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Things have been changing rapidly with respect to COVID-19 vaccines in Canada, as supply becomes more available, and we have more information about the safety of these vaccines, and risks of COVID-19 infection to people with autoimmune and autoinflammatory conditions.
Rheumatology organizations, such as the Canadian Rheumatology Association (CRA), and the American College of Rheumatology (ACR), have produced updated recommendations regarding people with arthritis and other rheumatic diseases, and their safety to get the COVID-19 vaccine. The CRA panel suggests that based on published evidence, the benefits of having the COVID-19 vaccine outweigh potential harms. They recommend the use of the Pfizer or Moderna mRNA vaccines currently approved in Canada (as of February 13, 2021). Patients on immune suppressing medications are recommended to receive the vaccine. The ACR guidelines have specific suggestions for timing of vaccine when taking certain infusible biologic medications or high dose steroids. Some patients taking immune suppressing medications may not make a robust response to the COVID-19 vaccine; however, it is felt that even a slightly less optimal response will be protective. The ACR has suggested to hold methotrexate for 1 week after each vaccine dose only in those patients who are completely stable in remission to increase the immune response to the vaccine. However, any decision to hold medications should be discussed between a patient and their rheumatologist or healthcare team.
Recommendations for use of the COVID-19 vaccines for children under age 16 years have not yet been made because trials of these vaccines in children are still underway, and early results are just being published.
Teenagers age 16-18 years, who have a rheumatic disease and are taking immunosuppressive medication are recommended to receive the COVID-19 vaccine, as people in their age range were included in COVID-19 vaccine trials.
Each province has been updating their criteria for who is eligible for the vaccine, and the process for obtaining it. This will continue to change in the next weeks and months, as new vaccine stock comes into provinces, and new information becomes available. We recommend you keep an eye on your provincial public health information sources as the most accurate information for your specific situation, and reach out to your pediatric rheumatology team who will be happy to answer questions as well.
Please remember: even after getting the vaccine, it is very important to continue to follow social distancing guidelines, use masks, and keep up with hand washing/sanitizing!
CRA Position Statement: https://rheum.ca/wp-content/uploads/2021/02/CRA-Recommendation-on-Covid-19-Vaccination-FINAL.pdf
For BC Guidance
BCCDC information: http://www.bccdc.ca/Health-Info-Site/Documents/COVID-19_vaccine/ARD_Clinical_Guidance.pdf
If you have any additional questions for our Medical Committee, please leave them in the comments or email info@cassieandfriends.ca
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