Wake Rheumatology & Osteoporosis Consultants, PA

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COVID Vaccination Guidance

COVID 19 Vaccination Guidance for Patients with Autoimmune or Rheumatic Inflammatory Disease

Developed by the American College of Rheumatology COVID 19 Vaccine Guidance Task Force

Patients with autoimmune or inflammatory arthritis are recommended to receive COVID vaccination. There is no preference for one COVID vaccine over another.

The expected response to COVID 19 vaccination for patients on immunomodulatory medications may be blunted in magnitude and duration compared to the general population.

Patients with autoimmune or inflammatory arthritis should be prioritized for vaccination before the general population of similar age and gender.

Following COVID 19 vaccination, patients should continue to follow all public health guidelines regarding physical distancing and other preventive measures per CDC guidelines.

COVID 19 Vaccine Guidance and Timing for patients on Immunomodulating medications:

  1. Methotrexate: Patients with well-controlled disease are recommended to hold methotrexate for one week after each vaccination dose.
  2. JAK Inhibitors (Xeljanz; Rinvoq; Olumiant): Hold medication for 1 week after each vaccination dose.
  3. Orencia once-weekly self-injection: Hold Orencia injection for 1 week before and after the first dose of COVID vaccination. No interruption for the second vaccination dose.
  4. Orencia IV monthly infusion: Time the first vaccination 4 weeks after the last Orencia infusion. Postpone the upcoming infusion by 1 week that is 5-week gap in total. No interruption for the second vaccination dose.
  5. Rituximab IV infusion (Rituxan; Truxima): Delay infusion 2-4 weeks after completing both doses of vaccination or complete both vaccinations at least 4 weeks before the next scheduled infusion cycle.
  6. Cyclophosphamide IV Infusion: Time infusion 1 week after each vaccination dose
  7. Patients taking all other medications not listed above may receive vaccinations with no change in their medication regimen.
  8. Please contact our office if you have additional questions.