Non Infectious Uveitis Risk May Be Affected By COVID-19 Vaccination Status

Overall, non infectious uveitis risk remains unchanged following COVID-19 vaccination, according to a study published in Ophthalmology. However, this risk does increase among individuals aged 5 to 44 years who underwent vaccination, according to the report.

Researchers performed a retrospective investigation including 4,611,378 individuals (mean age, 43.5 years; 50.8% women), which consisted of participants who underwent COVID-19 vaccination between December 2020 and November 2021 (n=2,305,689) and a matched control group of individuals who were unvaccinated due to data included prior to the vaccine rollouts (2018-2019). The team examined non infectious uveitis risk in both cohorts and made adjustments for age, corticosteroid and immunosuppressant use, smoking history, and recent non COVID-19 vaccinations.

Overall, COVID-19 vaccination did not increase the condition’s risk (hazard ratio [HR], 0.91; 95% CI, 0.75-1.10; P =.33), the report shows. A self-controlled case series of 686 vaccinated individuals comparing post vaccine risk with the risk during control intervals confirmed these findings (incidence rate ratio [IRR], 1.05; 95% CI, 0.89-1.23, P =.57). However, a subgroup analysis of individuals aged 5 to 44 years revealed an increased non infectious uveitis risk following COVID-19 vaccination (IRR, 1.40; 95% CI, 1.04-1.87, P =.024). 

Individuals undergoing immunomodulation therapy had an increased risk for the disorder (hazard ratio [HR], 2.85; 95% CI, 1.91-4.24, P <.001), while individuals with a recent history of non COVID-19 vaccines had a lower risk (HR, 0.66; 95% CI, 0.47-0.94; P =.02), the report shows.

“Though risk of non-infectious uveitis is known to increase with age, these results may
indicate that younger age may be a risk factor for the development of vaccine-associated [non infectious uveitis],” according to the researchers. “This could be explained by the fact that younger individuals with heightened antibody responses have exaggerated immune reactions to the vaccination, a phenomena consistent with the finding of increased risk of other rare post-vaccination outcomes in specifically younger populations, such as myocarditis.”

The strict inclusion of individuals with medical insurance is an acknowledged limitation to the research.