COVID-19 Vaccination in Autoimmune Patients: A Literature Review
Downloads
Patients with autoimmune diseases, especially rheumatic diseases, have their own concerns regarding the coronavirus disease 2019 (COVID-19) vaccination. Their concerns are specifically related to the physicological response, side effects, and effectiveness of the COVID-19 vaccination. COVID-19 and autoimmune diseases share some similarities in their clinical manifestations, immune responses, and pathogenic mechanisms. The correlation between COVID-19 vaccination and autoimmune diseases can be attributed to epitope mimicry, where the antigen contained in the vaccine has a structural similarity to self-antigen. The purpose of this literature review was to discuss the various types of vaccines, the side effects of the COVID-19 vaccination, and the effect of autoimmune patients' medication on the administration of the COVID-19 vaccination. According to several articles obtained in this study, most autoimmune patients typically experienced mild to moderate side effects. It was not advised for these patients to stop treatment before receiving the COVID-19 vaccination, as doing so was unlikely to affect the vaccine's effectiveness or the patients' immune response. The condition of the autoimmune patients was what influenced the immune response mediated by antibodies. Therefore, the COVID-19 vaccination must be administered when the patients are in a stable condition. In conclusion, it was determined that there is no restriction preventing autoimmune patients from receiving the COVID-19 vaccination. However, it should be noted that autoimmune patients are not recommended to receive live vaccines.
Highlights:
- This study reviewed the concerns of autoimmune patients over the side effects of the COVID-19 vaccination on their prescribed medication.
- It is advisable for autoimmune patients to refrain from obtaining live-attenuated vaccines because of their potential effect on the immune response.
Boekel L, Kummer LY, van Dam KPJ, Hooijberg F, van Kempen Z, et al. (2021). Adverse events after first COVID-19 vaccination in patients with autoimmune diseases. The Lancet Rheumatology 3(8): e542–e545. doi: 10.1016/S2665-9913(21)00181-8.
Cairoli E, Espinosa G (2021). Autoimmune diseases and vaccines against COVID-19. Decision making in uncertain scenarios. Medicina Clínica (English Edition) 157(5): 247–252. doi: 10.1016/j.medcle.2021.05.003.
Chen Y, Xu Z, Wang P, Li X, Shuai Z, et al. (2022). New‐onset autoimmune phenomena post‐COVID‐19 vaccination. Immunology 165(4): 386–401. doi: 10.1111/imm.13443.
Ciotti M, Ciccozzi M, Terrinoni A, Jiang W-C, Wang C-B, et al. (2020). The COVID-19 pandemic. Critical Reviews in Clinical Laboratory Sciences 57(6): 365–388. doi: 10.1080/10408363.2020.1783198.
Esquivel-Valerio JA, Skinner-Taylor CM, Moreno-Arquieta IA, Cardenas-de la Garza JA, Garcia-Arellano G, et al. (2021). Adverse events of six COVID-19 vaccines in patients with autoimmune rheumatic diseases: A cross-sectional study. Rheumatology International 41(12): 2105–2108. doi: 10.1007/s00296-021-05017-9.
Frasca L, Ocone G, Palazzo R (2023). Safety of COVID-19 vaccines in patients with autoimmune diseases, in patients with cardiac issues, and in the healthy population. Pathogens 12(2): 233. doi: 10.3390/pathogens12020233.
Jeyanathan M, Afkhami S, Smaill F, Miller MS, Lichty BD, et al. (2020). Immunological considerations for COVID-19 vaccine strategies. Nature Reviews Immunology 20(10): 615–632. doi: 10.1038/s41577-020-00434-6.
Kaswa R, Govender I (2020). Novel coronavirus pandemic: A clinical overview. South African Family Practice 62(1). doi: 10.4102/safp.v62i1.5123.
Kocivnik N, Velnar T (2022). A review pertaining to SARS-CoV-2 and autoimmune diseases: What is the connection? Life 12(11): 1918. doi: 10.3390/life12111918.
Koesnoe S, Maria S (2021). The 2nd Symposium of Trending Topics in Internal Medicine Cases. In: Rekomendasi pemberian vaksinasi COVID-19 pada pasien dengan komorbid. Retrieved from https://scholar.ui.ac.id/en/publications/rekomendasi-pemberian-vaksinasi-covid-19-pada-pasien-dengan-komor.
