Covid Vaccines 101

Updated Feb. 28, 2021

Covid Vaccines 101 for Empower Rheumatology Patients and Families:

1. What are approved?

Pfizer, Moderna and Johnson and Johnson vaccines. They are NOT live virus vaccines.

2. Who can benefit from them?

Aside from lack of studies in children and pregnant women(active plans to recruit this population for Covid vaccine testing), these vaccines are considered providing more benefits and safe to receive in our autoimmune patient population.

3. What are common side effects?

Injection site pain, muscle and joint achiness and flu like symptoms that self-limit and resolve timely in most cases.

4. When should we get the vaccines?

1^st batch of vaccines are prioritized to health care workers and long term care residents and their care takers.  Public vaccination has been rolled out and in accordance to announced phases by each state.

5. Should I hold my rheumatology medication before I obtain the vaccine?

Updated recommendation from American College of Rheumatology(ACR) released in early February 2021 states no modification to either immunomodulatory therapy or vaccination timing if patients are on Hydroxychloroquine, Sulfasalazine, Leflunomide, Mycophenolate(Cellcept), Azathioprine, oral Cyclophosphamide, TNF inhibitor(ie. Humira, Enbrel), IL-6 inhibitor(ie. Actemra, Kevzara), IL-1 inhibitor (ie. Anakinra), IL-17 inhibitor (ie. Cosentyx, Taltz), IL-12/23 inhibitor (ie. Stelara), IL-23 inhibitor (ie. Tremfya), Belimumab (ie. Benlysta), oral Cyclosporin, IVIG or/and prednisone (equivalent to <20mg/day, likely 20mg/day or great is ok as well).

For patients on Methotrexate, Jakinase inhibitor (ie. Xeljanz, Rinvoq, Olumiant), ACR recommends holding treatment 1 week AFTER each vaccine dose for those with Well-Controlled disease.

For patients on SubQ Orencia, ACR recommends to consider holding injection one week prior to and one week after the First covid 19 vaccine dose (only) with no interruption around the second vaccine dose. Similarly those on IV Orencia, consider obtaining the first Covid vaccine 4 weeks after the last Orencia infusion and postpone subsequent infusion 1 week after the first vaccine (total of 5 week gap between infusions).

For patients on Rituximab (Rituxan, Truxima), consider scheduling vaccination so that the vaccine series is initiated approximately 4 weeks prior to next scheduled rituximab cycle; after vaccination, delay rituximab 2-4 weeks after 2nd vaccine dose, IF disease activity allows.

6. I have severe allergy (aka anaphylaxis) to vaccines, can I still be a good candidate for the vaccine?

Early data from UK suggests people with severe (life threatening allergy) may have more pronounced side effects from the vaccines.  We recommend discussing your allergy history and severity with your family medicine providers before making the decision.

7. If I already had Covid 19 infection, should I still get the vaccine? Will it be helpful still?

Early data suggests our body will have the Covid virus antibody for months and then it begins to wean.  Therefore, it is advisable to obtain the vaccines still.

8. After I get my vaccine, do I still need to wear mask and wash hands and keep safe distance from people?

Yes.  We do not know what constitutes the Herd Immunity nor do we know asymptomatic Covid 19 infection amongst the vaccinated people.  It is still important we practice common-sense protection.