Keri Losavio is the staff editor of The Rheumatologist, a position she has held since 2014.
Watch: Building Vaccine Confidence in Rheumatic Disease Patients
This virtual town hall, held May 13, addressed the reasons some rheumatic disease patients, including those in communities of color and underserved communities, are hesitant to take the COVID-19 vaccine. The discussion included best practices, resources, and talking points that rheumatology providers can use to provide information to their patients.
References
- Engber D. America is now in the hands of the vaccine-hesitant. The Atlantic. 2021 Mar 22.
- The ACR COVID-19 Vaccine Clinical Guidance Task Force. COVID-19 vaccine clinical guidance summary for patients with rheumatic and musculoskeletal diseases. American College of Rheumatology. 2021 Mar 4.
ACR Guidance Statement: Recommendations for Use of the COVID-19 Vaccine in Patients with Rheumatic & Musculoskeletal Disease2
| Guidance Statement | Level of Task Force Consensus |
|---|---|
| RMD and AIIRD patients should receive COVID-19 vaccination, consistent with the age restriction of the EUA and/or FDA approval.* | Moderate |
| RMD patients without an AIIRD who are on immunomodulatory therapy should be vaccinated in a similar fashion as described in this guidance for AIIRD patients receiving those same treatments. | Moderate |
| Based on the data for the mRNA COVID-19 vaccines available in the U.S., there is no preference for one COVID-19 vaccine over another. Therefore, AIIRD patients should receive either vaccine available to them. | Moderate |
| For a multi-dose vaccine, AIIRD patients should receive the second dose of the same vaccine, even if there are non-serious adverse events associated with receipt of the first dose, consistent with timing described in CDC guidelines. | Strong |
| Healthcare providers should not routinely order any lab testing (e.g., antibody tests for IgM and/or IgG to spike or nucleocapsid proteins) to assess immunity to COVID-19 post-vaccination, nor to assess the need for vaccination in a yet-unvaccinated person. | Strong |
| Following COVID-19 vaccination, RMD patients should continue to follow all public health guidelines regarding physical distancing and other preventive measures. | Strong |
| Household members and other frequent, close contacts of AIIRD patients should undergo COVID-19 vaccination when available to them to facilitate a cocooning effect that may help protect the AIIRD patient. No priority for early vaccination is recommended for household members. | Moderate |
| While vaccination would ideally occur in the setting of well-controlled AIIRD, except for those patients with life-threatening illness (e.g.,in the ICU for any reason), COVID vaccination should occur as soon as possible for those for whom it is being recommended, irrespective of disease activity and severity. | Strong-Moderate |
*age ≥16 as of January 2021
RMD=rheumatic and musculoskeletal disease; AIIRD=autoimmune and inflammatory rheumatic disease; EUA=emergency use authorization; FDA=Food and Drug Administration; mRNA=messenger RNA; CDC=Centers for Disease Control and Prevention; ICU=intensive care unit