VIDEO: Discussing COVID vaccination with RA patients

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify cperla@healio.com if there are concerns regarding accuracy of the transcription.

The short answer is carefully. The long answer is I'll come to COVID in a minute but I think it's really important that we get our patients vaccinated with Shingrix, and that is the only herpes virus vaccination we have now. But we've got data that past herpes infections, this is recent data, have really been linked to the incidence of multiple sclerosis and also with lupus, probably this is true in RA as well.

And what we do know is that the majority of our patients have already had herpes virus infections. And the last thing we want to have them have is a zoster infection reinfection. So that's first, second about COVID, well, that's been very complicated but I think we finally know a little bit more about how to advise our patients. Should they get, you know, a booster? Should they get two boosters, and what are they receiving for their immunomodulator therapy? So there's obviously concern about rituximab and there's concern that with rituximab you wanna be very, very careful and wait until say, they're just about ready for a next course before you give them a vaccination but then you wait.

With methotrexate we're not so worried, we've been holding methotrexate for a couple of weeks or a week before and a week after with flu vaccination. That seems to be working pretty well with COVID. But I think we still are a little bit more worried about what, what do we do with abatacept and with the other immunomodulators, and I don't know that it's helpful to really check antibody levels but that's certainly a lot easier to do than to check T-cell responses.

But I think we're gonna be talking about a fourth booster, or should we say a second booster after the two shots and the first booster. I think we're be talking about doing that sooner than later. Most of all, we have to allay fears that our patients have about these vaccinations. And I think they're worried that the vaccinations may some way affect their disease or that while we're trying to hold their background immunomodulators, they may flare.