The Department of Medicine at Hospital for Special Surgery offers the following guidance to patients with rheumatic diseases on vaccination against COVID-19 infection. We will update this guidance as new information comes to light from ongoing scientific studies during the broad rollout of the vaccines.
As the COVID-19 pandemic surges across the country, we are looking with hope to the wide administration of a vaccine that will end this public health emergency. In the United States, the FDA has granted emergency use authorization for three vaccines (one from Pfizer, one from Moderna, and one from Johnson and Johnson), which are being distributed throughout the country for administration to individuals age 12 and up. We are already seeing that vaccination is reducing the burden of COVID-19 disease, and we look forward to having all individuals protected against COVID-19 as appropriate for their medical situation.
People with rheumatic diseases (RD) have many very important questions about the vaccines. At this time, it is difficult to offer definitive answers. The Pfizer and Moderna vaccines are injections of messenger RNA, which is a new vaccination technology that differs from traditional vaccines. The Johnson and Johnson vaccine is delivered by an inactive form of adenovirus, a type of virus associated with the common cold. Our understanding of the novel coronavirus continues to evolve, particularly for people with RD. While we would like to understand how the vaccine impacts people with RD, collection of informative data is ongoing. Several research groups, including international consortia and investigators at HSS, are collecting and will be analyzing such data. We are following those results closely and will provide the best and most current advice to our patients and the RD community.
Based on information collected to date, we know that vaccination offers protection against COVID-19. The risks posed by vaccination appear minimal, unlike the risks of COVID-19. It is reassuring that the RNA vaccines have been constructed to minimize inappropriate immune system activation, which may reduce the likelihood of bad reactions. Patients receiving certain drugs for treatment of their RD, such as rituximab, may not develop an optimal anti-virus antibody response. Extremely rare complications involving serious blood clots have been observed in women of child-bearing age after receiving the Johnson and Johnson vaccine. Some RD patients on immunosuppressive medications may be at increased risk of severe illness and death if they contract COVID-19, so for the majority of patients, the benefits of vaccination are likely to far outweigh the small risks.
Our understanding of the effectiveness and safety of COVID-19 vaccination in RD patients will improve as data from observational studies emerge during the roll out of vaccines. Now that the vaccines are available to RD patients, we strongly suggest that you speak to your rheumatologist about receiving a vaccine so that you can discuss the most up-to-date information and have all of your questions answered.
We will provide regularly updated guidance as we learn more from scientific studies on the positive and negative aspects of the new COVID-19 vaccines in people with RD. We encourage you to stay informed through conversations with your rheumatologist and from trusted sources such as the Centers for Disease Control and Prevention, your local Department of Health, and the HSS website. In addition, the American College of Rheumatology has prepared guidance regarding COVID-19 vaccination for patients with RD. This guidance is very current (updated April 28, 2021). Patients may access this information through the following link, and they are encouraged to discuss the presented information with their rheumatologist: