• Int J Rheum Dis · Jun 2021

    Recommendations for COVID-19 vaccination in people with rheumatic disease: Developed by the Singapore Chapter of Rheumatologists.

    • Amelia Santosa, Chuanhui Xu, Thaschawee Arkachaisri, Kok Ooi Kong, Aisha Lateef, Tau Hong Lee, Keng Hong Leong, Andrea Hsiu Ling Low, Melonie K Sriranganathan, Teck Choon Tan, Gim Gee Teng, Bernard Yu-Hor Thong, Warren Fong, and Manjari Lahiri.
    • Division of Rheumatology, Department of Medicine, National University Hospital, Singapore, Singapore.
    • Int J Rheum Dis. 2021 Jun 1; 24 (6): 746-757.

    AimPeople with rheumatic diseases (PRD) remain vulnerable in the era of the COVID-19 pandemic. We formulated recommendations to meet the urgent need for a consensus for vaccination against SARS-CoV-2 in PRD.MethodsSystematic literature reviews were performed to evaluate: (a) outcomes in PRD with COVID-19; (b) efficacy, immunogenicity and safety of COVID-19 vaccination; and (c) published guidelines/recommendations for non-live, non-COVID-19 vaccinations in PRD. Recommendations were formulated based on the evidence and expert opinion according to the Grading of Recommendations Assessment, Development and Evaluation methodology.ResultsThe consensus comprises 2 overarching principles and 7 recommendations. Vaccination against SARS-CoV-2 in PRD should be aligned with prevailing national policy and should be individualized through shared decision between the healthcare provider and patient. We strongly recommend that eligible PRD and household contacts be vaccinated against SARS-CoV-2. We conditionally recommended that the COVID-19 vaccine be administered during quiescent disease if possible. Immunomodulatory drugs, other than rituximab, can be continued alongside vaccination. We conditionally recommend that the COVID-19 vaccine be administered prior to commencing rituximab if possible. For patients on rituximab, the vaccine should be administered a minimum of 6 months after the last dose and/or 4 weeks prior to the next dose of rituximab. Post-vaccination antibody titers against SARS-CoV-2 need not be measured. Any of the approved COVID-19 vaccines may be used, with no particular preference.ConclusionThese recommendations provide guidance for COVID-19 vaccination in PRD. Most recommendations in this consensus are conditional, reflecting a lack of evidence or low-level evidence.© 2021 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

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