Liu E, Perl A (2019). Pathogenesis and treatment of autoimmune rheumatic diseases. Current Opinion in Rheumatology 31(3): 307–315. doi: 10.1097/BOR.0000000000000594.
Liu Y, Sawalha AH, Lu Q (2021). COVID-19 and autoimmune diseases. Current Opinion in Rheumatology 33(2): 155–162. doi: 10.1097/BOR.0000000000000776.
Mahroum N, Lavine N, Ohayon A, Seida R, Alwani A, et al. (2022). COVID-19 vaccination and the rate of immune and autoimmune adverse events following immunization: Insights from a narrative literature review. Frontiers in Immunology 13. doi: 10.3389/fimmu.2022.872683.
Muthu S, Manohar M, Selvaraj P, Jeyaraman N, Jeyaraman M, et al. (2023). Impact of COVID-19 vaccination in patients with auto-immune diseases – A nationwide survey from 842 autoimmune patients. Indian Journal of Medical Sciences 75: 114. doi: 10.25259/IJMS_50_2023.
Najafi S, Rajaei E, Moallemian R, Nokhostin F (2020). The potential similarities of COVID-19 and autoimmune disease pathogenesis and therapeutic options: New insights approach. Clinical Rheumatology 39(11): 3223–3235. doi: 10.1007/s10067-020-05376-x.
Ndwandwe D, Wiysonge CS (2021). COVID-19 vaccines. Current Opinion in Immunology 71: 111–116. doi: 10.1016/j.coi.2021.07.003.
Olivieri B, Betterle C, Zanoni G (2021). Vaccinations and autoimmune diseases. Vaccines 9(8): 815. doi: 10.3390/vaccines9080815.
Pisetsky DS (2023). Pathogenesis of autoimmune disease. Nature Reviews Nephrology 19(8): 509–524. doi: 10.1038/s41581-023-00720-1.
Rodríguez Y, Rojas M, Beltrán S, Polo F, Camacho-Domínguez L, et al. (2022). Autoimmune and autoinflammatory conditions after COVID-19 vaccination. New case reports and updated literature review. Journal of Autoimmunity 132: 102898. doi: 10.1016/j.jaut.2022.102898.
Sadarangani M, Marchant A, Kollmann TR (2021). Immunological mechanisms of vaccine-induced protection against COVID-19 in humans. Nature Reviews Immunology 21(8): 475–484. doi: 10.1038/s41577-021-00578-z.
Sen P, Lilleker J, Agarwal V, Kardes S, Milchert M, et al. (2022a). Vaccine hesitancy in patients with autoimmune diseases: Data from the coronavirus disease-2019 vaccination in autoimmune diseases study. Indian Journal of Rheumatology 17(2): 188. doi: 10.4103/injr.injr_221_21.
Sen P, Ravichandran N, Nune A, Lilleker JB, Agarwal V, et al. (2022b). COVID-19 vaccination-related adverse events among autoimmune disease patients: Results from the COVAD study. Rheumatology 62(1): 65–76. doi: 10.1093/rheumatology/keac305.
Soy M, Keser G, Atagunduz P, Mutlu MY, Gunduz A, et al. (2021). A practical approach for vaccinations including COVID-19 in autoimmune/autoinflammatory rheumatic diseases: A non-systematic review. Clinical Rheumatology 40(9): 3533–3545. doi: 10.1007/s10067-021-05700-z.
Tharwat S, Abdelsalam HA, Abdelsalam A, Nassar MK (2022). COVID-19 vaccination intention and vaccine hesitancy among patients with autoimmune and autoinflammatory rheumatological diseases: A survey. International Journal of Clinical Practice 2022: 1–10. doi: 10.1155/2022/5931506.
Velikova T, Georgiev T (2021). SARS-CoV-2 vaccines and autoimmune diseases amidst the COVID-19 crisis. Rheumatology International 41(3): 509–518. doi: 10.1007/s00296-021-04792-9.
Copyright (c) 2024 Atiqah Nurul Wardhany, Awali, Rebekah J Setiabudi
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) Author
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions.
3. The formal legal aspect of journal publication accessibility refers to Creative Commons Atribution-Share Alike 4.0 (CC BY-SA).