As the time approached for the COVID-19 vaccines to be approved by the FDA, there was very little safety and efficacy data available for patients with systemic rheumatic disease (SRD). Sara K. Tedeschi, MD, MPH, co-director of the Fast Track Clinic for Giant Cell Arteritis at Brigham and Women’s Hospital, Daniel H. Solomon, MD, MPH, chief of the Section of Clinical Sciences in the Division of Rheumatology, and colleagues surveyed patients with SRD about their attitudes toward COVID-19 vaccination.
In ACR Open Rheumatology, they report high interest and a high trust in physician recommendations about vaccination.
The researchers invited a convenience sample of 968 patients to complete a survey in English or Spanish. Surveys were distributed in December 2020 and January 2021, and responses were accepted through April 2021.
Responses were compared with responses on the nationwide Harris Poll Survey Wave 36 (October 2020; n=1954 respondents) and Wave 50 (February 2021; n=2043 respondents), which surveyed a sample of the general population and included questions similar to those asked at the Brigham.
Characteristics of the Respondents
The 243 respondents had a mean age of 56, 82% were women, 33% were from racial/ethnic minority groups, and 7% completed the survey in Spanish. 76% had a college degree or higher level of education. All participants had a systemic rheumatic disease, with rheumatoid arthritis being the most common (49.8%) followed by systemic lupus erythematosus (27.6%) and psoriatic arthritis (13.2%).
88% of participants were using a disease-modifying antirheumatic drug and/or glucocorticoids, and 30% had previously been hospitalized for some type of infection.
Vaccination in General
Attitudes toward vaccination, in general, were positive:
- “Very in favor” or “pretty much in favor” of vaccines—91%
- Influenza vaccination received in the past year—92%
- Most common reasons for previously receiving vaccines—Recommendation by a doctor (90%) and desire to avoid infection (70%); 45% endorsed “important for community health”
- Having declined a vaccine recommended by a doctor in the past—11%; reasons included concerns about a possible flare of rheumatic disease, concerns about safety, not believing in getting vaccines, previous adverse reaction to vaccines, and allergy
Intent to Receive COVID-19 Vaccination
Desire to receive a COVID-19 vaccine was high and did not vary by immunomodulator use:
- 91% of respondents said they wanted to get vaccinated (92% of Asian participants, 79% of Black participants, 83% of Latinx participants, and 93% of white participants, but these differences were not statistically significant); 84% said “as soon as possible”
- 7% were unsure
- 2% did not want to be vaccinated
The percentage of Harris Poll general population respondents who said they were very likely to get a COVID-19 vaccine as soon as possible was significantly lower than in the Brigham SRD cohort (29% in October 2020, P<0.001, and 42% in February 2021, P<0.001).
Features of COVID-19 Vaccines
“Important” or “very important” features of a COVID-19 vaccine were:
- Safety—95% of participants
- No need to stop immunomodulator treatment—62%
- Only one dose is required—25%
85% of respondents said they were very likely to get a COVID-19 vaccine if it decreased their risk of infection by approximately 75%, and 92% were very likely if it reduced the risk by more than 90%. The corresponding figures in the October 2020 Harris poll were 31% and 38%.
Publicity about COVID-19 vaccine study results, availability of the vaccines and the general public’s knowledge of the vaccines changed during the study period and may have influenced the results, as well as the comparability to the October 2020 Harris Poll.