Does the COVID-19 vaccine cause a disease flare in patients with primary Sjögren’s syndrome? A Cross-Sectional Study

Background: Data regarding the efficacy of the COVID-19 (coronavirus disease) vaccine is limited in rheumatic disease patients. We aimed to study the post-COVID-19 vaccine disease exacerbation prevalence and characteristics in a sample of Primary Sjogren Syndrome (PSS) patients in Syria. Patients and Methods: We evaluated 32 PSS (Primary Sjogren Syndrome) patients. The pattern of vaccine received was evaluated, and the ESSDAI (Sjögren’s syndrome disease activity index). Activity score was used to assess the disease activity before and after vaccination. 32 patients had the first and second COVID-19 vaccine, 21 received a third dose, and 20 received the mRNA (Messenger ribonucleotide antibody vaccine) vaccine. The mean age of patients was 52 years, 22 patients were female, with a median disease duration of 7 years. Results: Respectively PSS flare was reported by 18 after the first vaccine dose, 15 after the second vaccine dose, and 13 after the third vaccine dose, typically appearing as musculoskeletal symptoms such as arthralgia/arthritis, without changing their medication. Eight patients discontinued the drug during vaccination. Seven patients used analgesics. Side effects were significantly higher in the mRNA vaccine group and in the first and second doses of the vaccine. There was no statistically significant difference in PSS exacerbation according to the pattern of vaccines. Conclusion: Our study highlights increased PSS flare risk post-COVID-19 vaccination, especially in high disease activity patients. Most flares were mild, mainly musculoskeletal symptoms. Side effects were higher with mRNA vaccines and initial doses. Despite risks, vaccination is recommended, prioritizing stable disease states for PSS patients.