Characteristics of emerging new autoimmune diseases after COVID-19 vaccination: A sub-study by the COVAD group

Shumnalieva R, Ravichandran N, Hannah J, Javaid M, Darooka N, Roy D, Gonzalez DE, Velikova T, Milchert M, Kuwana M, Joshi M, Gracia-Ramos AE, Boyd P, Yaadav P, Cheng K, Kobert L, Cavagna L, Sen P, Day J, Makol A, Gutiérrez CET, Caballero-Uribe CV, Saha S, Parodis I, Dey D, Nikiphorou E, Distler O, Kadam E, Tan AL, Shinjo SK, Ziade N, Knitza J, Chinoy H, Aggarwal R, Agarwal V, Gupta L (2024)

Publication Type: Journal article

Publication year: 2024


Book Volume: 27

Article Number: e15178

Journal Issue: 5

DOI: 10.1111/1756-185X.15178


Background: Despite the overall safety and efficacy of COVID-19 vaccinations, rare cases of systemic autoimmune diseases (SAIDs) have been reported post-vaccination. This study used a global survey to analyze SAIDs in susceptible individuals' post-vaccination. Methods: A cross-sectional study was conducted among participants with self-reported new-onset SAIDs using the COVID-19 Vaccination in Autoimmune Diseases (COVAD) 2 study dataset—a validated, patient-reported e-survey—to analyze the long-term safety of COVID-19 vaccines. Baseline characteristics of patients with new-onset SAIDs and vaccinated healthy controls (HCs) were compared after propensity score matching based on age and sex in a 1:4 ratio. Results: Of 16 750 individuals, 74 (median age 52 years, 79.9% females, and 76.7% Caucasians) had new-onset SAID post-vaccination, mainly idiopathic inflammatory myopathies (IIMs) (n = 23, 31.51%), arthritis (n = 15; 20.53%), and polymyalgia rheumatica (PMR) (n = 12, 16.40%). Higher odds of new-onset SAIDs were noted among Caucasians (OR = 5.3; 95% CI = 2.9–9.7; p <.001) and Moderna vaccine recipients (OR = 2.7; 95% CI = 1.3–5.3; p =.004). New-onset SAIDs were associated with AID multimorbidity (OR = 1.4; 95% CI = 1.1–1.7; p <.001), mental health disorders (OR = 1.6; 95% CI = 1.3–1.9; p <.001), and mixed race (OR = 2.2; 95% CI = 1.2–4.2; p =.010), where those aged >60 years (OR = 0.6; 95% CI = 0.4–0.8; p =.007) and from high/medium human development index (HDI) countries (compared to very high HDI) reported fewer events than HCs. Conclusion: This study reports a low occurrence of new-onset SAIDs following COVID-19 vaccination, primarily IIMs, PMR, and inflammatory arthritis. Identified risk factors included pre-existing AID multimorbidity, mental health diseases, and mixed race. Revaccination was well tolerated by most patients; therefore, we recommend continuing COVID-19 vaccination in the general population. However, long-term studies are needed to understand the autoimmune phenomena arising post-vaccination.

Authors with CRIS profile

Involved external institutions

Aleksandrovska University Hospital / университетска болница "Александровска" BG Bulgaria (BG) Byramjee Jeejeebhoy Government Medical College & Sassoon General Hospital IN India (IN) Instituto Mexicano del Seguro Social MX Mexico (MX) Maharashtra Institute of Medical Sciences and Research IN India (IN) University of Pittsburgh US United States (USA) (US) Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) IN India (IN) University of Manchester GB United Kingdom (GB) Institute of Post Graduate Medical Education and Research IN India (IN) University of Texas Medical Branch (UTMB) US United States (USA) (US) University of São Paulo / Universidade de São Paulo (USP) BR Brazil (BR) Universidad del Norte CO Colombia (CO) Université Saint-Joseph (USJ) / جامعة القديس يوسف / Սուրբ Ժոզեֆի համալսարան LB Lebanon (LB) Mymensingh Medical College / ময়মনসিংহ মেডিকেল কলেজ BD Bangladesh (BD) University Hospital St. Ivan Rilski BG Bulgaria (BG) Karolinska University Hospital / Karolinska Universitetssjukhuset SE Sweden (SE) University of Ghana GH Ghana (GH) King’s College London GB United Kingdom (GB) Universitätsspital Zürich (USZ) CH Switzerland (CH) King Edward Memorial Hospital and Seth G.S. Medical College / கிங் எட்வர்ட் நினைவு மருத்துவமனை,राजा एड्वर्ड स्मारक रुग्णालय व सेठ गोवर्धनदास सुंदरदास वैद्यकीय महाविद्यालय IN India (IN) King's College Hospital (KCH) GB United Kingdom (GB) NIHR Leeds Musculoskeletal Biomedical Research Unit (LMBRU) GB United Kingdom (GB) Myositis Support and Understanding US United States (USA) (US) Pomeranian Medical University / Pomorski Uniwersytet Medyczny w Szczecinie (PMU) PL Poland (PL) The Myositis Association US United States (USA) (US) Università degli Studi di Pavia IT Italy (IT) Maulana Azad Medical College (MAMC) IN India (IN) Pontifical Xavierian University / Pontificia Universidad Javeriana CO Colombia (CO) Royal Melbourne Hospital (RMH) AU Australia (AU) Mayo Clinic US United States (USA) (US) Aga Khan University (AKU) / آغا خان یونیورسٹی‎ PK Pakistan (PK)

How to cite


Shumnalieva, R., Ravichandran, N., Hannah, J., Javaid, M., Darooka, N., Roy, D.,... Gupta, L. (2024). Characteristics of emerging new autoimmune diseases after COVID-19 vaccination: A sub-study by the COVAD group. International Journal of Rheumatic Diseases, 27(5).


Shumnalieva, Russka, et al. "Characteristics of emerging new autoimmune diseases after COVID-19 vaccination: A sub-study by the COVAD group." International Journal of Rheumatic Diseases 27.5 (2024).

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