Opoka-Winiarska Violetta, Lipinska Joanna, Michalak Arkadiusz, Burzyński Jacek, Kądziołka Olga, Smolewska Elżbieta
Department of Paediatric Pulmonology and Rheumatology, Medical University of Lublin, Lublin, Poland.
Department of Paediatric Cardiology and Rheumatology, Medical University of Lodz, Lublin, Poland.
Front Pediatr. 2023 Mar 10;11:1103763. doi: 10.3389/fped.2023.1103763. eCollection 2023.
The safety of COVID-19 vaccines in children with juvenile idiopathic arthritis (JIA) is the concern of patients and their parents and doctors in the current pandemic reality. The main objective of the study was to evaluate the safety of COVID-19 vaccine in patients with JIA.
A cohort study based on short clinical follow-up of 43 children with JIA was conducted in the years 2021-2022 in two centres of paediatric rheumatology in Poland. All patients received mRNA COVID-19 vaccine. The patients' data were collected using appropriate validated questionnaire. Disease activity was evaluated using Juvenile Arthritis Disease Activity Score 27-joint count (JADAS-27).
Ten (22.7%) children had COVID-19 infection before getting COVID-19 vaccine. After first dose of COVID-19 vaccine 25/43 (58.1%) patients presented typical adverse events: arm pain or oedema at the application side or weakness. Also, twenty five (58.1%) children had side effects after second dose of this vaccine, however the spectrum of the symptoms was wider (additionally: headache, fever, lymphadenopathy, arrhythmia). Thirteen out of 43 (30.2%) patients had active disease before and 8/43 (18.6%) after COVID-19 vaccination, while the degree of JADAS-27 activity was higher in the study group before COVID-19 vaccination ( = 0.047).
Our study found out that children and adolescents with JIA with remission without treatment or on the long-term treatment-cDMARDs or even bDMARDs, can be safely vaccinated for COVID-19. Moreover, the study found that COVID-19 vaccination does not interfere with the JIA treatment and does not exacerbate symptoms of the disease and that vaccination protected against developing COVID-19 in children with JIA even on treatment.
在当前的疫情现实中,新冠病毒疫苗在幼年特发性关节炎(JIA)患儿中的安全性是患者及其家长以及医生所关注的问题。本研究的主要目的是评估新冠病毒疫苗在JIA患者中的安全性。
2021年至2022年期间,在波兰的两个儿科风湿病中心对43名JIA患儿进行了一项基于短期临床随访的队列研究。所有患者均接种了mRNA新冠病毒疫苗。使用经过适当验证的问卷收集患者数据。使用幼年关节炎疾病活动评分27关节计数法(JADAS-27)评估疾病活动度。
10名(22.7%)儿童在接种新冠病毒疫苗前感染过新冠病毒。在接种第一剂新冠病毒疫苗后,25/43(58.1%)的患者出现了典型的不良事件:接种部位手臂疼痛或水肿或乏力。此外,25名(58.1%)儿童在接种第二剂该疫苗后出现了副作用,然而症状范围更广(另外还有:头痛、发热、淋巴结病、心律失常)。43名患者中有13名(30.2%)在接种新冠病毒疫苗前疾病活动,8/43(18.6%)在接种后疾病活动,而研究组在接种新冠病毒疫苗前JADAS-27活动度更高(P = 0.047)。
我们的研究发现,未经治疗处于缓解期或正在接受长期传统改善病情抗风湿药物(cDMARDs)甚至生物制剂改善病情抗风湿药物(bDMARDs)治疗的JIA儿童和青少年可以安全地接种新冠病毒疫苗。此外,研究发现新冠病毒疫苗接种不会干扰JIA的治疗,也不会加重疾病症状,并且疫苗接种能保护正在接受治疗的JIA儿童不感染新冠病毒。