{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T15:51:00Z","timestamp":1740153060678,"version":"3.37.3"},"reference-count":29,"publisher":"The Journal of Rheumatology","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"accepted":{"date-parts":[[2023,9,7]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine if coronavirus disease 2019 (COVID-19) vaccines were associated with adverse events of special interest (AESIs) and healthcare use among adults with rheumatoid arthritis (RA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among adults with RA who received at least 1 COVID-19 vaccine, a self-controlled case series (SCCS) analysis was conducted to evaluate relative incidence (RI) rates of AESIs (Bell palsy, idiopathic thrombocytopenia, acute disseminated encephalomyelitis, pericarditis\/myocarditis, Guillain-Barr\u00e9 syndrome, transverse myelitis, myocardial infarction, anaphylaxis, stroke, deep vein thrombosis, pulmonary embolism, narcolepsy, appendicitis, and disseminated intravascular coagulation) in any 21-day period following vaccination compared to control periods. Secondary outcomes included emergency department (ED) visits, hospitalizations, and rheumatology visits. A matched non-RA comparator group was created and a separate SCCS analysis was conducted. RI ratios (RIRs) were used to compare RA and non-RA groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 123,466 patients with RA and 493,864 comparators, the majority received mRNA vaccines. For patients with RA, relative to control periods, AESIs were not increased. ED visits increased after dose 2 (RI 1.06, 95% CI 1.03-1.10) and decreased after dose 3 (RI 0.93, 95% CI 0.89-0.96). Hospitalizations were lower after the first (RI 0.83, 95% CI 0.78-0.88), second (RI 0.86, 95% CI 0.81-0.92), and third (RI 0.89, 95% CI 0.83-0.95) doses. Rheumatology visits increased after dose 1 (RI 1.08, 95% CI 1.07-1.10), and decreased after doses 2 and 3. Relative to comparators, patients with RA had a higher AESI risk after dose 3 (RIR 1.28, 95% CI 1.05-1.56). Patients with RA experienced fewer ED visits (RIR 0.73, 95% CI 0.58-0.90) and hospitalizations (RIR 0.52, 95% CI 0.36-0.75) after dose 4.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>COVID-19 vaccines in patients with RA were not associated with an increase in AESI risk or healthcare use after every dose.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.2023-0355","type":"journal-article","created":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T12:20:22Z","timestamp":1696162822000},"page":"88-95","source":"Crossref","is-referenced-by-count":1,"title":["Safety and Healthcare Use Following COVID-19 Vaccination Among Adults With Rheumatoid Arthritis: A Population-Based Self-Controlled Case Series Analysis"],"prefix":"10.3899","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5300-2662","authenticated-orcid":false,"given":"Jennifer J.Y.","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-2802","authenticated-orcid":false,"given":"Sasha","family":"Bernatsky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7820-2046","authenticated-orcid":false,"given":"Jeffrey C.","family":"Kwong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7139-464X","authenticated-orcid":false,"given":"Qing","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0354-4794","authenticated-orcid":false,"given":"Timothy S.H.","family":"Kwok","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7464-0460","authenticated-orcid":false,"given":"Jessica","family":"Widdifield","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2262","published-online":{"date-parts":[[2023,10,1]]},"reference":[{"key":"2024030708001985000_51.1.88.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2021.07.054"},{"key":"2024030708001985000_51.1.88.2","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1002\/mus.27681","article-title":"COVID-19 vaccination in autoimmune diseases (COVAD) study: vaccine safety in idiopathic inflammatory myopathies","volume":"66","author":"Gil-Vila","year":"2022","journal-title":"Muscle Nerve"},{"key":"2024030708001985000_51.1.88.3","doi-asserted-by":"crossref","first-page":"834","DOI":"10.3390\/biomedicines10040834","article-title":"Immunogenicity, effectiveness, and safety of COVID-19 vaccines in rheumatic patients: an updated systematic review and meta-analysis","volume":"10","author":"Tang","year":"2022","journal-title":"Biomedicines"},{"key":"2024030708001985000_51.1.88.4","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-021-02059-5"},{"key":"2024030708001985000_51.1.88.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2035389"},{"key":"2024030708001985000_51.1.88.6","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7008e3"},{"key":"2024030708001985000_51.1.88.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.15072"},{"key":"2024030708001985000_51.1.88.8","doi-asserted-by":"crossref","first-page":"6115","DOI":"10.1016\/j.vaccine.2012.06.004","article-title":"Vaccine and immunization surveillance in Ontario (VISION) \u2013 using linked health administrative databases to monitor vaccine safety","volume":"30","author":"Wilson","year":"2012","journal-title":"Vaccine"},{"key":"2024030708001985000_51.1.88.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4515"},{"key":"2024030708001985000_51.1.88.10","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1186\/s12874-016-0225-0","article-title":"The use of relative incidence ratios in self-controlled case series studies: an overview","volume":"16","author":"Hawken","year":"2016","journal-title":"BMC Med Res Methodol"},{"key":"2024030708001985000_51.1.88.11","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008695"},{"key":"2024030708001985000_51.1.88.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-021-04938-9"},{"key":"2024030708001985000_51.1.88.13","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s41927-022-00307-6","article-title":"Rheumatic disease patient decision-making about COVID-19 vaccination: a qualitative analysis","volume":"6","author":"Shaw","year":"2022","journal-title":"BMC Rheumatol"},{"key":"2024030708001985000_51.1.88.14","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2021-001814"},{"key":"2024030708001985000_51.1.88.15","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-15-216"},{"key":"2024030708001985000_51.1.88.16","unstructured":"Government of Canada . 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