ABSTRACT
Background: Patients with rheumatological diseases like SLE are at an increased risk of COVID-19 infection and hence should be prioritized for vaccination. Vaccine hesitancy is a major hindrance in achieving herd immunity against COVID-19. In this study, we aim to determine the COVID-19 vaccination rate in our SLE population and the factors associated with vaccine hesitancy. Materials and methods: We conducted an interview-based cross-sectional study on patients >18 years attending the lupus clinic of our Institute. Questionnaires were used to collect demographic details, disease status, vaccination-related data, and information regarding attitude and beliefs about COVID-19 vaccination. Descriptive statistics were used for analysis. Results: Of the 584 patients studied, the vaccination rate was 67%, and there was vaccine hesitancy of 21%, and vaccine resistance of 12%. Non-vaccination was strongly associated with older age, rural living, unemployment, and in patients with anti-phospholipid antibodies, prior stroke, prior COVID- 19 infection, and those who were currently using corticosteroids. The major reasons for vaccine hesitancy were fear of worsening lupus, fear of side effects, and religious reasons. We also came to know about various misconceptions regarding COVID vaccination prevalent among SLE patients under our follow-up causing them to opt against the vaccine. The vaccine-hesitant group may rethink their decision if there is proper reassurance and guidance from their treating physician or if more friends and family members start accepting vaccines. Conclusions: Vaccine hesitancy is a major problem in our group of SLE patients keeping the vaccination rates low. The reasons for vaccine hesitancy must be looked into and addressed to improve the vaccination rates and thereby achieve herd immunity. Proper guidance from the treating rheumatologist was reported as the major factor which may encourage the vaccine-hesitant population to opt in for the vaccination.