Originally published by our sister publication, Pain Medicine News
People with rheumatic disease who are taking immunosuppressant therapy to manage their symptoms should strongly consider getting an additional COVID-19 vaccine dose beyond the CDC’s current recommendations, according to new guidance from the American College of Rheumatology (ACR).
The ACR’s most recent update to the “COVID-19 Vaccine Clinical Guidance for Patients with Rheumatic and Musculoskeletal Diseases” advises the administration of a third dose of messenger RNA (mRNA) vaccine (Moderna, Pfizer) beyond the previously recommended two doses of an mRNA vaccine or one dose of the Johnson & Johnson viral vector vaccine, plus a booster of the mRNA vaccine in both cases. For some individuals, that means potentially receiving a fourth shot.
“These recommendations for primary vaccination, supplemental dosing, and booster doses apply regardless of whether patients have experienced natural COVID-19 infection,” according to the ACR, in a press release.
The guidance also makes recommendations regarding the timing of injections in relation to immunomodulatory medication use, and supports the preventive use of monoclonal antibody treatment before and after vaccination, to help avoid adverse events in high-risk autoimmune and inflammatory rheumatic disease patients.
“It remains important for rheumatology providers to assess the vaccination status of all patients with rheumatic diseases,” said Jeffrey Curtis, MD, the chair of the ACR COVID-19 Vaccine Guidance Task Force, in a press release. “Initially, it might have been acceptable to just ask a patient if they have been vaccinated. There is now more nuance with supplemental and booster dose recommendations that should prompt us to ask patients not only whether they have been vaccinated, but with what, how many times and how recently.”
Based on the limited data available, the ACR recommends individuals get a third shot of the same mRNA vaccine they previously received if possible, but stressed that either is fine if the specific vaccine is not known or not available.
Based on a press release from the ACR.
