Recommendations for COVID‐19 vaccination in people with rheumatic disease: Developed by the Singapore Chapter of Rheumatologists

Abstract

Aim People with rheumatic diseases (PRD) remain vulnerable in the era of the COVID‐19 pandemic. We formulated recommendations to meet the urgent need for a consensus for vaccination against SARS‐CoV‐2 in PRD. Methods Systematic literature reviews were performed to evaluate: (a) outcomes in PRD with COVID‐19; (b) efficacy, immunogenicity and safety of COVID‐19 vaccination; and (c) published guidelines/recommendations for non‐live, non‐COVID‐19 vaccinations in PRD. Recommendations were formulated based on the evidence and expert opinion according to the Grading of Recommendations Assessment, Development and Evaluation methodology. Results The consensus comprises 2 overarching principles and 7 recommendations. Vaccination against SARS‐CoV‐2 in PRD should be aligned with prevailing national policy and should be individualized through shared decision between the healthcare provider and patient. We strongly recommend that eligible PRD and household contacts be vaccinated against SARS‐CoV‐2. We conditionally recommended that the COVID‐19 vaccine be administered during quiescent disease if possible. Immunomodulatory drugs, other than rituximab, can be continued alongside vaccination. We conditionally recommend that the COVID‐19 vaccine be administered prior to commencing rituximab if possible. For patients on rituximab, the vaccine should be administered a minimum of 6 months after the last dose and/or 4 weeks prior to the next dose of rituximab. Post‐vaccination antibody titers against SARS‐CoV‐2 need not be measured. Any of the approved COVID‐19 vaccines may be used, with no particular preference. Conclusion These recommendations provide guidance for COVID‐19 vaccination in PRD. Most recommendations in this consensus are conditional, reflecting a lack of evidence or low‐level evidence.

Coronavirus Disease 2019 (COVID-19) and Immune-mediated Rheumatic Diseases. Recommendations of the Association of Rheumatologists of Russia

“…В целом отсутствие синтеза нейтрализующих антител имело место у каждого 10-го пациента (9,5%), o n l i n e fi r s t Таблица 3. Рекомендации по терапии и вакцинации пациентов с ревматическими заболеваниями в период пандемии COVID-19 [90][91][92][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107][108] Продолжение таблицы 3 o n l i n e fi r s t страдающего ИВРЗ, и у каждого 100-го (0,5%) в группе контроля. Наконец совсем недавно было показано, что базовое лечение МТ ассоциируется с неадекватным синтезом анти-SARS-CoV-2 (у 62,2% пациентов) и отсутствием вирусспецифической активации CD8 + -Т-клеток [169].…”

COVID-19 from a rheumatology perspective: bibliometric and altmetric analysis

“…Despite the lack of persuasive studies involving this cohort of people, ACR published official guidelines suggesting recommendations and vaccination against COVID-19 strategies for people with ARDs [47]. Over time, local, national guidelines [48][49][50] and expert opinions [51] appeared. In addition, we identified articles devoted to the vaccination against COVID-19 in patients with ARDs, covering this topic from different perspectives.…”

Vaccination against SARS-CoV-2 in rheumatic diseases: Safety issues

“…Несмотря на нерешенные проблемы, связанные с безопасностью вакцинации против SARS-CoV-2, эксперты всех международных и национальных ревматологических научных обществ [59][60][61][62][63][64][65][66], включая Ассоциацию ревматологов России [67], поддерживают положение о том, что польза от вакцинации значительно превосходит потенциальный вред, связанный с развитием НЯ, поскольку вакцинация, несомненно, снижает риск инфицирования SARS-CoV-2 и тяжелого течения COVID-19.…”