COVID-19 Vaccination for Rheumatology Patients

The following is vaccination advice from the Australian Rheumatology Association (January 2021) 

Why is it important for me to have the vaccine?

Some diseases (including rheumatoid arthritis) are caused by the body’s immune system, which usually protects us from infection. When the immune system is affected by arthritis or drugs to treat the condition, the risk from COVID-19 may be increased.

If you get vaccinated, you will be less likely to get COVID-19. Even if you are infected, it is more likely to be a milder illness.

People who catch COVID-19 can become very unwell. Many people will need hospital treatment even if they don’t have a health condition.

What vaccination will be available?

Two COVID-19 vaccines will be available in Australia in early 2021 – the Pfizer vaccine, and the Oxford (Astra Zeneca) vaccine. Neither of these vaccines is a ‘live’ vaccine that could make you ill. Both are safe for people whose immune system may not be strong.

Other vaccines are likely to be available later in 2021. None of these are live vaccines. The COVID-19 vaccines which will be available in Australia are safe for people with arthritis and people taking drugs that suppress the immune system, even if the condition is active.

Patients will not get to choose which vaccine they receive.

Protection from COVID-19

Both the Oxford and Pfizer COVID-19 vaccines are very good at stopping serious illness caused by COVID-19. This is what the trials found:

  • Oxford (Astra Zeneca) vaccine: Prevented COVID-19 in about 7 in every 10 people (70%), and with no severe cases from 14 days after the first injection.
  • Pfizer vaccine: Prevented COVID-19 in over 9 in every 10 patients (95%) and starts to work around 10 days after the first dose.

Need for a second dose

Both the Pfizer and Oxford vaccines will require a second dose, usually 21 days after the first dose. The second dose gives more long-term protection from COVID-19.

Will the drugs that I take for my condition affect the way the vaccine works?

Some people who are taking drugs that suppress the immune system may be given advice to continue avoiding exposure to COVID-19 after they have had the vaccination. This is because their medications could mean their immune system doesn’t respond as strongly to the vaccine as people who don’t take these drugs. This does not mean you should stop your treatment, because this can result in a flare of your condition which puts you at greater risk from COVID-19.

Everyone in Australia will need to follow Government advice on reducing the spread of COVID-19, even after they have had the vaccine.

Should I delay my rituximab treatment so that I can have the vaccine?

It is best that vaccination occurs as far away from a rituximab infusion as possible. Please discuss with your rheumatologist.

Can I have surgery after having the COVID-19 vaccine?

Surgery guidelines recommend people do not have major surgery and vaccines within one week of each other. This is because both surgery and the vaccine can cause a fever.

Can I have the COVID-19 vaccine if I am pregnant or breastfeeding?

These vaccines haven’t been tested during pregnancy and breastfeeding. You can talk to your midwife and/or rheumatology healthcare team if you’re not sure what to do.

Can children have the COVID-19 vaccine?

Trials for the vaccine in children have only just begun, so it is generally not recommended for children under 16. It’s also known that children and young people are at a very low risk of COVID-19 generally. It’s possible these recommendations may change once more adults have had the vaccination.

Are there any side effects?

Some people will get mild side effects. These can include pain where the injection goes in, tiredness, headache and aching of muscles.

Serious reactions like allergic reactions are extremely rare. If you have any concerns about the vaccine, ask your doctor, nurse or pharmacist.

When will people with rheumatology conditions receive the vaccine?

In Australia, people with pre-existing underlying medical conditions have been identified as one of the initial priority groups for COVID-19 immunisation.

How is the vaccine given?

Vaccines are usually given as an injection into the upper arm.

Do you still need to have the vaccine if you have had COVID-19?

It’s possible for people who have already had COVID-19 to have the vaccine for it. It’s not known yet how long the antibodies made by your body in response to COVID-19 last, so a vaccine could offer more protection or boost any antibodies your body has already made.

The information above is correct as of 22nd January 2021. The ARA will update this advice as new information becomes available.

Page updated January 2021