Eventos supostamente atribuíveis à vacinação ou Imunização (ESAVI) contra o Sars-Cov-2 reportados em pessoas idosas com doenças autoimunes; Scoping Review

Abstract

COVID-19, caused by the SARS-CoV-2 virus, is an acute respiratory infection with high transmissibility, primarily spread through aerosols, respiratory droplets, and direct contact with contaminated surfaces. Since its emergence in 2019, the pandemic has triggered global efforts to develop vaccines capable of reducing morbidity and mortality associated with the virus. Within this context, vaccination has become an essential public health strategy, although its implementation has required continuous monitoring of potential post-immunization adverse events. Adverse Events Following Immunization (AEFI) represent clinical manifestations that occur after the administration of vaccines and may or may not be causally related to immunization, including local and systemic reactions, which may be exacerbated by pre-existing clinical conditions. Therefore, the general objective of this study is to map and describe AEFI associated with vaccination against SARS-CoV-2 in elderly individuals with autoimmune diseases, identifying types of reported reactions and their possible clinical and immunological implications. This study is a scoping review conducted in the BVS, Embase, and Medline via PubMed databases, using the descriptors “Vaccines,” “SARS-CoV-2,” “Adverse drug reaction,” “Elderly,” and “Autoimmune disease.” Inclusion criteria comprised studies employing different methodological designs, available in full text online, and published between January 1, 2020, and September 20, 2025. Editorials, opinion articles, letters to the editor, and commentaries were excluded. The search strategy involved three stages: search validation, database and grey literature screening, and manual reference checking. Fifteen articles were selected, demonstrating a predominance of mild to moderate adverse events, including pain at the injection site, fever, fatigue, headache, and dermatological reactions. Some studies reported exacerbations of autoimmune diseases, such as systemic lupus erythematosus, vitiligo, rheumatoid arthritis, myasthenia gravis, and hemolysis in patients with paroxysmal nocturnal hemoglobinuria. Reduced immunological responses were observed in individuals undergoing immunosuppressive therapy, such as rituximab. However, all studies indicated that severe events were rare, reinforcing that the benefits of vaccination outweigh the risks in this population.