Updated COVID-19 Vaccines May Reduce Hospitalization Risk in People With Autoimmune Rheumatic Diseases

People living with autoimmune rheumatic diseases may benefit from staying current with COVID-19 vaccination, according to new research examining the relationship between vaccination status and the risk of COVID-19-related hospitalization.

The study, published online September 9, 2026, in Arthritis & Rheumatology, found that adults with autoimmune rheumatic conditions who received an updated or booster COVID-19 vaccine had lower adjusted odds of hospitalization after developing COVID-19 compared with people who were unvaccinated or had received only the initial vaccine series.

The findings add to evidence suggesting that COVID-19 vaccination remains an important consideration for people whose underlying health conditions may increase their risk of complications from respiratory infections.

Study Examined Nearly 61,000 Adults

Researchers led by Lesley E. Jackson, M.D., of the University of Alabama at Birmingham, analyzed information from the National Clinical Cohort Collaborative. The investigators focused on adults diagnosed with autoimmune rheumatic conditions who subsequently developed COVID-19.

The study included 60,980 patients, with a median age of 62 years. About 10 percent of the participants had received an updated COVID-19 vaccine covering the 2023 to 2024 period.

Researchers compared COVID-19 outcomes according to participants' vaccination status. The analysis considered people who were unvaccinated, those who had completed an initial vaccine series, those who had received a booster, and those who had received an updated vaccine.

The results showed a consistent association between vaccination and a lower likelihood of COVID-19-related hospitalization.

Updated Vaccines Were Associated With Lower Hospitalization Odds

After statistical adjustment, the researchers reported lower odds of hospitalization among vaccinated participants compared with those who had not been vaccinated.

The adjusted odds ratios were:

• 0.59 for people who had received the initial vaccine series
• 0.29 for people who had received a boosted vaccine series
• 0.31 for people who had received an updated vaccine series

In general terms, an adjusted odds ratio below 1 indicates that the outcome was less common in the vaccination group than in the comparison group after accounting for factors included in the analysis.

The researchers also reported an absolute risk reduction of 5.6 percent among patients who had received only the initial vaccine series when compared with those who had received a booster or updated vaccine.

These findings suggest that protection may not be limited to the original COVID-19 vaccination schedule. Staying up to date with newer vaccine formulations may provide additional protection against severe outcomes, including hospitalization, among people with autoimmune rheumatic disease.

Why This Matters for Autoimmune Rheumatic Disease

Autoimmune rheumatic diseases include a range of conditions in which the immune system plays a central role in causing inflammation and other health problems. Examples include rheumatoid arthritis, lupus and several other systemic autoimmune disorders.

Treatment for these conditions may also involve medications that modify or suppress immune activity. Because of these factors, preventing serious infections can be an important part of ongoing care.

COVID-19 can affect people differently depending on age, underlying health conditions, medications, immune status and other individual characteristics. For patients with autoimmune rheumatic disease, questions about vaccination can therefore be particularly important.

The new study does not mean that every person with an autoimmune rheumatic condition will experience the same degree of benefit. Instead, the findings describe an association observed across a large population of patients.

Individual protection can depend on several factors, including the specific rheumatic condition, current medications, previous COVID-19 infections, previous vaccinations, age and other medical conditions.

The Importance of Staying Current

COVID-19 vaccines have been updated over time as the virus has continued to evolve. An updated vaccine is designed to provide protection against more recently circulating variants and may help strengthen immunity in people whose protection from earlier vaccination has declined.

For people with autoimmune rheumatic diseases, discussing vaccination status with a healthcare professional can help determine whether an updated vaccine is appropriate.

This can be particularly relevant for people taking immune-modifying medications. In some circumstances, the timing of vaccination may need to be considered alongside the timing of certain treatments. Patients should not stop, delay or change prescription medication without advice from the clinician managing their condition.

The researchers emphasized the importance of continued efforts to help people with autoimmune rheumatic diseases remain up to date with COVID-19 vaccination.

Vaccination Is Only One Part of COVID-19 Protection

Although vaccination can reduce the risk of serious COVID-19 outcomes, it is not a guarantee that someone will avoid infection or hospitalization.

Other preventive measures and early medical care may also be important, particularly for people at higher risk of complications.

Anyone who develops symptoms of COVID-19 should consider appropriate testing and contact a healthcare professional when necessary. People at increased risk of severe illness may be eligible for antiviral treatment, but treatment decisions depend on individual circumstances and should be discussed promptly with a healthcare professional.

Patients with autoimmune rheumatic diseases should also continue routine management of their underlying condition. Keeping regular appointments and maintaining an appropriate treatment plan can help reduce the overall health risks associated with chronic autoimmune disease.

What Patients Can Take From the Research

The main message from this study is that being up to date with COVID-19 vaccination may provide additional protection against hospitalization for people with autoimmune rheumatic disease.

The strongest associations in the study were observed among participants who had received booster or updated vaccines. While these findings are encouraging, the study was observational and retrospective. That means researchers identified patterns in existing health data rather than assigning participants to different vaccination groups in a randomized clinical trial.

As a result, the findings demonstrate an association rather than proving that vaccination alone caused the difference in hospitalization risk.

Nevertheless, the large number of participants provides useful information about COVID-19 outcomes in a population that can face additional health considerations.

For people living with autoimmune rheumatic conditions, vaccination decisions should be individualized. A healthcare professional can take into account the person's diagnosis, medications, age, previous vaccination history, previous infections and other risk factors.

The Bottom Line

New research involving nearly 61,000 adults with autoimmune rheumatic conditions found that COVID-19 vaccination was associated with lower odds of COVID-19-related hospitalization. The association was particularly pronounced among people who had received booster or updated vaccines compared with those who were unvaccinated.

The findings support continued attention to staying current with recommended COVID-19 vaccinations, especially among people who may have an increased risk of complications.

If you have an autoimmune rheumatic disease, speak with your doctor, rheumatologist or other qualified healthcare professional about your current vaccination status and whether an updated COVID-19 vaccine is appropriate for you.

Source

Lesley E. Jackson, M.D., and colleagues published online September 9, 2026, in Arthritis & Rheumatology.

Medical Disclaimer

This article is for general informational and educational purposes only. It is not intended to provide medical advice, diagnosis or treatment recommendations. The study findings describe population-level associations and do not predict exactly how COVID-19 vaccination will affect any individual person. Healthcare decisions should be based on an individual's medical history, current medications, risk factors and other circumstances. If you have an autoimmune rheumatic disease or questions about COVID-19 vaccination, speak with a qualified healthcare professional. Do not start, stop or change prescription medications without appropriate medical guidance.