COVID-19 Vaccine Information for Patients
What are the Bottom Line Recommendations for Our Patients?
We advise all of our patients who are immunocompromised to receive the COVID-19 vaccine.
Patients with autoimmune diseases and on immunosuppressant medications should be aware that they may not have as robust a response to the vaccine but some degree of immunity is better than no degree of immunity.
Some medications need to be withheld following the COVID-19 vaccinations and for some IV medications including Orencia or Rituximab the timing of the vaccine needs to be determined for optimal protection.
Should Medications be Temporarily stopped at the Time of the Vaccination?
Some medications should be stopped as follows:
Methotrexate: Hold for 1 week after each vaccine dose, for patients with well-controlled disease.
JAK-Inhibitors - Xeljanz (Tofacitinib), Olumiant (Baricitinib), & Rinvoq (Upadacitinib): Hold for 1 week after each vaccine dose, for patients with well-controlled disease.
Orencia (Abatacept) - SC: Hold injectable (subcutaneous) Orencia both one week prior to and one week after the first COVID-19 vaccine dose (only); no interruption around the second vaccine dose
Orencia (Abatacept) - IV: Time vaccine administration so that the first vaccination will occur four weeks after Orencia infusion (i.e., the entire dosing interval), and postpone the subsequent Orencia infusion by one week (i.e., a 5-week gap in total); no medication adjustment for the second vaccine dose.
Rituximab: Assuming that patient's COVID-19 risk is low or is able to be mitigated by preventive health measures (e.g., self-isolation), schedule vaccination so that the vaccine series is initiated approximately 4 weeks prior to next scheduled rituximab cycle; after vaccination, delay RTX 2-4 weeks after 2nd vaccine dose, if disease activity allows
For all other medications no dose modifications are necessary