LAUSR

Vaccination is an important and effective tool to prevent infections in the general population as well as in patients with systemic autoimmune or inflammatory rheumatic diseases (AIIRDs) who may be at increased risk of serious infection. While the global race for vaccines against COVID-19 has already lead to first authorizations and vaccinations in some countries, multiple questions arise for access and provisions as well as for the acceptance of vaccine policies by immunocompromised patients.We conducted an international survey about expectations and potential concerns regarding SARS-CoV-2 vaccine in patients with AIIRDs and healthcare professionals.The online study consisted of 57 questions which addressed determinants associated with SARS-2-CoV-2 vaccine willingness. Dissemination was ensured through social media and patient associations between December 12 and December 21, 2020.The study included 1266 patients with AIIRDs and 265 healthcare professionals from 56 countries. SARS-CoV-2 vaccine willingness was reported by 54.2% of AIIRD patients (uncertainty in 32.2% and unwillingness in 13.6%) and 74.0% of healthcare professionals. In patients, the willingness to get vaccinated increased significantly with age (p<0.0001) and was strongly associated with the fear to be infected by SARS-CoV-2 (p<0.0001) or to develop severe COVID19 (p<0.0001) but not with presence of additional comorbidities (p=0.71) or immunocompromised status (p=0.94). The most trusted healthcare professional regarding the recommendation to get vaccinated against COVID-19 was their specialist (rheumatologist, internist, etc.) for 69.9%. Vaccine unwillingness was low (7.9%) among healthcare professionals and willingness was significantly increased in those who had been vaccinated against influenza in the last 3 years (p=0.01).Subject groupsPatientsHealthcare professionalsN1266265Age (years), median [IQR25-75]50 [40-61]40 [32.5-53]Female, n (%)1141 (90.1%)150 (56.6%)Male, n (%)115 (9.9%)115 (43.4%)Country, n (%) France320 (25.3%)159 (60%) UK345(27.3%)4 (1.5%) Chile123 (9.7%)4 (1.5%) USA114 (9.0%)7 (2.6%) Venezuela43 (3.4%)26 (9.8%) Spain57 (4.5%)3 (1.1%) Mexico53 (4.2%)3 (1.1%) Argentina45 (3.6%)8 (3.0%) Other*166 (13.1%)51 (19.2%)Rheumatic diagnosis, n (%)1266- Systemic lupus erythematosus492 (38.9%)- Spondyloarthritis176 (13.9%)- Rheumatoid arthritis160 (12.6%)- Giant cell arteritis / Polymyalgia rheumatica144 (11.4%)- Primary anti-phospholipid syndrome64 (5.1%)- Inflammatory myositis62 (4.9%)- Relapsing polychondritis45 (3.6%)- Other**123 (9.7%)--Health professionals, n (%)-265 Doctor-203 (76.6%) Nurse (or equivalent)-23 (8.7%) Nursing assistant-11 (4.2%) Other***-28 (10.6%)Associated comorbidities, n (%) Diabetes69 (5.5%)6 (2.3%) Hypertension267 (21.1%)24 (9.1%) Myocardial infarction, stroke, transient stroke60 (4.7%)1 (0.4%) Respiratory disease (asthma, chronic bronchitis, emphysema, etc.)169 (13.3%)13 (4.9%)Renal failure47 (3.7%)1 (0.4%)Obesity (BMI > 30)228 (18.0%)18 (6.8%)At least one associated comorbidity, n (%)588 (46.4%)50 (18.9%)Smoker, n (%)128 (10.2%)22 (8.3%) Current411 (32.7%)51 (19.2%) Past719 (57.1%)192 (72.5%) NeverUse of oral glucocorticoids, n (%)551 (56.1%)3 (1.1%)Immunocompromised$, n (%)770 (60.8%)0On a 0 to 10 scale, median8 (6-10)5 (3-8)[IQR25-75]9 (7-10)5 (1-8)−Afraid to get infected by SARS-CoV-2−Afraid to get a severe COVID-19Willing to get vaccinated (Yes / uncertain / No), %54.2 / 32.2 / 13.674.0 / 18.1 / 7.9Vaccine hesitancy, n (%)357 (28.2%)59 (22.3%)Data from this study are crucial to understand the main expectations and concerns regarding SARS-CoV-2 vaccination in patients with AIIRDs and healthcare workers and allow the identification of valuable strategies to increase vaccine coverage in those populations.We wish to acknowledge the crucial role of the following patient associations: LupusEurope (tweeter: @LupusEurope), Agrupacion Lupus Chile (@Lupus_Chile), RarasNoInvisibles (@Noinvisibles), Lupus UK, Lupus France, SPONDYL’ASSO, Spondyl(O)action, AFL+, in the dissemination of the survey. We are indebted to Gonzalo Tobar Carrizo (@pinkycito) for the Spanish translation of the survey, all patients, families, and health professionals for their kind participation in our study. We wish to thank Ms. Sylvie Thuong for her invaluable assistance.Renaud FELTEN Speakers bureau: Pfizer, Maxime Dubois: None declared, Manuel F. Ugarte-Gil Speakers bureau: Janssen and Pfizer, Jérémy Fort: None declared, Luc PIJNENBURG: None declared, Aurore Chaudier: None declared, Lou Kawka: None declared, Charlotte Costecalde: None declared, Hugo Bergier: None declared, Emmanuel Chatelus: None declared, Rose-Marie Javier: None declared, Christelle Sordet: None declared, Jacques-Eric Gottenberg Speakers bureau: Pfizer and Astra-Zeneca, Jean Sibilia Speakers bureau: Pfizer, Yurilis Fuentes-Silva: None declared, Laurent Arnaud Speakers bureau: Pfizer and Astra-Zeneca.