Ana Esteban-Vázquez

Since the development of vaccines for coronavirus disease 2019 (COVID-19), the course of infections has changed significantly. Over the past 4 years of coexisting with the virus, a marked improvement in disease outcomes has been observed, especially in patients with rheumatological diseases; this is largely attributable to widespread immunization. This study aimed to evaluate the perception of COVID-19 vaccine protection and to describe the incidence and severity of COVID-19 in the pre- and post-vaccination periods among different patient typologies and immunosuppressive treatments in rheumatology patients. This study used observational, descriptive–analytical, ambispective, and cross-sectional methods. We administered a questionnaire in the rheumatology department to patients with immune-mediated inflammatory diseases (IMID), with or without disease-modifying antirheumatic drugs, including conventional synthetic drugs, biological drugs, and targeted synthetic drugs, and to patients with musculoskeletal conditions (non-autoimmune patients). All patients received at least 2 doses of the COVID-19 vaccine. A total of 407 patients, with a mean age and standard deviation 59.1 ± 13.6 and 66.1% female, were studied. Most patients (78.1%) reported feeling protected or very protected by the COVID-19 vaccine, with the perception of safety ranging from 66.9% to 87.5% across different patient typologies. The proportion of patients who felt protected or very protected was significantly lower in the non-autoimmune group (63.9%) than in the IMID patients treated with conventional synthetic drugs (87.5%) or biological drugs [excluding CD-20 inhibitors (rituximab)] and targeted synthetic drugs (82.1%) (P < .001 and P = .011, respectively). There were no significant differences in the incidence of COVID-19 infection or in the severity of its clinical presentation (in both the pre- and post-vaccination stages) among the different typologies of patients, or in relation to the immunosuppressive therapy they received. Patients with IMID who received immunosuppressive treatment reported higher levels of perceived protection after COVID-19 vaccination. However, the incidence and severity of COVID-19 were similar between patients with and without IMIDs. This study supports the importance of infection prevention in these patients and emphasizes the need for closely monitored vaccination programs.