This past year, with Covid-19 in our lives, has been such a challenging time. It’s been especially challenging for those of us with chronic illness. We already live with the uncertainty of our health and many of us already had challenges with feeling isolated. So the past year has delivered an extra dose of anxiety to add to those concerns. But like most people in the world, we too have been excited about the vaccine. Because once we have a large percentage of every community vaccinated, we can all begin to heal — physically and emotionally. But is the vaccine safe for people with an autoimmune disease? Is the Covid-19 Vaccine recommended for Sjogren’s patients?

This week, we have some news about the Covid-19 vaccine that will help us rest more easily.

The Sjogren’s Foundation Created a Covid-19 Vaccine Committee

Several months ago, the Sjogren’s Foundation created a committee compiled of rheumatology and immunization experts to answer the question; Is the Covid-19 Vaccine Recommended for Sjogren’s Patients? Dr. Alan Baer, chair of the Sjögren’s Foundation’s Medical and Scientific Advisory Council and Director of the Jerome L. Greene Sjögren’s Syndrome Clinic at Johns Hopkins University led the committee. Also on the committee were:

• Cassandra Calabrese, DO. Rheumatology and Infectious Diseases, Cleveland Clinic
• Steven Carsons, MD. Chief of Rheumatology, NYU Winthrop; Senior Associate Dean, Translational Science
• Integration; and Chair, NYU-Winthrop Vaccine Center for Treatment and Evaluation
• Nancy Carteron, MD. Rheumatology and Immunology, University of California San Francisco and Sjögren’s Center, University of California Berkeley
• Katherine M. Hammitt, MA. Vice President, Medical & Scientific Affairs, Sjögren’s Foundation
• Marie Wahren-Herlenius, PhD. Professor of Experimental Rheumatology and Department of Molecular & Cell Biology,
• Karolinska Institute, Sweden

They spent time reviewing all of the data related to the two currently distributed vaccines in the US: The Pfizer and the Moderna vaccines. and they have complied their findings and recommendation in a document.

The Sjogren’s Foundation Recommends the Covid-19 Vaccine.

There opening statement of the document “Sjögren’s and COVID-19 Vaccination Statement” produced by the Sjogren’s Vaccine Committee is a great summary:

The advent of effective vaccines is a critical development in the global effort to contain the deadly COVID-19 pandemic. Two vaccines (Pfizer and Moderna) have received Emergency Use Authorization (EUA)* in the United States and additional ones will likely become available early in 2021. These vaccines are expected to be suitable for virtually everyone in the population-based on their design and reported clinical trial experience in over 75,000 people. Based on what we know and the mechanism of action of these vaccines, we expect these vaccines to be safe in people affected by Sjögren’s. We thus recommend COVID vaccination for individuals with Sjögren’s, given their demonstrated efficacy against a deadly disease and favorable side effect profile.

This recommendation is based on information that has been made available to the public and on the expert opinion of our physician panel. It is also consistent with guidelines established by the Centers for Disease Control and other professional health care organizations, including the American College of Rheumatology, American Society of Hematology, Johns Hopkins University, and Cleveland Clinic. As new information becomes available, this document will be updated. Overall vaccine safety has been proven in large clinical trials that have taken place to date. In the Pfizer and Moderna mRNA vaccination** clinical trials alone, over 75,000 people have participated. In the Moderna trial, 41% of participants were at risk for progression to severe COVID-19 based on age (≥65 years of age) and/or comorbid illness (including diabetes, chronic lung disease, severe obesity, significant cardiovascular disease, liver disease, or infection with HIV).

Sjögren’s and COVID-19 Vaccination Statement

This page of the Foundation website lists the Covid-19 Statement from the committee and also answers some common questions. Additionally, you can print this document to take to your physician or the place you receive your shot.

Timing Concerns with Methotrexate or Rituximab

There is some data that the vaccine efficacy may be reduced if a vaccine is given close to a methotrexate or rituximab dose. So do speak with your rheumatologist about your individual treatment and vaccine plan. This is also in the document I reference above. So those of you on these immunosuppressive medications, you do need to PLAN the timing for when you get the vaccine and when you get your meds. This needs to be planned out for a couple of months to cover your first and second vaccine.

As a reminder, hydroxychloroquine (Plaquenil) is NOT an immune suppressant and can be continued as normal without concern of when you get vaccinated. This is in the Q&A portion of the document linked above.

Sjogren’s Patients with Lung and/or Kidney Involvement

I have stage 3 renal disease so this one caught my eye! There is some data that Sjogren’s patients with lung and/or kidney involvement should stay EXTRA careful about our Covid-19 protocols. There is data showing that this patient profile can have a very difficult time with Covid. So stay in, mask up, and make hand sanitizer your best friend until you are through with both vaccines.

In Conclusion

So, Is the Covid-19 Vaccine Recommended for Sjogren’s? The answer is YES, even if you’ve already had Covid. There are other considerations in the document that I did not discuss here, and you want to be well-informed. So read it, and then bring the document to your physician and discuss any special needs.

And most of all be safe!