Coronavirus – COVID-19

• Keep a supply of rapid home tests for COVID on hand. Click here to get free at-home COVID tests.
• Test yourself right away, and if negative, consider testing yourself again 24-48 hours later. It can take time for the viral load to be large enough for the test to detect.
• Contact your healthcare provider if you test positive. The treatments that can reduce your risk of COVID progressing to a severe disease need to be started early (within the first 5-7 days of onset of symptoms) to be effective.
• Begin treatment with an oral antiviral medication such as paxlovid or molnupiravir OR receive an infusion of monoclonal antibodies such as bebtelovimab.

• It is strongly recommended that anyone taking rituximab or cyclophosphamide receive Evusheld.
• Consult with your healthcare provider on the timing of vaccines. It is preferable to wait as long as possible after your last rituximab/cyclophosphamide dose before being vaccinated. No matter how you space your rituximab/cyclophosphamide and your vaccines, you are unlikely to have a robust immune system response to vaccines. In plain English, the vaccine won’t work very well. That is why you should discuss Evusheld with your healthcare provider. 
• In some cases, you can hold rituximab to allow the vaccine time to work. This is a very individualized decision and there are a number of factors you and your healthcare provider need to consider.
• One guideline that may be helpful when making decisions about holding medications and the spacing of treatments and vaccines is to make decisions about your vasculitis first and vaccines second. Treating your vasculitis is your first priority.

• If you have not already done so, get your first two COVID mRNA vaccines (Pfizer or Moderna). These shots should be given 3 weeks apart.
• Get your first booster (third dose) 4 weeks after you receive the second dose of the COVID vaccine.
• Boost again (fourth dose) at least 4 months later after your previous booster.

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html

You can, but in most cases it is not helpful. There is currently no medical consensus on what level of antibodies is enough for protection. About all the test can tell you is if you have produced no antibodies or some antibodies (which may or may not be enough). If the test is negative, meaning no antibodies, then you should consider Evusheld.

Flares do occur occasionally after vaccines, but they also occasionally occur after getting COVID-19. When balancing the risks and benefits, the benefits of being vaccinated outweigh the slight risk of a flare.

The mission and vision of the COVID-19 Global Rheumatology Alliance is to bring together the global rheumatology community to collect, analyze, and share information about COVID-19 and rheumatology to patients and physicians.

Creaky Joints Article: Three doses of the Moderna or Pfizer COVID-19 vaccines found to prevent hospitalization in people taking immunosuppressive drugs. 

One study looked at the risk of severe COVID-19 for people with vasculitis.

Plain Language Summaries of COVID-19 Global Rheumatology Alliance Research.

American College of Rheumatology 2022 Guidelines for Vaccinations.

CDC Vaccine Recommendations for People Who Are Immunocompromised.

If You Take Rituximab, Here’s How a Third COVID-19 Vaccine Dose Boosts Your Immune Response.

What Doctors Wish Immunocompromised Patients Knew During Covid.

Effectiveness of COVID-19 boosters in preventing hospitalization in patients taking immunosuppressive drugs. 

SARS-CoV-2 Vaccination in the Immunocompromised Host

Efficacy Study of Paxlovid and Molnupiravir in Real World Settings

Study on effectiveness of COVID vaccine at preventing hospitalization in immunosuppressed individuals.