Recommendations | LOA |
---|---|
1. Based on their risk for COVID-19, patients with IMRD should be encouraged to get their COVID-19 vaccination in a shared-making decision process | 100% |
2. The decision on the best timing to be vaccinated with COVID-19 vaccines should be individualized, considering the patient's age, the underlying IMRD, and its treatment, aiming to optimize the vaccine response | 100% |
3. COVID-19 vaccination should ideally occur in the setting of stable disease activity in patients with IMRD and absence or low immunosuppression | 95.9% |
4. The rheumatologist should inform their patients on the possibility of not effective vaccine response, especially those under high immunosuppression | 100% |
5. Immunomodulatory or immunosuppressive treatment in patients with IMRD should not be discontinued before and or after receiving COVID-19 vaccines, except for B-cell depleting agents (e.g., rituximab) | 95.8% |
6. COVID-19 vaccination should be ideally done 6Â months after the last dose of rituximab and four weeks before the next one considering the complete vaccination schedule *If this is not possible, this recommendation should be followed at least for the first dose | 95.8% |
7. IMRD patients should receive the same COVID-19 vaccine platform in the complete schedule *In cases of severe adverse events (anaphylaxis) or immediate reactions (urticaria, angioedema, or respiratory distress) to any vaccine platform, an alternative approach is recommended for additional doses following local availability | 95.8% |
8. An additional dose of the COVID-19 vaccine should be considered for patients with IMRD who completed their vaccination schedule | 100% |
9. The additional dose should preferably be with a COVID-19 vaccine platform different than that used in the primary COVID-19 vaccination schedule | 95.8% |
10. Temporary interruption of immunomodulatory drugs before an additional dose of COVID-19 vaccines for patients with IMRD should not be recommended | 91.7% |
11. Temporary interruption of rituximab should not be recommended concerning the COVID-19 vaccine additional dose *Until high-quality evidence is available | 83.4% |
12. COVID-19 vaccines can be administered simultaneously with the other vaccines | 92.3% |
13. Assessment for seroconversion after COVID-19 vaccination is not recommended | 95.9% |
14. Seasonal influenza and pneumococcus vaccination are strongly recommended for patients with IMRD * It is essential to keep vaccination cards updated | 92.3% |
15. Vector viral COVID-19 vaccine should be recommended for patients with IMRD and thrombocytopenia or previous thrombotic events | 95.9% |
16. Pregnant patients with IMRD should receive only non-vector viral COVID-19 vaccines *Until new safety evidence is available for this scenario | 100% |
17. Children and adolescents (12–17 years) with IMRD should receive COVID-19 vaccination | 95.8% |