The impact of corona virus disease-2019 (COVID-19) vaccination on patients with systemic rheumatic diseases attending a tertiary care university-based hospital

Background: Safety and efficacy of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine among systemic rheumatic diseases (SRDs) remain a serious concern. Aim of the work: To explore different corona virus disease-2019 (COVID-19) vaccine adverse reactions, postvaccination COVID-19 infection, disease flare and acceptability of vaccine among patients with SRDs. Patients and methods: This study was conducted on 750 patients with SRDs attending the Rheumatology Department, Cairo University Hospitals (December 2022 - February 2023). All patients were subjected to full clinical history, COVID-19 infection, vaccine history, adverse events, disease flare and assessment of their acceptability to the vaccine. Results: The mean age of the patients was 41.6 +/- 11.7 years with a female:male 8.4:1 and 52.5 % were educated. 414 (55.2 %) received COVID-19 vaccine. Only 26 (6.3 %) suffered from post-vaccination COVID- 19 infection (one mild attack). The causes for not receiving the vaccine were either due to unacceptability (78.9 %) or doctors' advice (21.1 %). 64.8 % received inactivated virus vaccines (64.8 %) and 87.9 % received two doses. The commonest local and systemic side effects were pain (73.9 %) and headache (30.2 %). Only four (0.96 %) patients reported disease flare. There was a significant difference between the diagnosis, type of vaccines and some of the adverse effects of the vaccines such as pain (p = 0.019) and fever (p = 0.021), redness (p = 0.007) and swelling (p = 0.013). Conclusion: The efficacy and safety of SARS-CoV-2 vaccine among Egyptian patients with SRDs is confirmed. There were significant differences in certain vaccine side effects especially pain, fever, redness and swelling. Most patients well tolerated the COVID-19 vaccine providing reassurance.