TOPLINE

Vaccinations against COVID, human papillomavirus, varicella, and herpes zoster were associated with a more than 50% reduced risk for developing new-onset idiopathic uveitis within 12 months, with the varicella vaccine showing the strongest protective effect.

METHODOLOGY

• Researchers conducted a retrospective cohort study using aggregated electronic health records from multiple health systems across the US, spanning 2006-2025, to examine the association between routine vaccination and the risk for new-onset idiopathic uveitis.
• Patients who received COVID vaccination (n = 595,270; mean age, 53.6 years), HPV vaccination (n = 80,186; mean age, 15.7 years), varicella vaccination (n = 191,886; mean age, 34.1 years), live herpes zoster vaccination (n = 23,530; mean age, 63.7 years), or recombinant herpes zoster vaccination (n = 66,309; mean age, 60.4 years) were propensity score matched in a 1:1 ratio with control individuals who did not receive the respective vaccines.
• Patients with known infectious or noninfectious causes of uveitis before vaccination and those diagnosed with infectious uveitis at any point were excluded from the analysis.
• The primary outcome measured was the incidence of new-onset idiopathic uveitis at 3, 6, and 12 months following vaccination.

TAKEAWAY

• Patients vaccinated against COVID had an 82% lower risk for new-onset idiopathic uveitis at 3 months (risk ratio [RR], 0.18; 95% CI, 0.16-0.20), a 75% lower risk at 6 months (RR, 0.25; 95% CI, 0.23-0.27), and a 65% lower risk at 12 months (RR, 0.35; 95% CI, 0.33-0.37) than matched control individuals.
• HPV vaccination was associated with a 56% relative reduction in the risk for new-onset idiopathic uveitis at 12 months (RR, 0.44; 95% CI, 0.35-0.54); recombinant and live herpes zoster vaccinations showed similar protective effects, with 69% (RR, 0.31; 95% CI, 0.26-0.37) and 68% (RR, 0.32; 95% CI, 0.23-0.43) relative reductions in the risk at 12 months, respectively.
• Varicella vaccination showed the highest protective effect, with a 71% relative reduction in the risk at 12 months (RR, 0.29; 95% CI, 0.25-0.33).
• Similar reductions were still observed after the exclusion of people with prior diagnoses of the respective viral infections.

IN PRACTICE

The findings “provide preliminary evidence for a potential protective benefit of vaccination against several viral diseases on uveitis incidence, warranting further mechanistic and prospective research,” the researchers reported. “Future studies should investigate the immunologic profiles of vaccinated individuals, explore longitudinal immune biomarkers associated with protection against uveitis, and assess whether booster strategies extend this apparent protective effect.”

SOURCE

The study was led by Matthew J. Schulgit and Suraj Bala, both from Cleveland Clinic Cole Eye Institute in Cleveland. It was published online on June 22 in the American Journal of Ophthalmology.

LIMITATIONS

This retrospective study cannot rule out hidden bias or prove cause and effect. Delays in healthcare during certain periods, including the start of the COVID pandemic, may also have affected when uveitis was diagnosed. In addition, vaccinated people may have differed from unvaccinated people in ways not fully captured by the matching process, such as being more engaged with preventive care or having lower baseline inflammation.

DISCLOSURES

The study received partial support from the Clinical and Translational Science Collaborative of Cleveland, which is funded by the National Institutes of Health, National Center for Advancing Translational Sciences, and Clinical and Translational Science Award grant. Some authors reported consulting fees and some also disclosed grant and contracted research support from pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.