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  • Writer's pictureDr. Chris Phillips

What You Need to Know About the COVID-19 Vaccine

Updated: Jun 8, 2023

We all know that the COVID-19 vaccine is a highly controversial topic.

So many questions surround the subject as many people have concerns and worries. Additionally, information about the vaccine is difficult to sift through, decipher and understand.

At Paducah Rheumatology, we always strive to inform and educate our patients about their medical options, including their choice to receive the COVID-19 vaccine.

Let’s look at what the top resources are saying about the COVID-19 vaccine in patients with rheumatic disease:

The Arthritis Foundation has an extensive FAQs webpage that addresses how the vaccine affects people taking arthritis medications. The Arthritis Foundation states, “Data shows that the vaccines on the market provide strong protection against the COVID-19 variants, including the newest delta variant. However, maximum protection doesn’t kick in until two weeks after the full vaccine regimen is completed. Immunocompromised individuals may experience a blunted response to current vaccines but will experience some protection and the Arthritis Foundation strongly advocates for vaccination.”

When questioned whether individuals with autoimmune diseases should or should not receive the vaccine, the response was: “There is no advisory against vaccinating people with autoimmune diseases, and experts say there is no reason to believe that the current COVID-19 vaccines on the market will be unsafe for these populations.”

Furthermore, a recent study published in The Lancet suggests, “Long-term vaccine-induced immunity is crucial for controlling the COVID-19 pandemic. Vaccination against COVID-19 is recommended for patients with rheumatic diseases.”

In an official journal of the American College of Rheumatology, Arthritis & Rheumatology, it was explained why taking precautions against contracting COVID-19 is so important by stating, “Patients with RA are at higher risk for COVID-19 and COVID-19 hospitalization or death than non-RA. With a COVID-19 risk that approaches other recognized chronic conditions, these findings suggest RA patients should be prioritized for COVID-19 prevention and management.”

In addition, the American College of Rheumatology assembled a multi-disciplinary panel of rheumatologists, infectious disease specialists, and public health experts to examine COVID-19 vaccine efficacy and safety in rheumatic disease patients. The goal of the ACR COVID-19 Vaccine Guidance Task Force was “to summarize the available evidence for newly available COVID-19 vaccines and to make timely clinical recommendations to rheumatology providers for their optimal use.”

The Task Force “achieved consensus” on 12 “guidance statements” related to general considerations of COVID-19 vaccination in rheumatic disease patients, including:

“-After considering the influence of age and sex, autoimmune inflammatory rheumatic disease (AIIRD) patients are at higher risk for hospitalized COVID-19 compared to the general population.

-Acknowledging heterogeneity due to disease- and treatment-related factors, AIIRD patients have worse outcomes associated with COVID-19 compared to the general population of similar age and sex.

-Based on an increased risk for COVID-19, AIIRD patients should be prioritized for vaccination before the nonprioritized general population of similar age and sex.

-Beyond known allergies to vaccine components, there are no known additional contraindications to COVID-19 vaccination for AIIRD patients.”

Per their recommendations, “AIIRD patients with active but non–life-threatening disease should receive COVID-19 vaccination” and “AIIRD patients with stable or low disease activity AIIRDs should receive COVID-19 vaccination.”

At Paducah Rheumatology, we feel the COVID-19 vaccine is a critical component to the health of our patients. It has been shown to be a proven solution that provides protection from the life-threatening effects of COVID-19. Our patients with autoimmune diseases, those who are immunosuppressed, and those who are older, are all at high risk of COVID-19 complications. While we understand concerns some may have, we urge a rationale look at the available safety and efficacy data, in consideration of what we know about vaccines and in general and the timing of any possible side effect:

  • Late developing (ie, >6 months) side effects of vaccines do not tend to occur, as the vaccine is simply a transient delivery vehicle, as opposed to a long-term medication where late side effects may be expected. Vaccine side effects uniformly occur within several weeks to months at most of the administration. With over 4 billion cumulative doses of the various COVID-19 vaccine products now administered worldwide, we have a better understanding of the safety profile of this vaccine than almost any in history. While side effects occur, most are mild, and for an individual patient, the risk of death or long-term complication from COVID-19 far exceeds the risk of a serious vaccine complication.

  • While common side effects of vaccination (joint/muscle aching) overlap with the symptoms of many rheumatic diseases, reports of serious autoimmune disease flares are few and again, the potential benefit is far greater than the risk for most patients.

  • It is expected that immune-suppressed patients, especially those on long-term steroids (ie, prednisone) may have a reduced response to the vaccine, some protection is better than none. We are still in the process of quantifying exactly how immunosuppressive treatments may impact vaccine response, and what the possible role of booster shots may be in the future.

We know that vaccination is a personal choice, and we respect your decision either way. However, especially in the midst of the delta surge, if you are unvaccinated, we encourage you to carefully consider this important choice and not delay making your decision.

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