目的:我们先前在2021年4月至5月调查了系统性硬化症(SSc)成人的COVID-19疫苗接种情况。本研究的目的是更新到2022年6月至7月,并评估自我报告的(1)COVID-19疫苗接种率,包括加强剂;(2)疫苗相关不良事件;(3)围接种期免疫抑制药物管理;(4)疫苗犹豫;(5)COVID-19感染的患病率和严重程度。
方法:在2021年4月至5月和2022年6月至7月,SPIN队列参与者完成了关于COVID-19疫苗接种和感染的调查。初级疫苗系列是根据每种COVID-19疫苗的标准定义的;额外的疫苗施用被认为是加强剂量。完全接种被定义为已经完成初级疫苗系列和至少一个加强剂量。
结果:544名参与者仅完成了2021年的调查,101仅限2022年调查,和388项调查。在489名拥有2022年数据的参与者中,437人(89%)接受了初级和加强疫苗。在所有1033名参与者中,960(93%)接受了至少一次剂量。首先,34%(960名参与者中的330名)报告了至少一种不良反应,48%(657名参与者中的314名)紧随其后,和34%(437名参与者中的147名)在加强疫苗剂量(主要是手臂疼痛和疲劳)后;没有严重的不良反应报告。第一次发生后,有6%的人报告SSc症状恶化(960人中有53人),6%后第二次(657人中的39人),加强剂量后的4%(437个中的17个)。在服用甲氨蝶呤或霉酚酸酯(包括Cellcept或Myfortic)的参与者中,266人中有34人(13%)报告说,他们在第一剂量时暂时停止或减少了药物治疗。在第二剂量的215中的32(15%),148人中有28人(19%)用于加强疫苗接种。在2022年未完全接种初级和加强剂量疫苗的52人中,有29人(56%)表示担心与疫苗相关的SSc耀斑。2022年489名参与者中有172名(35%)报告有至少一次COVID-19感染史;114名(66%)发生在至少接受了主要疫苗系列后。在最初的COVID-19感染中,9人(5%)无症状,66(38%)症状轻微,82(48%)中度症状,和15(9%)需要住院治疗。
结论:研究中大多数患有SSc的人都完全接种了疫苗,和大多数继续他们的甲氨蝶呤或霉酚酸酯后初级和加强疫苗接种。超过一半的疫苗犹豫参与者担心SSc耀斑的风险;然而,很少有接种疫苗的参与者报告这一点。这些数据可能有助于为SSc患者提供关于COVID-19疫苗安全性和结果的咨询。
OBJECTIVE: We previously surveyed adults with systemic sclerosis (SSc) regarding COVID-19 vaccination in April-May 2021. The objective of the present
study was to update through June-July 2022 and assess self-reported (1) COVID-19 vaccination rates, including boosters; (2) vaccine-related adverse events; (3) peri‑vaccination immunosuppressive medication management; (4) vaccine hesitancy; and (5) prevalence and severity of COVID-19 infections.
METHODS: In April-May 2021 and June-July 2022, SPIN Cohort participants completed surveys on COVID-19 vaccination and infection. Primary vaccine series was defined according to the standard for each COVID-19 vaccine; additional vaccine administrations were considered booster doses. Fully vaccinated was defined as having completed a primary vaccine series and at least one booster dose.
RESULTS: 544 participants completed the 2021 survey only, 101 the 2022 survey only, and 388 both surveys. Among 489 participants with 2022 data, 437 (89 %) had received both primary and booster vaccines. Among all 1,033 participants, 960 (93 %) received at least one dose. At least one adverse reaction was reported by 34 % (330 of 960 participants) following first, 48 % (314 of 657 participants) following second, and 34 % (147 of 437 participants) following booster vaccine doses (primarily sore arm and fatigue); no severe adverse reactions were reported. SSc symptom worsening was reported in 6 % (53 of 960) after the first, 6 % after the second (39 of 657), and 4 % (17 of 437) after the booster dose. Of participants taking methotrexate or mycophenolate (including Cellcept or Myfortic), 34 of 266 (13 %) reported that they temporarily stopped or decreased their medication at the first dose, 32 of 215 (15 %) at the second dose, and 28 of 148 (19 %) for booster vaccination. Of 52 individuals not fully vaccinated with primary and booster doses in 2022, 29 (56 %) reported worry about vaccine related SSc flares. 172 of 489 (35 %) 2022 participants reported a history of at least one COVID-19 infection; 114 (66 %) occurred after receiving at least a primary vaccine series. Among initial COVID-19 infections, 9 (5 %) were asymptomatic, 66 (38 %) involved mild symptoms, 82 (48 %) moderate symptoms, and 15 (9 %) required hospitalization.
CONCLUSIONS: Most people with SSc in the
study were fully vaccinated, and most continued their methotrexate or mycophenolate post-primary and booster vaccinations. Over half of vaccine-hesitant participants were concerned regarding risk of SSc flare; however, few vaccinated participants reported this. These data may be useful for counselling people with SSc regarding COVID-19 vaccine safety and outcomes.