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Comparison of reporting rates of arthritis and arthralgia following AstraZeneca, Pfizer-BioNTech, Moderna, and Janssen vaccine administration against SARS-CoV-2 in 2021: analysis of European pharmacovigilance large-scale data

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Abstract

This study aimed to investigate the reporting rates of arthritis and arthralgia following the administration of four vaccines against SARS-CoV-2: Pfizer-BioNTech (Tozinameran), Moderna (CX-024414), AstraZeneca (Chadox1 NCOV-19), and Janssen (AD26.COV2.S) in 2021. We used data from the EudraVigilance database, specifically analyzing spontaneous reports of suspected adverse reactions (ADRs) from the European Union (EU)/European Economic Area (EEA) region. Age-group-specific reporting rates were calculated by dividing the number of arthralgia and arthritis reports per 1,000,000 vaccine doses administered per age group. Reporting rates were compared using a rate ratio among the four vaccines, using the AstraZeneca vaccine as a comparator. The AstraZeneca vaccine was associated with the highest rate of arthralgia across all age groups. Arthritis reporting rates were significantly lower, with the AstraZeneca vaccine having the highest rates in most age groups, except the 60–69 and 80+ groups, where the Janssen and Pfizer-BioNTech vaccines demonstrated higher reporting rates, respectively. The distribution of arthritis rates did not follow the arthralgia pattern, being higher in the 50–79 age group. This study is the first spontaneous reporting system analysis of arthritis reporting rates post-SARS-CoV-2 vaccination at a European level, revealing a higher reporting of suspected musculoskeletal adverse reactions after AstraZeneca vaccination. The findings underscore the need to consider commonly reported events like arthralgia in risk–benefit assessments prior to vaccination against SARS-CoV-2. Given the high prevalence of rheumatic and musculoskeletal diseases and vaccine hesitancy in this population, our results could influence vaccine choice and acceptance.

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Data availability

Data are available upon reasonable request from the authors.

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Acknowledgements

The authors are grateful to Mr. Rodrigo Postigo from EudraVigilance for providing insightful comments on the manuscript prior to its initial submission. Furthermore, the authors are grateful to EudraVigilance for providing access to the requested data.

Funding

No funding was provided for this study.

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Authors and Affiliations

  1. School of Medicine, University of Zagreb, Zagreb, Croatia

    Elena Primorac Padjen, Robert Marcec, Ivan Padjen, Branimir Anic & Robert Likic

  2. Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia

    Matija Zidar

  3. Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

    Ivan Padjen & Branimir Anic

  4. School of Dental Medicine, University of Zagreb, Zagreb, Croatia

    Tomislav Katanec

  5. Division of Clinical Pharmacology and Therapeutics, Department of Internal Medicine, University Hospital Centre Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia

    Robert Likic

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Contributions

EPP, RM, MZ, TK, and IP: wrote the manuscript and performed data analysis, while BA and RL: performed critical revision and coordination for the study. All authors approved the final version of the manuscript.

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Correspondence to Robert Likic.

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Thical Committee of the School of Medicine, University of Zagreb, October 27, 2021, number 380-59-10106-21-111/230, class 641-01/21-02/01.

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Primorac Padjen, E., Marcec, R., Zidar, M. et al. Comparison of reporting rates of arthritis and arthralgia following AstraZeneca, Pfizer-BioNTech, Moderna, and Janssen vaccine administration against SARS-CoV-2 in 2021: analysis of European pharmacovigilance large-scale data. Rheumatol Int 44, 273–281 (2024). https://doi.org/10.1007/s00296-023-05512-1

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