We've gotten many questions from our patients with rheumatic diseases asking whether they are at an increased risk for Covid (the answer is no) and whether their medication (i.e. prednisone, methotrexate and biologic medications) will be a problem when they get their Covid vaccine. The concern is whether these medicines blunt the body's ability to mount a robust antibody reaction to the vaccine. First, we think it is important to get vaccinated as the risk from Covid is much greater than the few case reports of side effects of the Covid vaccines (both Pfizer and Moderna brands). They include a few case reports of Bell's Palsy and anaphylactoid reactions in patients with a previous history of anaphylaxis. These are small numbers of the 70,000 patients who have been vaccinated.
As to the timing of when to get the vaccine in relation to the biologics and methotrexate, there is no solid data, but based on the science as we currently understand it and experience with other vaccines, we think that if you take methotrexate, it would be best to skip 2 weeks before getting the Covid vaccine. With regard to the biologics that inhibit B cells such as Rituxan and Benlysta, we think it is advisable to get vaccinated towards the end of the cycle (i.e. 5-6 months from the last Rituxan shot). Prednisone does not appear to be a factor in minimizing the immune response generated by the vaccine.
Pfizer has just agreed to make another 100 million doses by March 2021. Moderna, a small start-up company, is also ramping up its production. Hopefully there will be announcements relatively soon as to when you can expect to be vaccinated. ... See MoreSee Less
2 months ago
Main Line Rheumatology sees many patients with osteoporosis. At least 95% are women, yet statistics looking at people over age 65, find the ratio closer to 50%. Why is that? Most women see their gynecologist for a yearly exam, and those doctors are very good about ordering DEXA (bone density) scans. There is no equivalent for men! Perhaps primary care physicians and urologists should be cautioned that men are at risk for osteoporosis as their testosterone levels fall, just the same as estrogen plummets in women after menopause. Read this informative column by Jane E. Brodey, Personal Health columunist for the New York Times, since 1976.
