IgA vasculitis risk following COVID-19 vaccine no greater than with other vaccines
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Patients who have received a COVID-19 vaccine demonstrate a “slight but significant” change of developing IgA vasculitis, but no more than with other vaccines, according to data published in the Journal of Rheumatology.
“COVID-19 pandemic outbreak triggered a worldwide vaccination campaign, using mainly a new messenger ribonucleic acid (mRNA)-based technology followed by several reports of related autoimmune manifestations,” Yanis Ramdani, MD, of the department of internal medicine at Bretonneau Hospital, in Paris, and colleagues wrote. “However incidental findings cannot be ruled out.”
To investigate the potential link between COVID-19 vaccination and IgA vasculitis, Ramdani and colleagues conducted an observational disproportionality study. Using Vigibase, a WHO global database of individual case safety reports, the researchers collected reports of IgA vasculitis involving COVID-19 vaccines that occurred through June 1, 2022, including all cases of patients who corresponded to the lowest level IgA vasculitis-identifying terms in the Medical Dictionary for Regulatory Activities.
The researchers extracted data from each case report, including patient demographics, exposure characteristics and present features of IgA vasculitis. Disease features included time-to-onset, seriousness of case, outcome and whether there was recurrence following additional vaccine doses.
The analysis included a total of 330 new cases of IgA vasculitis from 24 countries, with 58% coming from the United States. On average, the time to onset was 7 days, and 85% of patients included in the analysis underwent vaccination using mRNA vaccines. In terms of severity, “seriousness” was reported in 188 cases. In all, 95 patients recovered and two died, according to the researchers. Additionally, a positive rechallenge was reported for three of four patients, they wrote.
Meanwhile, the researchers identified 996 cases of IgA vasculitis in relation to other vaccines. According to the researchers, there was a “small significant increase in IgAV reporting” with the COVID-19 vaccines vs. all other drugs (IC = 0.22; 95% CI, 0.04 to 0.35). There was no significant difference between mRNA vaccines and viral vector COVID-19 vaccines, they added.
Significant overreporting of IgAV but not greater than that observed with other vaccines,” Ramdani and colleagues wrote. “Despite the small number of cases considered, the existence of positive rechallenge with IgAV relapse in this study, and the demographic characteristics of the reported cases, support the hypothesis of a triggering effect of COVID-19 vaccines.
“This study, however, provides reassuring results regarding the safety of COVID-19 vaccines in the occurrence of IgAV compared to other vaccines,” they added.
References:
- Chen Y, et al. Immunology. 2022;doi:10.1111/imm.13443.
- N AM, et al. Clin Rheumatol. 2022;doi:10.1007/s10067-022-06097-z.
- Park JW, et al. Int J Biol Sci. 2021;doi:10.7150/ijbs.59233.
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