Patient-Reported Flare Symptoms Following COVID-19 Vaccination in Systemic Lupus Erythematosus.

INTRODUCTION

Disease flare after COVID-19 vaccination is a major concern among patients with systemic lupus erythematosus (SLE) and may contribute to vaccine hesitancy. We evaluated patient-reported flare symptoms, associated factors, and adverse events following COVID-19 vaccination in patients with SLE.

METHODS

We conducted a cross-sectional study of adult patients with SLE who received at least one COVID-19 vaccine dose. Demographic data, disease activity, treatments, and patient-reported flare symptoms occurring within four weeks after vaccination were collected.

RESULTS

A total of 324 patients were included; 94.4% were women with a mean age of 40.8 ± 11.7 years. Most patients received at least two vaccine doses (92.0%), and 66.0% received three doses. Patient-reported flare symptoms occurred in 17.0% of patients. The most common manifestations were joint pain, fatigue, hair loss, and myalgia. Most patient-reported flares were mild, though 9% required hospitalization. Current prednisolone use was associated with patient-reported flare symptoms (p = 0.049), though this borderline association should be interpreted cautiously. Vaccine type and baseline disease activity were not associated with patient-reported flare.

CONCLUSIONS

Patient-reported flare symptoms following COVID-19 vaccination were generally mild in this SLE cohort. Vaccine type was not associated with patient-reported flare symptoms, supporting the overall tolerability of repeated COVID-19 vaccination in patients with SLE.