Webinar: COVID-19 Vaccine: What to Know if You Are Immunocompromised

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Presented by:

• Jeffrey Curtis, MD, MS, MPH, Professor of Medicine at the University of Alabama at Birmingham

There is consensus among experts, including the U.S. Centers for Disease Control and Prevention (CDC) and a task force convened by the American College of Rheumatology (ACR), that people with autoimmune conditions and those who are immunocompromised should get the COVID-19 vaccine. This is because the benefits of getting the vaccine outweigh the risks of not getting it.

In this webinar, Dr. Curtis, Chair of the ACR COVID-19 Vaccine Clinical Guidance Task Force, provided an overview of the ACR’s guidance and debunked myths about the COVID-19 vaccine. This webinar was intended to help people living with autoimmune and inflammatory conditions make better informed medical decisions with their health care providers during the COVID-19 pandemic.

Fast Facts from the Webinar

1. Being immunocompromised means your immune system is not able to fight off infections as well as it should. There are different reasons people may be immunocompromised.

“Immunocompromised” is a broad term that covers anyone who has a weakened immune system. People who are immunocompromised are unable to fight off infections as well as people who have a healthy immune system.

There are many different reasons someone might be immunocompromised, either due to a condition that attacks the immune system itself, like HIV/AIDS, or due to taking immunomodulating medications (e.g., biologics, methotrexate, prednisone) for treat autoimmune or inflammatory conditions like rheumatoid arthritis (RA), psoriatic arthritis (PsA), spondyloarthritis, lupus, or inflammatory bowel disease (IBD).

Behaviors like smoking may also interfere with the healthy functioning of the immune system, so smokers, in particular, are more susceptible to respiratory infections like COVID-19. People with diabetes and other medical problems may also be at increased risk.

2. People with autoimmune conditions and those who are immunocompromised are advised to get the COVID-19 vaccine, but need to be aware of a few caveats.

The ACR Task Force developed clinical guidance to provide answers for rheumatic disease patients and their providers about getting the COVID-19 vaccine. The guidance is meant to be a starting point for informed conversations between doctors and patients. It is not meant to replace individual recommendations from a patient’s health care team or to be a “one-size-fits-all” set of rules. Overall, the ACR guidance recommends that patients with rheumatic disease should get the COVID-19 vaccine, asserting that the benefits outweigh potential risks.

The guidance specifies which immunosuppressive medications could be temporarily paused or where the timing of taking certain medications needs to be considered, and which ones can be continued without interruption, in the weeks leading up to and immediately following COVID-19 vaccination. The guidance is based on what is currently known about COVID-19 and is based on principles and data for other existing vaccines (such as influenza). Read more here on the ACR guidance.

3. Getting some protection from the vaccine is better than not getting the vaccine at all.

Even if the vaccine is somewhat less effective in immunocompromised people, including those living with autoimmune conditions, some protection is better than none. The current assessment is that the effectiveness of the COVID-19 vaccine in people with autoimmune conditions and those who are on immunomodulating medication may be slightly lower than it is for the general population.

As our resource Getting a COVID-19 Vaccine with Autoimmune or Inflammatory Rheumatic Disease: New Guidance from the American College of Rheumatology states, “if you had a choice between being in a snowstorm wearing a warm winter coat, hat, gloves, and scarf (fully effective vaccine) versus only the winter coat (less effective vaccine), versus just a T-shirt (no vaccine), of course, you’d prefer having all the winter clothing. But having the coat is way better than just the T-shirt.”

4. There were no shortcuts taken in the vaccine development process that would jeopardize peoples’ health and safety.

The science used to develop the new COVID-19 vaccines is not new. In fact, this technology has been studied for over a decade. Clinical trials for the COVID-19 vaccines were done with the same thoroughness as with all other vaccine trials, and the results were reviewed and approved by multiple advisory panels. If you are interested in learning more about the new technology behind the COVID-19 vaccine, read Getting a COVID-19 Vaccine: What to Know If You’re Immunocompromised.

5. Don’t rely on antibody tests to tell you if the vaccine ‘worked’

Antibodies are proteins that your body makes to help you fight an infection. They play a role in protecting you. Your body will make them either in response to an infection (e.g., COVID-19) or a vaccine. A COVID-19 antibody test is a blood test to find if you have certain proteins in your blood that may indicate protection against COVID-19. The problem with some antibody tests for COVID-19 is that the test to know if you have had prior or current COVID-19 infection is not necessarily the same test as the one needed to know if the vaccine may have been effective. Further, health care providers don’t yet know what level of antibodies are required for robust protection, which can lead to alarm if someone thinks their antibody level is too low, or false reassurance (if they think that they are protected but might not be).

Until the science is better standardized and more evidence is accrued regarding how to interpret the results of antibody testing, the ACR guidance specifically recommends against routine antibody testing after getting the vaccine for these and other reasons. It is always encouraged to speak your health care provider before taking any tests and for interpretation if test results. Read more here about what to know about antibody testing if you’re immunocompromised.

If you are interested in learning more about the COVID-19 vaccines or staying up to date on the latest information about the COVID-19 vaccines, and especially as someone with an autoimmune disease please click visit the COVID-19 Vaccine Information for Immunocompromised Patients resource on CreakyJoints.