Stock COVID-19 vaccine

Monica,

I have rheumatoid arthritis. I was excited to get my second Moderna COVID-19 vaccine on March 3. I take 7.5 mg of Methotrexate once a week and I stopped taking the medication for two weeks after each dose. After getting the vaccine I had some mild side effects, mild fever, tired and sore arm. However, recently I was led to believe that I may not be protected by the vaccine.

First and foremost, always talk to your doctor about any concerns you may have regarding the vaccine and your condition.

The American College of Rheumatology says rheumatoid arthritis patients should get the vaccine at a time when their disease is well controlled. People with RA were included in the clinical trials but not those who were taking immune-dampening drugs.

There is concern that some immune-compromising drugs may make the vaccine less effective.

A small study published last month in the Annals of Rheumatic Diseases, found 62% of patients taking methotrexate did not produce a strong immune response to the Pfizer-BioNTech vaccine, compared to 90% of those who were not taking the drug.

The American College of Rheumatology recommended patients work with their doctors to consider shifting the timing of some common RA medications, including methotrexate.

These recommendations are not intended to replace your doctor’s clinical judgment: For methotrexate, the recommendation suggests holding for one week after each vaccine dose for people with well-controlled disease.

For JAK inhibitors, hold for one week after each dose regardless of the patient’s state of disease.

With abatacept for subcutaneous delivery, hold for one week before and one week after the first dose only. For IV delivery, time the first vaccine only to occur four weeks after the drug’s infusion, then postpone the subsequent infusion by one week, for a five-week gap. For those not yet on subcutaneous or intravenous abatacept, therapy can be started following the recommended one-week delay after the first vaccine dose.

For rituximab, schedule the vaccine about four weeks before your next scheduled cycle and delay the drug two to four weeks after the vaccine series is completed, if possible

For cyclophosphamide, time drug administration about one week after each vaccine dose, if possible.

There were no recommendations to alter drug regimens for hydroxychloroquine, intravenous immunoglobulin, prednisone less than 20 milligrams per day, sulfasalazine, leflunomide, mycophenolate, azathioprine, cyclophosphamide, TNF inhibitors, belimumab, oral calcineurin inhibitors, or IL-6R, IL-1, IL-17, IL-12/23, or IL-23.

ACR admitted there was a lack of evidence from the COVID-19 research, so they made these recommendations from the experience of other vaccines.

The most common side effects of the vaccines are pain and swelling at the injection site. Fever, chills, and headache are more common after the second shot.

Again, I strongly suggest talking to your doctor about your concerns.


Monica Robins is the Senior Health Correspondent at 3News. The information provided in this column is for educational and informational purposes only. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read in this column or on our website.

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