RA and COVID-19

Q:  I am on Renvoq.  Can I receive any of the COVID-19 Vaccines? 

A:  Based on the current information, yes.  People with rheumatic diseases will not be able to get any of the live vaccines under development for the novel coronavirus. However, according to William Chen, MD, Chief of the Adult Clinical Studies, Center for Vaccine Development and Global Health, University of Maryland, “…we don’t expect that there will be any issue with non-live vaccines.”  The currently announced vaccines use a new technology whereby a genetic molecule called messenger RNA (mRNA) teaches cells to create a version of the coronavirus spike protein. This prompts the immune system to make antibodies against this protein so the body can recognize the virus and fend off future infections. Unlike traditional vaccines that use weakened live or dead versions of the entire virus, these new types of vaccines are expected to be as safe for immunocompromised patients and patients on immunosuppressant medications. 

Current, although limited, evidence shows that people taking disease-modifying antirheumatic drugs (DMARDs), including biologics, are not at a higher risk for getting COVID-19 and the death rate is the same as the regular population.  2.8% of those hospitalized for COVID have autoimmune disease which is about equal or even less than the percentage of those in the general public.  European League Against Rheumatism (EULAR) suggests that the majority of people with rheumatic diseases who contract COVID-19 have similar outcomes to the general population, regardless of which disease-modifying medication they take. There is some limited, observational data that there are some medications taken for rheumatic disease that may be slightly protective. 

Do note that certain medications may need to be temporarily stopped if you have a confirmed COVID-19 infection, have been exposed to someone with a COVID-19 infection, or are experiencing common COVID-19 symptoms such as fever, dry cough, or shortness of breath. However, please do not stop or change medication dosage without contacting your rheumatologist or primary care provider. This is especially important with corticosteroids, which should never be stopped suddenly.

COVID-19 Vaccine Pre-Testing for Reactions

Q: Flu shots have been making me progressively sicker. Skin rashes, large irritated area at shot site, etc. Might there be something like an allergy test with micro dosing to test COVID-19 vaccine reaction?

A: No, but as far as allergic reactions to previous influenza vaccines are concerned, none of these newly announced COVID-19 vaccines are grown in eggs, so egg allergies (the most common cause of reaction from influenza vaccine) should not be a problem. Also, make sure your provider knows of your reactions from influenza vaccine as there are egg-free options (for flu shots) that might work better for you.

Travel for the Holidays

Q: I know a lot of people who are traveling for the holidays, do you think that is safe?

A: Travel dramatically increases your chance of getting infected and infecting others and should be undertaken with caution. The CDC recommends you stay at home as much as possible and social distance. If you do decide to travel and take that risk to yourself and others, be aware that some communities within the United States may require visitors to quarantine themselves for 14 days upon entering the community or when returning home from a trip. When my family was in Africa and my grandmother could not come out to see us for Thanksgiving, she sent dozens of cookies packed in old Folgers cans. When we opened them up, it was if she was there. Please understand this is a temporary crisis we are having, and we will reunite in the same room with long hugs soon.

Flu Shot, Or Not?!

Q: Will getting a flu shot protect me from Covid-19?

A: The short answer is no; it will not prevent coronavirus. But the question is more complex. By getting a flu shot and helping to prevent yourself from catching the flu, you help lessen the load of an already overburdened healthcare system. Additionally, those who get a flu shot are helping to eliminate symptoms that might be suspected as COVID-19 and confusing folks into thinking they need to be off work, to have to stay away from their loved ones for extended periods of time, etc.  Getting your annual flu shot can keep yourself and everyone around you healthier.