Understanding caregiver vaccine hesitancy and experiences in children with paediatric rheumatic diseases: results from the C19-GRA Global Pediatric Survey.

Objectives: To examine COVID-19 vaccination rates, parental hesitations, and reported adverse events among children with paediatric rheumatic diseases (PRDs), and to describe long-term COVID-19 complications in this population using data from the 2023 COVID-19 Global Rheumatology Alliance Pediatric Survey. Methods: The survey was written in English, translated into 25 languages, and disseminated globally through email, social media, and patient organisations. Eligible respondents were aged ≥18 years and caregivers of children aged <18 years with PRDs. Caregiver-reported data included severe and long-term COVID-19 outcomes, as well as vaccine hesitancy and adverse events. Results: A total of 592 caregivers provided information on 616 children with PRDs. Vaccination rates were 92% among caregivers and 70% among children. Vaccine adverse events were uncommon, with severe events in 12 children (2.7%). Among children, 407 (66%) had at least 1 COVID-19 infection, with 15 (3.7%) requiring hospitalisation. Postacute sequelae of COVID-19 symptoms were reported in 55 children (13.5%), although only 32 (58.1%) were formally diagnosed. Multisystem inflammatory syndrome in children was reported in 14 children (3.4%). Conclusions: COVID-19 vaccination rates in this cohort exceeded those of otherwise healthy children, and adverse events were rare. Severe and long-term COVID-19 outcomes were infrequent, supporting vaccine safety in children with PRDs.