Key PointsQuestion听
What is the risk of uveitis recurrence after COVID-19 vaccination in individuals with a history of uveitis?
Findings听
In this cohort study including 473鈥�934 individuals with history of uveitis and COVID-19 vaccination, the 3-month and 1-year cumulative incidences of postvaccination uveitis were 8.6% and 16.8%, respectively. Risk varied with different vaccine types and was higher between the first andf second vaccination doses, decreasing after subsequent vaccinations.
Meaning听
These results support consideration of monitoring for uveitis recurrence, particularly for the first month following vaccination in individuals with a history of uveitis.
Importance听
Understanding the potential risk of uveitis recurrence after COVID-19 vaccination in individuals with a history of uveitis is crucial for vaccination strategies and clinical monitoring.
Objective听
To investigate the risk of uveitis recurrence after COVID-19 vaccination in a cohort of individuals with a history of uveitis.
Design, Setting, and Participants听
This retrospective population-based cohort study included individuals diagnosed with uveitis between January 1, 2015, and February 25, 2021, in South Korea. After excluding individuals without COVID-19 vaccination or with SARS-CoV-2 infection, individuals with a history of uveitis who had received at least 1 dose of a messenger RNA (BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna]) or adenovirus vector-based (ChAdOx1 [AstraZeneca] or Ad26.COV2.S [Janssen]) COVID-19 vaccine were included. Data were analyzed from February 26, 2021, to December 31, 2022.
Exposure听
Demographic and clinical data, along with vaccination details, were retrieved from the Korean National Health Insurance Service and Korea Disease Control and Prevention Agency databases.
Main Outcomes and Measures听
Outcomes of interest were incidence and risk of postvaccination uveitis in association with different COVID-19 vaccines and periods before and after COVID-19 vaccination. Uveitis was categorized by onset (early, within 30 days, or delayed) and type (anterior or nonanterior). Hazard ratios (HRs) with 95% CIs were calculated to evaluate the risk of uveitis following COVID-19 vaccination, stratified according to vaccine type and vaccination period.
Results听
Of 543鈥�737 individuals with history of uveitis, 473鈥�934 individuals (mean [SD] age, 58.9 [17.4] years; 243鈥�127 [51.3] female) had documented COVID-19 vaccination and were included in analysis. The cumulative incidence of postvaccination uveitis was 8.6% at 3 months, 12.5% at 6 months, and 16.8% at 1 year, predominantly of the anterior type. Variations in the risk of postvaccination uveitis were observed across different vaccines and intervaccination periods. The risk of early postvaccination uveitis was increased for individuals receiving the BNT162b2 (HR, 1.68; 95% CI, 1.52-1.86), mRNA-1273 (HR, 1.51; 95% CI, 1.21-1.89), ChAdOx1 (HR, 1.60; 95% CI, 1.43-1.79), and Ad26.COV2.S (HR, 2.07; 95% CI, 1.40-3.07) vaccines. The risk of uveitis was higher particularly between the first and second vaccination doses (HR, 1.64; 95% CI, 1.55-1.73).
Conclusions and Relevance听
These findings suggest that there was an elevated risk of uveitis following COVID-19 vaccination, with the vaccine type and period mediating this risk. For individuals with a history of uveitis, clinicians should consider the potential risk of uveitis recurrence in vaccination strategies and clinical monitoring.