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COVID-19 Update for the GRAPPA 2021 Annual Meeting: Focus on COVID-19 Vaccination
Philip J Mease1, Kevin Winthrop2, Wendy Olsder3
1P.J. Mease, MD, MACR, Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; pmease@philipmease.com.
Abstract:
The efficacy and safety of coronavirus disease 2019 (COVID-19) vaccination in patients with autoimmune inflammatory diseases (AIRDs) who are treated with immunomodulatory therapies was the focus of a symposium at the 2021 virtual annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). The keynote address was delivered by Dr. Jeffrey Curtis, chair of the American College of Rheumatology COVID-19 Vaccine Clinical Guidance task force, detailing what we do and do not know about vaccine efficacy and safety in patients with AIRDs and providing guidance about the need for modification of dosing in some immunomodulatory medications for optimal vaccine response. A consensus of the task force was that all patients with AIRDs should be vaccinated as soon as it is allowed in their respective locations, since the benefits of increased protection against COVID-19 infection outweigh the potential for vaccination reactions, including flares of underlying disease, or for reduced efficacy of vaccination because of disease state or medications. Key issues among patient research partners with psoriatic disease expressed in the premeeting survey and panel discussion/question-and-answer period included: vaccine efficacy and safety, the need to continue safe social habits and masking, how to assess efficacy of vaccination, how to deal with vaccine hesitancy among social contacts, medication management relative to vaccination, and concerns about the adequacy of ongoing telehealth visits vs the convenience of that technology.
Insights
COVID-19 vaccination is recommended for patients with autoimmune inflammatory diseases (AIRDs) on immunomodulatory therapy. Benefits of vaccination outweigh potential risks like flares or reduced efficacy, ensuring better protection against COVID-19.
Area of Science:
- Rheumatology
- Immunology
- Infectious Diseases
Background:
- Focus on COVID-19 vaccine efficacy and safety in patients with autoimmune inflammatory diseases (AIRDs) on immunomodulatory therapies.
- Keynote address by Dr. Jeffrey Curtis (ACR COVID-19 Vaccine Clinical Guidance task force) discussed current knowledge gaps and guidance.
- Addressed concerns from patient research partners regarding vaccine efficacy, safety, and medication management.
Framework:
- Consensus: Vaccinate all AIRD patients as soon as eligible.
- Vaccine benefits (protection against COVID-19) outweigh potential risks (flares, reduced efficacy).
Implementation:
- Guidance on potential modification of immunomodulatory medication dosing for optimal vaccine response.
- Discussion on managing vaccine hesitancy among social contacts and assessing vaccine efficacy.
- Consideration of telehealth efficacy versus convenience for patient care.
Implications:
- Ensures optimal COVID-19 protection for vulnerable AIRD patient population.
- Provides evidence-based recommendations for clinicians managing AIRD patients.
- Highlights the importance of patient-reported outcomes and concerns in vaccine guidance.
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