The majority of patients with autoimmune inflammatory rheumatic diseases (AIIRD) should receive a COVID-19 vaccination, preferably not during active disease and taking into account the timing of immunosuppressants. Researchers from University Medical Center Groningen, among others, have registered this Autoimmunity Reviews.
The timing of vaccination and its relationship to concomitant immunosuppressive therapy in patients with AIIRD is a matter of debate. Vaccination is crucial for preventing infections, which are known risk factors for flare-ups in AIIRD and also carry an increased risk of complications and mortality.
Field studies show that vaccines have no significant influence on disease activity. Conversely, disease activity – especially in systemic lupus erythematosus – can predict vaccine response; high disease activity correlates with reduced seroconversion. Therefore, according to the EULAR 2019 recommendation, vaccination should preferably not be administered during active AIIRD.
In addition to the activity of the disease, background immunosuppressive treatment should also be considered when performing the vaccination, the authors write, because several DMARDs reduce the immunogenicity of the vaccine. Furthermore, irrespective of the vaccine type, AIIRD patients are preferably vaccinated before starting immunosuppression.
Bron:
Bijl M, Westra J, Mancuso S, et al. Should we vaccinate during an active rheumatic disease? Autoimmun Rev. 2023 Aug 25. Online ahead of print.
2023-09-04 10:13:34
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