Devy Zisman1, Noa Hayat1, Amir Haddad2, Joy Feld3, Tal Gazitt1, Idit Lavi1, Ilan feldhamer4, ARNON DOV COHEN4 and Walid Saliba1, 1Carmel Medical Center, Haifa, Israel, 2Carmel Medical Centre, Haifa, Israel, 3Carmel and Zvulun Medical Centre, Haifa, Israel, 4Clalit Health Services, Tel Aviv, Israel
Background/Purpose: The importance and efficacy of anti COVID-19 vaccine in coping with the pandemic are well established, but inconsistencies remain in the data regarding side effects, especially in patients with rheumatic diseases.We aimed to assess the incidence of Herpes Zoster (HZ) in patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS) after each of the three doses of the BNT162b2 mRNA vaccine compared to HZ incidence in a similar period two years prior to vaccination.
Methods: The database of Clalit Health Services, the largest health care provider of approximately 4.7 million members in Israel, was retrospectively analyzed for patients with a diagnosis of PsA and AS in 2018 who later received the first dose of BNT162b2 mRNA vaccine in a national vaccination campaign. The incidence of HZ events was calculated in the 42 days following each of the three vaccine doses and compared to a similar time period within this group of patients two years prior. Comparison of categorical variables between the group of patients with HZ events compared to the group without HZ events was performed by Chi square test. Student's t-test was used to examine the age difference between the two groups. The number of HZ events recorded following vaccine administration compared to a similar time period two years prior was tested by McNamara test.
Results: The study population consisted of 6525 patients, 4580 (70.2%) PsA, 1830 (28%) AS and 115 (1.8%) with PsA and AS with a mean age of 55.5±15.1 years, of whom 3377 (51.8%) female. Of the 6525 patients who received the first vaccine dose, 6266 (96%) and 5369 (82.3%) received the 2nd and 3rd doses, respectively. The number of HZ events recorded following vaccination compared to a similar time period two years prior were 9 cases (0.14%) versus 8 (0.12%) cases (p=1) after the first vaccine dose , 11 (0.18%) cases versus 7 (0.11%), p=0.48 after the second dose, and 4 cases (0.07%) versus 0, p=0.13 after the third dose, respectively. None of the patients who suffered from HZ two years prior to vaccine administration had HZ reactivation following vaccination. No differences were noted in the HZ reactivation rate among the different patient groups. Patients who suffered from HZ reactivation were older, mean age 63.1±10.5 years, compared to 55.5±15.1 years (p= 0.013) in non-HZ group. There was no statistically significant difference regarding sex or socioeconomic status between patients who developed HZ after vaccine doses compared to PsA and AS patients without HZ.
Conclusion: The risk of HZ after each one of the three BNT162b2 mRNA vaccination doses was not increased in PsA and AS patients compared to a similar time period two years prior . The risk of HZ increased with age.
Disclosures: D. Zisman, Pfizer, Elli Lilly, AbbVie/Abbott, Janssen; N. Hayat, None; A. Haddad, None; J. Feld, None; T. Gazitt, None; I. Lavi, None; I. feldhamer, None; A. DOV COHEN, None; W. Saliba, None.
