Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai, China.
Front Immunol. 2023 Feb 9;14:1030810. doi: 10.3389/fimmu.2023.1030810. eCollection 2023.
This study aimed to investigate the Coronavirus disease 2019 (COVID-19) vaccination rate, reasons for vaccine hesitancy and clinical effects on patients with Takayasu's arteritis (TAK).
A web-based survey was administered to a TAK cohort established by the Department of Rheumatology, Zhongshan Hospital through WeChat in April, 2022. Responses from a total of 302 patients were received. The Sinovac or Sinopharm inactivated vaccination rate, side effects, and vaccine hesitancy reasons were analyzed. In addition, disease flare, new disease onset, and changes of immune-related parameters after vaccination were analyzed in vaccinated patients.
Among 302 patients, 93 (30.79%) received the inactivated COVID-19 vaccination. Among the 209 unvaccinated patients, the most common reason for hesitancy were concern about side effects (136, 65.07%). Vaccinated patients had a longer disease duration (p = 0.08) and lower use of biologic agents (p < 0.001); 16 (17.20%) of the 93 vaccinated patients developed side effects, and most of them were mild; 8 (8.60%) developed disease flares or new-onset disease 12-128 days post-vaccination and 2 (2.15%) developed serious adverse effects (vision defect and cranial infarction). Immune-related parameters of 17 patients indicated decreases in IgA and IgM after vaccination (p < 0.05). Eighteen (19.35%) of the 93 vaccinated patients were diagnosed post-vaccination.These patients had a significantly higher percentage of CD19 B cells at disease onset (p < 0.05) than the unvaccinated patients diagnosed at the same time.
The vaccination rate was low in TAK, which was mainly caused by concerns about negative effects of vaccination on their disease. An acceptable safety profile was observed in vaccinated patients. The risk of disease flare associated with COVID-19 vaccination warrants further investigation.
本研究旨在调查 2019 年冠状病毒病（COVID-19）疫苗接种率、疫苗犹豫的原因以及 COVID-19 疫苗接种对大动脉炎（TAK）患者的临床影响。
2022 年 4 月，中山医院风湿科通过微信向 TAK 队列中的患者进行了一项网络调查。共收到 302 例患者的回复。分析了科兴或国药灭活疫苗接种率、不良反应和疫苗犹豫的原因。此外，还分析了接种疫苗患者的疾病发作、新发病例以及接种后免疫相关参数的变化。
302 例患者中，93 例（30.79%）接受了 COVID-19 灭活疫苗接种。在 209 例未接种疫苗的患者中，最常见的犹豫原因是担心副作用（136 例，65.07%）。接种组患者的病程更长（p=0.08），使用生物制剂的比例更低（p<0.001）；93 例接种疫苗的患者中，有 16 例（17.20%）出现不良反应，大多数为轻度；8 例（8.60%）在接种后 12-128 天发生疾病发作或新发疾病，2 例（2.15%）发生严重不良反应（视力缺陷和颅梗死）。17 例患者的免疫相关参数显示接种后 IgA 和 IgM 下降（p<0.05）。接种疫苗后 8 例（19.35%）患者确诊，这些患者在发病时 CD19 B 细胞的百分比明显高于同时确诊的未接种疫苗患者（p<0.05）。
TAK 的疫苗接种率较低，主要是由于担心疫苗对疾病的负面影响。接种疫苗的患者观察到可接受的安全性。与 COVID-19 疫苗接种相关的疾病发作风险需要进一步研究。
