Introduction: Coronavirus disease 2019 (COVID-19) has severely influenced all aspects of life since its emergence and one of the strategies to end this pandemic rests on the vaccination to achieve herd immunity. While vaccinations are usually a safe and effective tool, the abbreviated development process of the available COVID-19 vaccines has increased uncertainties about the safety among the general population especially among patients with rheumatic and musculoskeletal diseases (RMD). Methods: A cross-sectional analysis was performed on rheumatic disease (RMD) patients from the rheumatology clinic at Hospital Tuanku Ja’afar Seremban (HTJS), investigating adverse events occurring within one month of receiving COVID-19 vaccines administered from 1st May 2021 to 30th September 2021. Results: 549 RMD patients were recruited in this study. Pfizer/BioNTech was the predominant vaccine (n = 257, 64.3%), followed by Sinovac (n = 60, 47.2%), Oxford/AstraZeneca (n = 7, 1.3%) and Moderna (n = 1, 0.2%). 330 (60.1%) patients experienced at least one adverse event, none of which required hospitalisation. Common side effects included pain at the site of injection (n = 169, 30.8%), generalised muscle pain (n = 91, 16.4%), fever (n = 90, 16.4%), arthralgia (n = 55, 10.0%), and lethargy (n = 43, 7.7%). Female patients (OR = 0.88, CI 0.79-0.97, p = 0.012), Sinovac recipients (OR = 0.51, CI 0.34-0.76, p = 0.001) and age >50 years (OR = 0.62, CI 0.44-0.89, p = 0.009) had significantly lower risks of experiencing adverse events. Among patients with autoimmune rheumatic disease (AIRD), 28 (6.4%) experienced disease flare. Patients with spondyloarthropathy (SpA) and overlap syndrome were more likely to experience disease flare following COVID-19 vaccination compared to rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients (OR = 2.87, CI 1.23 – 6.69, p = 0.014). The use of combination conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) was associated with a tendency toward increased risk of disease flare (OR = 2.34, CI: 0.97–5.64, p = 0.056). However, the use of glucocorticoids (OR = 2.02, CI 0.72–5.61, p = 0.17) and an active disease state (OR = 1.94, CI 0.75–5.02, p = 0.171) did not show a statistically significant impact on the frequency of disease flares. Conclusions The study affirms the overall safety of COVID-19 vaccines in rheumatic musculoskeletal disease patients, supporting efforts to address vaccine hesitancy in this population.
COVID-19 ; SARS-CoV-2 ; Vaccination