthritis, muscle pain and weakness | prior infection, flare in the past 6 months, use of combination therapy | cDMARDs, biologics | 2.5% (35/1377) |
0 (0/151) |
| Haslak | JIA (24.2%); FMF (56.5%); CTD (13.5%); Vasculitis (4); other (1.8%) |
mRNA, inactivated | 12.1% (27/223) |
10.3% (23/223) mRNA:20/198 inactive:3/28 |
3.1% (7/223) mRNA:7/198 |
arthritis or arthralgia, fever, cutaneous involvement | / | / | / | / |
| Braun-Moscovici | inflammatory arthritis (58%); CTD (34%); vasculitis (7%); other (2%) | mRNA | 0.4% (1/264) |
/ | / | arthritis | / | / | / | / |
| E.Fragoulis | inflammatory arthritis (58.1%); CTD (27.5%); vasculitis (10.5%); other (3.9%) | adenovirus-based, mRNA | 2% (9/441) |
0.23% (1/441) |
1.81% (8/441) |
/ | discontinuation of treatment | / | / | / |
| Pinte | RA (15.7%); SLE (15.6%); SS (12.5%); AS (10.4%); PsA (8.5%); scleroderma (5.0%); other (9.1%) | adenovirus-based, mRNA | 6% (25/416) mRNA: 21/371 adenovirus-based:4/37 |
0.7% (3/416) |
5.3% (22/416) |
/ | more than one immune disease, corticosteroids, history of flare-up during the previous year | / | 5% (21/416) |
40% (10/25) |
| Barbhaiya | SRDs | adenovirus-based, mRNA | 14.9% (165/1101) | 10.6% (117/1101) mRNA:114/1080 adenovirus-based:3/19 |
13.6% (85/626) all in mRNA |
arthritis or arthralgia, myagia, fatigue, skin rash | / | / | / | / |
| Spinelli | RA (24.6%); SLE (24.6%); PsA (20.6%); UCTD (8.7%); AS (7.1%); other (14.3%) | mRNA | 2.8% (3/126) |
/ | / | arthritis | / | / | / | / |
| Sattui | RA (42.3%); myositis (17%); SS (15.3%); SLE (13.7%); SpA (16.2%); vasculitis (5.8%); scleroderma (4.4%) other (4.2%) |
adenovirus-based, mRNA | 13.4% (382/2860) mRNA:280/2132 adenovirus-based:100/695 |
/ | / | / | / | / | 4.6% (132/2860) |
/ |
| Rider | RA (30.3%); IIMs (14.7%); SLE (14.1%); SS (9.6%); PsA (5.4%); AS (5.2%); other (8.9%) |
adenovirus-based, mRNA, other | 4.9% (274/5619) mRNA:190/4063 adenovirus-based:76/1200 other:8/356 |
/ | / | / | Oxford AstraZeneca vaccine, female, SLE, PsA, PMR, prior serious reaction to non-COVID-19 vaccine | IMs | / | / |
| Tzioufas | RA (27.8%); SLE (19.5%); seronegative arthritis (20.8%); vasculitis (11.1%); SS (9.6%); IIMs (4.6%); other (11.4%) | mRNA | 10.6%(64/605) | / | / | / | / | / | / | / |
| Felten | SLE | adenovirus-based, mRNA, inactivated | 3.0% (21/696) | / | / | fever, cutaneous flare, musculoskeletal, fatigue | flare history during the past year | / | 2.1% (15/696) | 19% (4/21) |
| Ozdede | BD (23.6%); FMF (22.4%); RA (13.4%); SLE (8.0%); AS (14.5%); vasculitis (7.7%) other (10.7%) |
mRNA, inactivated | 10.9% (120/1104) mRNA:68/562 inactivated: 52/542 |
/ | / | skin-mucosal lesion, joint symptoms | BD, FMF, experience any AE | / | / | / |
| Boekel | RA (40.4%) MS (16.0%) |
mRNA, adenovirus-based | 5.1% (26/505) mRNA:12/274 adenovirus-based:14/231 |
/ | / | / | / | / | / | / |
| Izmirly | SLE | mRNA, adenovirus-based | 11.4% (9/79) | 1 | 8 | thrombocytopenia, arthritis | / | / | / | / |
| Bixio | RA | mRNA | 7.8% (6/77) | 1 | 5 | / | / | / | 0 | 0 |
| Firinu | RDs | mRNA | 0 (0/102) | / | / | / | / | / | / | / |
| Dimopoulou | JIA | mRNA | 0 (0/21) | / | / | / | / | / | / | / |
AE, adverse events; AS, ankylosing spondylitis;AZA, azathioprine; BD, Becet’s disease; csDMARDs, conventional disease-modifying antirheumatic drugs; FMF, familial mediterranean fever; HCQ, hydroxychloroquine; IIMs, idiopathic inflammatory myositis; JIA, juvenile idiopathic arthritis; mRNA, messenger RNA; MS, multiple sclerosis; PMR, polymyagia rheumatica; PsA, psoriatic arthritis; pSS, primary sjogren’s syndrome; RA, rheumatic arthritis; RD, rheumatic disease; SLE, systemic lupus erythematosus; SpA, spondyloarthropathy; UCTD, undifferentiated connective tissue disease.