COVID-19 Vaccine Clinical Guidance Summary for Patients with Rheumatic and Musculoskeletal Diseases (Part 2)
We now discuss the general considerations related to COVID-19 vaccination among rheumatic and musculoskeletal disease patients.
The American College of Rheumatology (ACR) presents guidelines which are timing-related considerations in relation to vaccine safety. This the reason that guidance regarding immunomodulatory medication and vaccination timing was given considering the need to maximize vaccine response.
An important portion of principled, assumptions and limitations are provided to clinicians but these guidelines are bound to change based on new evidence obtained.
The clinician is responsible for letting the patient assess COVID-19 vaccination status and enter into a shared decision-making process. The purpose is to know the benefits and disadvantages of getting the vaccine.
The clinician should discuss disease and treatment-related factors, and to consider the influence of the patient’s age, gender and other factors.
It is important to consider the known allergies to vaccine components and extra contraindications.
It should be considered that systemic immunomodulatory therapies are to be blunted for the moment when getting the vaccine.
There is a theoretical risk for disease worsening after vaccination.
However, the benefit of vaccination for patients outweighs the potential risk for onset of autoimmunity. We will continue our discussion on the recommendations and guidelines for vaccine use among rheumatic disease patients in our next column.