What About Other Vaccines?
While COVID-19 is the most important infectious disease we are facing right now, it is not the only one that concerns us or our patients. Last year, the dynamic daughter-father duo of rheumatology, Cassandra (Cassie) Calabrese, DO, and Leonard H. Calabrese, DO, both of the Cleveland Clinic, wrote to the Executive Committee and challenged ACR members to become active proponents in the vaccination of their patients. This is extremely important because our patients’ altered immune systems and the medications they take put them at higher risk of infections, such as influenza, pneumococcal pneumonia and herpes zoster. However, we don’t have published guidelines on the safety and efficacy of these vaccines in any condition except rheumatoid arthritis.
This past year, the ACR Quality of Care Committee convened a panel of experts under the leadership of Eliza Chakravarty, MD, Oklahoma Medical Research Foundation, to create guidelines for all vaccines in the different diseases we treat. Although speed is of the essence for the COVID-19 guidance document, the general vaccine guideline will follow our formal process of extensive literature review, generation of PICO questions (i.e., P=patient, problem or population; I=intervention; C=comparison; and O=outcome) and group assessments of the data on vaccine safety and efficacy. This process is anticipated to take up to 18 months, but it will ultimately result in a source we can look to for years.
Conclusion
As the current COVID-19 pandemic has shown, effective vaccines are essential tools for both public health and the personal health of our patients, in whom infections occur more often and with greater severity than in the general population. The ACR is working hard to be sure our members have all the right information to keep their patients safe.
David R. Karp, MD, PhD, is chief of the Division of Rheumatic Diseases and the Harold C. Simmons Chair in Arthritis Research at UT Southwestern Medical Center, Dallas, and the ACR’s 84th president.
