Immune suppressed population “may” need COVID-19 vaccine booster

Curtis J. Patient webinar: COVID-19 vaccine and treatment. Speaker: Rheumatism Research Foundation. May 11, 2021 (Virtual Q&A).
Curtis J. Patient webinar: COVID-19 vaccine and treatment. Speaker: Rheumatism Research Foundation. May 11, 2021 (Virtual Q&A).
Jeffrey R. Curtis, MD, chair of the COVID-19 Vaccine Clinical Guidance Working Group of the American Academy of Rheumatology, said that immunosuppressed patients will “possibly” need to regularly use COVID-19 vaccine boosters in the future.
Curtis, a rheumatologist, epidemiologist, and professor of medicine at the University of Alabama at Birmingham, told attendees at a recent Q&A event held by the Rheumatology Research Foundation that he believes that the COVID-19 vaccine booster may be Become common in these patients.
“Of course, there is a lot of science, and science is constantly evolving. Whatever you think you know this month, next month may be different, so for this reason, I think everything we say or talk about tonight It may change,” Curtis told attendees on the virtual forum. “I personally think that people may need boosters. It may not be the case for everyone, but I think it may be common to get a booster and then do it periodically. It may end up more or less like a flu vaccine, if not every year , Then you need it at least every year.”
He added that depending on the treatment the patient receives, individuals may also be more likely to benefit from booster immunizations or even repeated series of vaccinations.
“Someone in the chat raised the situation that they might not be the dose or vaccine they wanted, so depending on the treatment you receive, this is something to discuss with your healthcare provider,” Curtis said. “But I very much think that the concept of boosters is likely to be attractive.”
When asked about the prospects of using Pfizer or Moderna vaccine series with another company’s enhancer, Curtis replied that he hoped that experts would recommend that people continue to use this vaccine as the initial vaccine.
He said: “It is very likely that this will not be a comprehensive study in the near future.” “I am full of expectations. You should stick to the support you got from the beginning.”
Curtis also commented on certain rheumatic drugs, including rituximab (Rituxan, Genentech) and mycophenolate mofetil, which may reduce the effectiveness of the COVID-19 vaccine.
He said: “I think Rituximab will be one of the most interesting drugs.” Rituximab is very effective in eliminating B cells and making it difficult for the body to produce antibodies. This is a good thing when you are treating something with antibodies that you want to get rid of, but if you want to help the immune system fight infections in the future, it may not be a good thing. ”
Rituximab may reduce the immune response to a greater extent than many other treatments. Mycophenolate mofetil is another. “These are the two things I might hesitate the most, to be completely convinced that someone is well protected against COVID-19.”
According to Curtis, issues including JAK inhibitors and reduced vaccine reactions, including the ACR COVID-19 Vaccine Clinical Guidance Working Group have also attracted attention.
Curtis said: “This is why some of them suggest that, if possible, a short period of treatment may be wise.” “This is not a general warning, you should do this at all costs, but with your rheumatism Talk to the patient doctor. ACR has obtained the latest recommendations from the guidance working group, and these recommendations were actually made within the last few days.”
A new study published in Gut found that patients with inflammatory bowel disease who received infliximab had a reduced immune response to the COVID-19 vaccine immediately after the first injection (Remicade, Janssen). However, when the same patient later received a second dose of treatment, the immune response seemed normal.
According to Curtis, this has extended the time frame for receiving a second dose to save doses in some countries, not only for IBD and infliximab, but also for patients with many autoimmune diseases and treatments.
“If you do live in a country and the U.S. is not one of them, then this is to extend the interval from the first dose to the second dose to save the dose so that everyone can get the first dose. I think, This may not be a good idea for people who are undergoing immunomodulatory therapy for Crohn’s disease or lupus, vasculitis, rheumatoid arthritis or other diseases.” Curtis. “Actually, it’s not just infliximab, but also Remicade and [biosimilars] Inflectra and Renflexis. I also suspect that many of our drugs are the same.”
He added that there are now several studies on the response of patients with autoimmune diseases to the COVID-19 vaccine after the first and second doses. The results show that complete antibodies will only be produced after the complete series of vaccines are completed. answer.
Curtis said: “Now, there are some studies in the literature, they study what happens after taking the first dose.” Many people’s vaccination response is OK, but for many people, the effect is not very good. Therefore, I think that the main information I learned from some of the manuscripts I reviewed is in the public domain, and some were sent to me secretly, and you really should accept the second dose.
“This is especially true if you have an autoimmune disease or are receiving treatments that affect immunity, because unless you complete the entire series of studies as expected, some people will continue to be at risk and before the expected antibody response is achieved , They got the second dose.” He added. “Then, generally speaking, patients with rheumatism seem to be well protected after receiving the second dose, but there are some exceptions.”

Post time: May-18-2021