COVID-19 and flu, exploring the infection of virus, the safety and attitudes of vaccination in pediatric patients with rheumatic diseases (preprint)

Background Patients with rheumatic diseases have an increased burden of infections. Immunization is recognized as being one of the most efficient means to prevent infections. However, many patients refuse or hesitate to be vaccinated mainly due to safety concerns. We performed this study to explore the infection of COVID-19 and influenza, the safety and attitudes regarding inactivated COVID-19 vaccination and influenza vaccination in pediatric rheumatic patients.Methods We conducted a retrospective survey using a questionnaire from November 1, 2021 to February 28, 2022. Pediatric rheumatic patients with inactive disease received inactivated COVID-19 vaccine at the age of 3–18 years old were recruited. Demographic data and vaccination adverse events (AEs) were collected. All parents of patients were telephone-interviewed in May 2023 regarding COVID-19 infection, influenza infection and influenza vaccination of their children in the past one year. Self-reported disease flares that occurred after infection and vaccination, as well as reasons for non-vaccination were recorded.Results A total of 192 patients were recruited. Local AEs occurred in 11.5% and 10.1% of patients after the first and the second dose of COVID-19 vaccination; the percentages were 8.9% and 6.3% for systemic AEs. Three (1.6%) patients experienced original disease flare. In total, 177 parents responded the telephone questionnaire, among which, 101 (57.1%) of their children had COVID-19 infection. All had mild symptoms and 8 patients experienced disease flares. Thirty-two (18.1%) patients had influenza infection. All experienced mild symptoms except one patient was hospitalization. One patient experienced a disease flare. Seventeen (9.6%) patients were vaccinated against influenza, none of them experienced serious AEs or disease flare. The main reasons for non-vaccination of influenza were the fear of AEs and disease flare (n = 60, 37.5%) and not receiving enough information about influenza vaccination from their doctors (n = 84, 52.5%). Ninety-six (60%) parents whose children were non-vaccination responded that would vaccinate their children if advised to by a rheumatologist.Conclusions These findings confirm on the safety of inactivated COVID-19 vaccination and inactivated influenza vaccination in pediatric rheumatic patients. Rheumatologists should take more responsibility in vaccination education of pediatric rheumatic patients.

Safety of inactivated COVID‑19 vaccine in pediatric patients with rheumatic diseases (preprint)

Background: Little is known about the safety of COVID-19 vaccines in pediatric patients with rheumatic diseases. We evaluated the occurrence of adverse events following immunization in pediatric patients with rheumatic diseases who received inactivated COVID-19 vaccine. Methods: : We performed a retrospective study from November 1, 2021 to February 28, 2022 about vaccine history in pediatric patients with rheumatic diseases of the outpatient rheumatology clinic of the First Affiliated Hospital of Xiamen University. The survey was conducted in the form of questionnaires. Data were collected after vaccination and included demographic, diagnosis, current treatment and adverse effects after vaccination. Results: : We recruited 192 patients. Juvenile idiopathic arthritis was the most common disease (n=145). All patients received the first dose of vaccine. After the first dose, 34 (17.7%) participants had at least one adverse effect, including 11.5% local reactions and 9.4% systemic reactions. About 97.5% adverse effects were self-limited. One hundred and eighty-nine patients received the second dose of vaccine, 30 (15.9%) participants had at least one adverse effect, including 10.05% local reactions and 7.4% systemic reactions, all adverse effects were self-limited. No severe adverse effects were observed, and no patients experienced hospitalized. The occurrence of flare of underlying rheumatic diseases were recorded in 5 (2.6%) of patients after vaccination, only 1 (0.5%) patient requiring a new medication to treat the flare. Conclusions: The current results support the safety of inactivated COVID-19 vaccine in pediatric patients with rheumatic diseases. This information can help fight vaccine hesitancy in this population.