Background: According to Statista, 78.5% of the population in Malaysia have completed their vaccination as of 6 ^th january 2022 [1].The acceptance of patients with rheumatic diseases on Covid-19 vaccination is crucial in the long term protection against Covid-19 infection. We conducted a survey to determine the acceptance of Covid-19 vaccination amongst patients with underlying rheumatic disease.

Objectives: To find out the reasons of vaccination refusal amongst rheumatology patients.

Methods: This was an interview survey. All rheumatology patients who were follow up in rheumatology clinic Hospital Sultan Ismail, Malaysia from 26 ^th April 2021 to 25 ^th July 2021 (total 3 months) were interviewed. Demographic and diagnosis of the patients were collected.

Results: A total of 952 patients were identified. 83.7% of them were female patients (797/952) and majority of them were Malay (46.4%). This was followed by Chinese (36.1%), Indian (16.3%) and others (1.2%). The mean age group was 48 (range from 13 -85).

97.6% of the respondents were categorized as having inactive disease during the interview sessions.

36.6% of the patients were diagnosed to have rheumatoid arthritis and 29.1% of them were having systemic lupus erythematosus. These were followed by psoriatic arthritis (10.9%), mixed connective tissue disease (5.5%), systemic sclerosis (2.9%), gout (2.6%), Sjogren syndrome (1.9%), ankylosing spondylitis (1.6%), myositis (1.5%), vasculitis (1.3%), osteoarthritis (1.2%), antiphospholipid syndrome (0.9%), non-specific arthralgia (0.8%), juvenile idiopathic arthritis (0.8%), seronegative spondyloarthropathy (0.8%), undifferentiated connective tissue disease (0.7%), adult onset still’s disease 0.5%) and others (< 0.5% each for Ig G 4 related disease, soft tissue rheumatism and fibromyalgia).

87.3% of them were keen or have already received Covid-19 vaccination. 12.7% of them were not keen for the vaccination with various reasons.

48.8% of them were worrying about worsening clinical condition, 12.4% of them were not keen as they concerned about side effects (3 worry about fever, 1 worry about hepatitis, 1 for nausea, 1 for dizziness, 1 for breathlessness, and 7 for non-specific reasons). 10.7% of them were not keen due to pregnancy, 5.79% of them were not keen as worried about allergic reactions, 4.9% of them were worrying about sudden cardiac death, 4% were not keen as on chemotherapy treatment, 3 % of them doubted the efficacy of vaccination, 2.5% were not keen as they worried about heart disease, 2.5% worried about increase risks of infection and others (2 for old age, 2 for thrombotic event, 2 for drug interaction and 1 patient due to hemodialysis).

Conclusion: The overall acceptance rate of Covid-19 vaccination amongst patients with rheumatic diseases is very encouraging with the percentage of >85% despite of lacking knowledge about vaccine Covid-19. This result can assist our Ministry of Health to plan for future battle to improve vaccine uptake that hopefully can lead to herd immunity against COVID-19 infection. More counseling sessions are required to clear up the doubts of vaccination and increase the vaccination rate amongst rheumatic patients.

REFERENCES:

[1]R. Hirschmann, Vaccination rate against Covid-19 Malaysia 2022, by state, Statista. Jan 7, 2022.

Disclosure of Interests: None declared