COVID-19 Vaccination for Rheumatology

Please continue to reference this page for updates as new information becomes available.

August 18, 2021

With new CDC recommendations on receiving booster vaccinations, we wish to provide the following guidance to our patients:

  • Our office recommendation is in alignment with the CDC recommendation for a booster/3rd dose of COVID for our patients who are on immunosuppressive or immunomodulatory
  • Timing: at least 28 days after completion of the primary mRNA COVID-19 vaccine series
  • Patients should stick to the same brand for the third dose
  • No determination was made on the safety of receiving one of the mRNA vaccines if a patient initially received the Johnson & Johnson shot.
  • For Rituximab: schedule the booster 4 weeks prior to the next scheduled rituximab cycle. Otherwise, no need to stop or withhold medications.
  • These recommendations might be revisited if new evidence or new recommendations from the American College of Rheumatology became available.

March 5, 2021

Rituxan (rituximab) or Orencia (abatacept): If you are taking these medications by infusion or injection and are planning to receive the COVID-19 vaccine or if you have received it in the last 14 days, your dosing or infusion schedule should be modified to help maximize the effectiveness of the vaccine.  If this impacts you, please call our office at (402) 609-1200 to discuss scheduling options. We will work around your vaccination schedule, knowing there is less flexibility to modify those dates and times.

If you already received the vaccine more than two weeks ago, no further action is needed.

January 4, 2021

Altered immunocompetence: Immunocompromised persons (including those with HIV or receiving immunosuppressant therapy) may have a diminished immune response to the vaccine (CDC 2020; FDA 2020a; FDA 2020b; Moderna Canadian product monograph; Pfizer-BioNTech Canadian product monograph). Patients with stable HIV infection were included in the clinical trials (FDA 2020a; FDA 2020b). Although data are not currently available to establish vaccine safety and efficacy in immunocompromised persons, the Centers for Disease Control and Prevention (CDC) recommends vaccination of immunocompromised patients if there are no contraindications. Revaccination is not recommended after immune competence is regained for those persons who received vaccination during chemotherapy or other immunosuppressive therapy (CDC 2020).

Autoimmune conditions: Although data are not currently available to establish vaccine safety and efficacy in patients with autoimmune conditions or inflammatory disorders, the CDC recommends vaccination of patients with autoimmune conditions if there are no contraindications (CDC 2020).

Cytoxan, Cellcept, or more than 10mg per day of Prednisone, please consult with your provider before taking the vaccine.

Current contraindications to receiving the COVID-19 vaccine are having a severe allergic reaction to any component of the vaccine.  If you have had a severe reaction to vaccines in the past, you should alert your provider prior to receiving this vaccine.

Please note that none of the currently approved COVID-19 vaccinations are live vaccines.

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