COVID-19 Vaccine Clinical Guidance Summary for Patients with Rheumatic and Musculoskeletal Diseases (Part 6)
Let us now continue our discussion on the use of Coronavirus disease (Covid)
vaccines on patients with rheumatic and musculoskeletal disease (RMD) and autoimmune and inflammatory rheumatic disease (AIIRD).
Household members and other frequent, close contacts of AIIRD patients should
undergo COVID-19 vaccination when available. This is done to protect the AIIRD patients from contracting the virus.
While vaccination would ideally occur in AIIRD patients, except for those patients
with life-threatening illness (e.g., in the ICU for any reason), COVID vaccination should occur as soon as possible.
The experts discussed the possibility of recommending additional and more sustained
public health measures in AIIRD patients.
The appropriateness for continued preventive measures (e.g., masking, physical distancing)
should be discussed with patients.
Schedule the vaccination so that it happens one week prior to the next dose of IV
abatacept treatment.
Hold for one to two weeks (as disease activity allows) after each COVID vaccine dose.
The use of non-steroidal anti-inflammatory drugs (NSAID) should be considered assuming
the disease is stable 24 hours prior to vaccination. No restrictions on use post vaccination once symptoms develop.
The use of Cyclophosphamide IV should occur approximately 1 week after each vaccine
dose, when possible.
On the use of Hydroxychloroquine, no modifications to either immunomodulatory therapy
or vaccination timing is needed.