Second, Third COVID-19 Vaccine May Up Relapse in Glomerular Disease

MONDAY, Nov. 7, 2022 (HealthDay News) — Exposure to a second or third dose of COVID-19 vaccine is associated with an increased risk for relapse for adults with glomerular disease, according to a study published online Nov. 3 in the Journal of the American Society of Nephrology.

Mark Canney, M.B., B.Ch., Ph.D., from the University of Ottawa in Ontario, Canada, and colleagues examined the relative and absolute risks of glomerular disease relapse following COVID-19 vaccination in a retrospective population-level cohort study involving 1,105 adults with biopsy-proven glomerular disease.

The researchers found that 12.1 percent of patients had a relapse during 281 days of follow-up. There was no association seen for first vaccine dose with relapse risk (hazard ratio, 0.67; 95 percent confidence interval, 0.33 to 1.36), but exposure to a second or third dose was associated with an elevated risk for relapse (hazard ratio, 2.23; 95 percent confidence interval, 1.06 to 4.71). A similar pattern of relative risk was seen across glomerular diseases. There was variation noted in the absolute increase in 30-day relapse risk linked to a second or third vaccine dose, from 1 to 2 percent in antineutrophil cytoplasmic antibody-related glomerulonephritis, minimal change disease, membranous nephropathy, or focal segmental glomerulosclerosis to 3 to 5 percent for immunoglobulin A nephropathy or lupus nephritis. Four of 24 patients experiencing a vaccine-associated relapse had a change in immunosuppression; none required a biopsy.

“These results indicate that although COVID-19 vaccines may be associated with a small increase in risk of causing a flare of glomerular disease, this risk is very small, and the well-established benefits of vaccination more that outweigh these risks,” a coauthor said in a statement.

One author disclosed financial ties to the pharmaceutical industry.