Please have a look at this useful link.

https://creakyjoints.org/living-with-arthritis/coronavirus/covid-19-vaccines/can-you-get-moderna-covid-19-vaccine-immunocompromised/

Dr Catina---kindly take at look at he following useful links:

https://healthydebate.ca/personal-health-navigator/covid-vaccine-immune-system

&

https://www.bmj.com/content/371/bmj.m4037/rapid-responses

Regards--

Please have a look at this useful link.

https://creakyjoints.org/living-with-arthritis/coronavirus/covid-19-vaccines/can-you-get-moderna-covid-19-vaccine-immunocompromised/

Hello,

Exact answers on your questions depends on the patient genotype and concrete type of autoantibodies that patient had prior vaccination.

Overall Spike protein is a trigger or autoimmunity. The amount of antigen matters for developing autoimmunity in short, mid or long term.

The constant immunosuppression with glucocorticoids in patient will cause less intensive immune response to vaccine.

Answers:

1) if prior vaccine patient had autoantibodies of the same germlines that are formed in response to Spike protein (depends on patient genetics) than we can assume that his chronical condition will worsening.

2) depending on patient genetics and amount of antigen. Overall, I think, we can estimate, a big chance of autoimmune complications.

3) with vaccination by mRNA vaccine patient will not be infected with the virus by vaccine administering, if that is what you mean.

If your question is related to: if patient can develop symptoms and syndromes, and conditions similar to sars-cov-2 infection itself after the vaccine administering (the one that contains, or cause expression of unmodified or limitedly S protein) - than answer is - depending on genetics - probably, yes.

Best regards,

Mikhail Fedorov

Many thanks to all the researchers for their useful answers.

Catina

From NEJM Paul E.Sax. MD

The CDC considers immunocompromised patients to be at increased risk for severe Covid-19. opens in new tab. This is broadly defined as patients with histories meeting the following criteria, which are not 100% inclusive:

• Cancer
• Bone marrow transplant
• Solid-organ transplant
• Stem cells for cancer treatment
• Genetic immune deficiencies
• HIV
• Use of oral or intravenous corticosteroids or other medicines called immunosuppressants that lower the body’s ability to fight some infections (e.g., mycophenolate, sirolimus, cyclosporine, tacrolimus, etanercept, rituximab)

The American Society of Hematology and the American Society for Transplantation and Cellular Therapy has a similar list with additional details. opens in new tab. Because of the heightened risk of severe Covid-19 in this population, immunocompromised patients should receive the Covid-19 vaccines if there are no contraindications. That’s the easy part.

What’s more challenging is estimating the safety, and particularly the efficacy, of the vaccines in this population, since neither clinical trial included large numbers of people in these individual categories. Since the Pfizer/BioNTech and the Moderna vaccines don’t include live virus, there is no risk of virus dissemination. Whether the antigens in the vaccine will trigger either an increased risk of rejection (for transplant patients) or autoimmune disease (for those with rheumatologic or other autoimmune conditions) is unknown, but it is reassuring that such adverse effects are infrequent with other vaccines. Furthermore, the clinical trials did not see a difference in the occurrence of autoimmune conditions or inflammatory disorders in study participants who received the vaccine as compared with placebo.

Vaccine effectiveness depends on an intact host response; as a result, immunization might be less effective in immunocompromised hosts than in the general population. When immunizing immunocompromised patients for Covid-19, we should counsel them about this potential difference and hence about the continued importance of other prevention measures, such as mask wearing, social distancing, avoidance of crowds, and hand washing. Household members of those with weakened immune systems should also be immunized if possible.

Clinicians may wonder about delaying or stopping immunosuppressive therapies or chemotherapy before starting the Covid-19 vaccine series and then resuming once the two shots have been administered. Although such strategies have theoretical appeal, no general guidance can currently be given applicable to this diverse group. We will need to consider holding or delaying immunosuppression on a case-by-case basis, depending on the seriousness of the underlying condition and the urgency of its treatment.

Both clinical trials included small numbers of clinically stable people with HIV who were on antiretroviral therapy — 120 and 176 in the Pfizer/BioNTech and Moderna trials, respectively. Although these numbers are too small to make any conclusions about safety and efficacy in people with HIV, there is no theoretical reason why someone with well-controlled HIV should have problems with these vaccines, and immunization is recommended. For people with HIV who are not on antiretroviral therapy, especially those with low CD4 cell counts, my opinion is that prioritization of HIV treatment over Covid-19 vaccination is warranted — both for prevention of HIV-related complications and to improve vaccine responsiveness. (Last reviewed/updated on 11 Jan 2021)

Many thanks for your precise answer.

Catina Feresin

Nice challenging Q! I think that any rheumatic patient that could postpone taking the vaccine for sometime yet taking into consideration the safety precautions, would be more suitable for such unknown outcomes for a completely new situation.

Dr CATINA: Clinicians will start rolling up their sleeves in just a few weeks to get their first doses of COVID-19 vaccines, both of which use mRNA technology to induce an immune response.For those who want more information on the history and science of mRNA vaccines and therapeutics before getting their jab, here's a primer.

https://www.medpagetoday.com/infectiousdisease/covid19/89998

the jab seeker must realize the following should he/she be immunocompromised:

https://creakyjoints.org/living-with-arthritis/coronavirus/covid-19-vaccines/covid-19-vaccine-immunocompromised/

Regards--

Dear doctors,

thanks for your precise answers regarding the topic.

I'll stick with my Daflon.

Add in resveratrol later.

mRNA vaccines are playing with wildfire.

Vectored ones, particularly Astrazeneca's, are not safe either.

Cases of multiple sclerosis, multiorgan failure, SLE, Guillian-Barre, Stevens-Johnson's, Sjogren's.