COVAD study corroborates the safety and tolerability of COVID-19 vaccines in patients with rheumatoid arthritis

Despite the various COVID-vaccine rollouts and improved accessibility, there are significant concerns regarding their safety and tolerability profiles in  patients with rheumatic diseases. The findings of the COVID-19 vaccination in autoimmune diseases (COVAD) study published in Rhuematology have provided reassuring results regarding the safety and tolerability of different COVID vaccine, in spite of the variable adverse events (AEs) noted.

The study conducted by Naveen and co-workers considered the data of 1347 RA patients who had received COVID-19 vaccination (mean age of 50.7years, 74.2% women, 49.3% Caucasian). The corresponding number of patients noted with minor and major AEs were 76.9% and 4.2%.  The rate of hospitalization and major AEs were comparable between patients with active and inactive RA among recipients of various vaccines. In addition, the frequency of AEs was comparatively lesser for BBV152 recipients and more for mRNA-1273 and BNT 162b2 recipients, as opposed to other vaccine types. Compared to healthy controls and those with other autoimmune rheumatic diseases, the rate of hospitalizations, total AEs, and minor AEs, were found to be similar among RA patients. Minor AEs were lesser in patients who were on methotrexate and hydroxychloroquine. The incidence of overall AEs, minor AEs (both OR. 0.7; 95%CI=0.5-0.9) and injection site pain (OR=0.6;95%CI=0.5-0.8) were found to be lesser in patients with RA when compared to those with non-rhematic autoimmune diseases.

In concurrence with the current study findings, the COVID-19 Global Rheumatology Alliance Vaccine Survey (2021) has reported typical presentation of patient-reported adverse events as that of general population in adults with systemic rheumatic disease who received COVID-19 vaccination. Fatigue/somnolence (33.4%) was the most commonly noted patient-reported adverse event, followed by headache (27.7%), muscle/joint pains (22.8%) and fever/chills (19.9%). Most of the enrolled patients (66.9%) were ready to temporarily discontinue DMARDs to enhance vaccine efficiency (44.3%), however, rheumatic disease flares were a major concern.

The present study adds to the current literature evidence on the safety, permissibility, and tolerability of COVID vaccines.  The study also underscores the need to further explore humoral responses to COVID-19 vaccines, and to spread awareness regarding the safety of such vaccines, especially in the susceptible group of individuals.

A comprehensive news update on the link between COVID-19 vaccines and arthritis flare is available in our Rheuma tv ‘News and Views’ section. A webinar by Dr. Florian Krammer on ‘Immune Response to COVID-19 infection’ discussing antibody responses to SARS-CoV-2 disease and vaccination is accessible in our webinar portion.

For further reading, please visit:


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R N, Parodis I, Joshi M, Sen P, Lindblom J, Agarwal V, et al. COVID-19 vaccination in autoimmune diseases (COVAD) Study: vaccine safety and tolerance in rheumatoid arthritis. Rheumatology. 2022 Oct 31;keac624.

Sattui SE, Liew JW, Kennedy K, Sirotich E, Putman M, Moni TT, et al. Early experience of COVID-19 vaccination in adults with systemic rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey. RMD Open. 2021 Sep;7(3):e001814.