Coronavirus disease (COVID-19) vaccine and gout flare (questionnaire survey at a gout specialty medical institution)

Abstract

The coronavirus disease (COVID-19) vaccine markedly contributes to the prevention of infection and aggravation of COVID-19, which has spread throughout the world, but many vaccinated people suffer from various local or systemic adverse events. In October 2021, a questionnaire survey was conducted involving outpatients with gout to examine the association between COVID-19 vaccination and gout flare. Of the 1,480 vaccinated gout patients, 20 (1.35%) had gout flare within 3 days of vaccination. There was no difference depending on the type of vaccine, Pfizer or Moderna. Thirteen patients were being treated with uric acid-lowering drugs, and 10 of them showed generally good control of serum uric acid levels. In addition to the responses to the questionnaire survey, considering the contents described in the medical records, it was determined that 57 patients (3.85%) were more likely to have gout flare after vaccination. It has been reported that vaccination increases the risk of gout flare, and the suggested mechanism is activation of NLRP3 inflammasomes by the aluminum adjuvant contained in the vaccine preparation, but the COVID-19 vaccine does not contain aluminum adjuvant. Although the pathogenesis of gout flare due to COVID-19 vaccination is unknown, gout flare may be one of the adverse events caused by the COVID-19 vaccine.