“Patients may balk since the vaccine may not be effective in them. Our data suggests this is an uncommon outcome, though. Around 85% had good responses. So again, we continue to preach getting vaccinated as the most frugal action,” he says.
Both Dr. Kim and Dr. Paik say current efforts to study the safety and immunogenicity of an additional booster of vaccine, including by the National Institutes of Health, are important. “Substantial work is being put into determining how to best protect those people whose original vaccine response was poor,” says Dr. Kim.
Benefits Greater than Risk
Dr. Prahalad says he is aware of emerging reports on suboptimal vaccine responses in adult patients, but he emphasizes the benefits of COVID-19 vaccination are greater than the risks to his young patients, especially the risk of hospitalization due to MIS-C.
“Generally, individuals who have been vaccinated tend to have milder disease if they are infected, which favors immunization over natural infection. Fortunately, the science is moving rapidly, and so if reports suggest that individuals on immunosuppression need booster doses, we will recommend that to ensure protection,” Dr. Prahalad says.
Dr. Stromquist says that once he explains how the vaccines work and their safety, his patients usually get a shot. He just tells them he is happy about their decision.
“It does not help to browbeat anyone, because some people may be worried and scared. I tell them that it is okay to feel worried and scared. I think validation is important,” Dr. Stromquist says.
Susan Bernstein is a freelance journalist based in Atlanta.
References
- U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation. Vaccine hesitancy for COVID-19: state, county and local estimates. 2021 May 28.
- Curtis JR, Johnson SR, Anthony DD, et al. American College of Rheumatology Guidance for COVID-19 vaccination in patients with rheumatic and musculoskeletal diseases: Version 2. Arthritis Rheumatol. 2021 Jun 15. Early view.
- Coronavirus (COVID-19) Update: FDA authorizes Pfizer/BioNTech COVID-19 vaccine for emergency use in adolescents in another important action in fight against pandemic. U.S. Food and Drug Administration. 2021 May 10.
- Boyarsky BJ, Ruddy JA, Connolly CM, et al. Antibody response to a single dose of SARS-CoV-2 mRNA vaccine in patients with rheumatic and musculoskeletal diseases. Ann Rheum Dis. 2021 Mar 23;annrheumdis-2021-220289.
- Deepak P, Kim W, Paley MA, et al. Glucocorticoids and B cell depleting agents substantially impair immunogenicity of mRNA vaccines to SARS-CoV-2. medRxiv. 2021 Apr 9. Preprint.