COVID-19 vaccination heightened risk for uveitis among individuals with history of uveitis
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Key takeaways:
- The 3-month and 1-year cumulative incidences of uveitis after COVID-19 vaccination were 8.6% and 16.8%, respectively.
- Risk varied by vaccine type and was higher between first and second doses.
Among individuals with a history of uveitis, COVID-19 vaccination was linked to an increased risk for recurrent uveitis, particularly in the first month after vaccination, according to a study published in JAMA Ophthalmology.
“For patients with a history of uveitis, understanding the potential impact of COVID-19 vaccination on its course, particularly its potential to induce uveitis recurrence vs. recurrences coincidental to widespread vaccinations,” Jiyeong Kim, PhD, and colleagues at Hanyang University in Seoul, wrote.
In a retrospective, population-based cohort study of 543,737 individuals in South Korea with a history of uveitis, researchers identified 473,934 individuals (mean age, 58.9 years; 51.3% women) who had at least one documented COVID-19 vaccination.
Study outcomes included the incidence and risk for postvaccination uveitis in association with COVID-19 vaccines before and after vaccination. Researchers categorized uveitis by onset and type.
According to results, uveitis occurred in 8.6% of individuals in the 3 months following vaccination, with 6.9% experiencing anterior uveitis and 1.6% experiencing nonanterior uveitis. At 6 months after vaccination, 12.5% had uveitis— 10.1% with anterior uveitis — and at 1 year 16.8% had uveitis, of whom 13.8% had anterior uveitis.
In the period before vaccination, the baseline uveitis rate was 0.02 per person-month, with researchers reporting an increased risk after vaccination (HR = 1.21). Moreover, the risk for postvaccination uveitis was higher in the early-onset period (HR = 1.64), although the risk was sustained in the delayed-onset period vs. the prevaccination period.
While all four vaccines were associated with an increased risk for uveitis after the first dose, BNT162b2 (Pfizer-BioNTech) exhibited a higher risk (HR = 1.68) compared with the others. The overall risk for uveitis was higher between first and second vaccination doses.
“Although uveitis following vaccination is rare, our findings support an increased risk after COVID-19 vaccination, particularly in the early postvaccination period,” Kim and colleagues wrote. “The type of vaccine administered also was associated with risk of uveitis. These results emphasize the importance of vigilance and monitoring for uveitis in the context of vaccinations, including COVID-19 vaccinations, particularly in individuals with a history of uveitis.”
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