Medically reviewed by Nancy Carteron, M.D., FACR — Written by Zawn Villines on June 29, 2021
People with arthritis may be concerned that the COVID-19 vaccine will trigger an arthritis flare-up. However, the chance of this occurring is relatively small. Additionally, those with arthritis generally tolerate the vaccine well.
A 2021 study involving 1,519 people with arthritis and other musculoskeletal conditions found that only 5% of the participants experienced flare-ups following the COVID-19 vaccine and that 1.2% experienced severe flare-ups.
Authors of the study also found that the vaccine was generally safe and that people with arthritis tolerated it well.
This article discusses why it is important to get the COVID-19 vaccine. It also looks at how safe and effective the vaccine is for those with arthritis.
It is important for a person to get the COVID-19 vaccine if they are medically able to do so.
A 2021 study in The LancetTrusted Source notes that it is advisable for those with rheumatic diseases to receive the COVID-19 vaccination.
This is because the vaccine reducesTrusted Source the likelihood of contracting and spreading the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It also helps prevent people from developing a severe illness with COVID-19 if they contract the virus.
Additionally, those with certain medical conditions have a higher riskTrusted Source of becoming severely ill with COVID-19. This can increase the likelihood of:
- requiring hospitalization
- needing intensive care
- requiring a ventilator to help them breathe
- experiencing chronic symptoms, or long COVID
- contracting SARS-CoV-2
- developing severe illness with COVID-19
- requiring hospitalization
- death due to COVID-19-related complications
The study found that people with RA were 25% more likely than those in the general population to contract the virus. They were also 35% more likely to require hospitalization or die.
The COVID-19 vaccine is safe and effectiveTrusted Source, and a person with arthritis should get the vaccine if they are medically able to do so. However, in rare cases, it is possible that the vaccine can trigger an arthritis flare.
Of the participants, 78% received the Pfizer vaccine, 16% received the Oxford-AstraZeneca vaccine, 5% received the Moderna vaccine, and 1% received an uncertain vaccine type.
After vaccination, 5% of the participants experienced arthritic flare-ups, and 1.2% experienced severe flare-ups.
Despite this, most data show that the COVID-19 vaccine is safe for people with arthritis. The study found that most adverse effects were the same as those experienced by the general population. The side effects were short-term and nonserious.
Authors of the study conclude that the COVID-19 vaccine is safe for those with RA and those taking treatments that influence the immune system.
Most studies have examined the relationship between the COVID-19 vaccine and those with autoimmune RA. The immune response to the COVID-19 vaccine may trigger flares in people with immune-related arthritis.
However, there is no evidence to date that the vaccine triggers flare-ups in osteoarthritis.
Some researchers have expressed concerns that disease-modifying drugs might change the immune system’s response to the COVID-19 vaccine, making it less effective.
Authors of a 2021 studyTrusted Source found lower antibody responses in some people with RA taking these drugs. However, almost all developed a sufficient antibody response by the time they received the second dose of the vaccine.
The lowest antibody response was among those taking Janus kinase (JAK) inhibitors in monotherapy or combination therapy.
Despite this, 67% of the 12 people who were taking JAK inhibitors in monotherapy or combination therapy developed a sufficient antibody dose to neutralize SARS-CoV-2.
The study notes that 94% of people taking anti-cytokine biologics developed a neutralizing antibody response. One anti-cytokine biologic, rituximab, which depletes B cells — which make antibodies — is not given until vaccination is complete.
The most common side effects in those with arthritis include:
The side effects are usually short-term and will resolve without treatment. However, a person should contact a doctor if the side effects persist or steadily worsen.
No arthritis or public health agency currently recommends discontinuing arthritis medication, either because of the vaccine or to avoid contracting SARS-CoV-2.
Stopping arthritis medication can trigger a flare, especially if a person stops taking their medication suddenly.
Moreover, research suggestsTrusted Source that even when taking arthritis medication, most people respond well to the vaccine and develop enough antibodies and immune cells to fight the virus.
A person should consult a doctor about the risks and benefits of continuing medications.
People with serious underlying health conditions should discuss these conditions with a doctor.
They may also want to undergo testing to ensure their bodies have produced antibodies in response to the vaccine.