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In light of their increased risk of worst outcomes following COVID-19 infection, patients with rheumatic and musculoskeletal diseases (RMDs) on immunosuppressive therapy, including systemic glucocorticoids, biological (b) and targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs), represent a vulnerable population which should be prioritised to receive vaccination. Controlled data on the effectiveness and safety of different COVID-19 vaccines on patients with RMD are not available yet. However, rheumatology providers and health professionals should be ready to offer timely guidance for the optimal use of vaccines for patients on immunomodulatory drugs. Based on the long-time experience with other non-live vaccines, the COVID-19 Task Force of the European League Against Rheumatisms (EULAR) first delivered a preliminary set of information in December 2020.1 Overall, it is expected that the safety and immunogenicity of COVID-19 vaccines for most of the DMARDs will be comparable with that registered for the general population,2–4 so that postponing vaccination pending more information appears unjustified. A number of independent surveys have however alarmingly reported that, among patients with RMD, potential acceptance of COVID-19 vaccines may not exceed 60%, without apparent differences in relation to specific diseases, comorbidities and type of medication.5–8 Strategies to effectively engage high-risk patients with RMD into vaccination programmes are therefore urgently needed.
Starting from 19 March 2021, rheumatologists of the IRCCS Policlinico San Matteo University Hospital of Pavia, Italy, have been actively involved in the vaccination campaign by personally contacting, booking and administering COVID-19 vaccines to patients with RMD on b/tsDMARDs followed at …
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Contributors SBu conceived the work, contributed to the analysis and interpretation of data, and drafted the manuscript. SBa contributed to the acquisition and interpretation of data and revised the manuscript critically for important intellectual content. LDS contributed to the acquisition and interpretation of data and revised the manuscript critically for important intellectual content. AM conceived the work, contributed to the interpretation of data and revised the manuscript critically for important intellectual content. BX contributed to the acquisition of data and revised the manuscript critically for important intellectual content. LB contributed to the acquisition of data and revised the manuscript critically for important intellectual content. SM contributed to the acquisition of data and revised the manuscript critically for important intellectual content. PD contributed to the acquisition of data and revised the manuscript critically for important intellectual content. CM conceived the work and revised the manuscript critically for important intellectual content. All the authors provided final approval of the version to be published.
Funding This study was supported in part by fundings from the IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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