Risk factors

Tenth of arthritis patients hesitant about COVID-19 vaccines: survey


Greater than a tenth of Australian patients with inflammatory arthritis experienced at least some vaccine hesitancy during the COVID-19 pandemic, a rate about as high as the general population, researchers have found.

They say the problem was mostly driven by lack of information and defies simple explanations, given rheumatology patients would be expected to be more familiar with novel and preventative medicine.

The finding was based on a pair of surveys answered by some 594 inflammatory arthritis patients just before the pandemic in January 2020 and May 2021 – about two months into the Australian vaccine rollout.

Of those who completed both questionnaires, 74 (12%) were COVID-19 vaccine hesitant. There were similar hesitancy rates between patients with RA (14%), ankylosing spondylitis (11%) and psoriatic arthritis (18%).

Otherwise, there was little demographic difference between those who said they believed they should have a COVID-19 vaccine and those who answered ‘no’ or ‘unsure’, the team led by Dr Christopher McMaster reported in Rheumatology.

What did make a difference was each patient’s pre-pandemic beliefs about medications being harmful (p<0.001) and overused (p=0.002), with stronger beliefs resulting in persistent vaccine hesitancy.

“In our cohort, there was a strong correlation between different sources of information and changes in vaccine hesitancy,” they wrote (link here).

“Those who became vaccine hesitant self-reported seeking information from healthcare professionals less, with the greatest decline seen for rheumatologists (35% down from 84% at baseline).”

On the other hand, overall rates of influenza vaccine hesitancy remained low, decreasing from 12.8% pre-pandemic survey to 9.4% at follow-up. Among those who were not hesitant pre-pandemic, only 1.5% reported hesitancy in the second survey.

And reassuringly, those who those who reported hesitancy around COVID-19 vaccines did not report becoming any less likely to take an influenza vaccine as a result.

“This poses important questions about the specific drivers of hesitancy, and particularly questions what distinguishes beliefs between these two vaccines,” the authors said.

“On a more practical level, we did not find any evidence to suggest that the development of COVID-19 vaccine hesitancy will drive similar hesitancy about the influenza vaccine, which may help to quell concerns that many patients may now shun the annual influenza vaccine.”

They added: “In contrast to general medication beliefs, sources of information were the best predictors of changing hesitancy, rather than persistent hesitancy.”

“While this does not address those who remain persistently vaccine hesitant, it does underscore the important role that healthcare professionals in general, and rheumatologists in particular, play in increasing COVID-19 vaccine uptake.”

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