Queen Square Centre for Neuromuscular Diseases


Covid-19 vaccines can be given to people with rheumatic and musculoskeletal diseases

27 January 2022

It is safe and effective to vaccinate people with inflammatory or autoimmune rheumatic and musculoskeletal diseases such as arthritis and lupus, a study led by UCL Queen Square Institute of Neurology has found.

The findings should provide reassurance to health professionals and vaccine recipients, and promote confidence in the safety of Covid vaccination in people with inflammatory RMDs.

Results come from the COVAX registry, launched by the European League Against Rheumatism (EULAR) in February 2021 to collect information about Covid vaccination in people with rheumatic and musculoskeletal diseases (RMDs). This work is led by Dr Pedro Machado, Associate Professor, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, and UCLH Consultant in Rheumatology and Neuromuscular Diseases.

Rheumatologists in EULAR-affiliated countries taking part were asked to report as many cases as possible of people with RMDs who had received a COVID vaccine, whether or not they had experienced side effects.

The latest COVAX data, published in the Annals of Rheumatic Diseases, comes from over 5,000 people.

The most common inflammatory RMDs were rheumatoid arthritis, axial spondyloarthritis, and psoriatic arthritis. The most common non-inflammatory RMDs were osteoarthritis and osteoporosis. Overall, 70% had received the Pfizer/BioNTech vaccine, 17% had the AstraZeneca/Oxford vaccine, and 8% received the Moderna vaccine, reflecting vaccine availability and access across reporting countries.

The results from COVAX show that the overwhelming majority of people with inflammatory RMDs tolerate their Covid vaccine well – with no difference in safety profile to that seen in the general population or people with non-inflammatory RMDs. The most common side effects were short-lived reactions to the injection.

One of the reasons for asking additional safety questions in people with inflammatory RMDs is the concern that the vaccine could cause a disease flare. In this study, only 4.4% of people experienced a flare after having their vaccine, and only 0.6% were classed as severe. Flares included joint pain or fatigue.

The majority of people (over 98%) were able to continue on their normal medication with no changes. The study also found there was a low rate of Covid-19 infections in people with RMDs once they were fully vaccinated. In fully vaccinated people, only 0.7% of those with an inflammatory RMD had a breakthrough infection after receiving a vaccine. The rate was 1.1% in people with a non-inflammatory RMD.

Dr Machado, UCL Queen Square Institute of Neurology said: “Patients and clinicians should be reassured by these findings. The results highlight the safety of the vaccines in these patient groups, and they will support discussions about the safety and benefit to risk ratio of vaccination, and will help support the development of recommendations for these patient groups.”



UCLH Biomedical Research Centre