March 28, 2023

Another update on the COVID19 vaccine, now with the availability of the Bivalent Vaccine against the original and BA.1 coronavirus variant, and its use for those with arthritis and other rheumatic diseases.

Hello today we’re going to provide another update on the covid-19 vaccine particularly how it relates to those with arthritis and rheumatic conditions as we always say this information is based on knowledge available at the time that we post this right now september 2022 things continue to change and we will continue to post more information here as well as

On our website as information becomes available so what is the update now so as we’ve shared and as we know for some time now there’s two main vaccines pfizer in the moderna products which are available for many age rages there are a number of other vaccines that are available not as commonly used particularly for those with arthritis and rheumatic conditions

What’s new though is there is now a new product by uh moderna which is a bivalent vaccine and this is now available as a one dose regimen typically spaced at least five months from your last dose of whatever covid-19 vaccine you had or your previous infection what’s important to note though is regardless of when you got your last vaccine you also need to make

Sure that you’ve received your primary series of coveted vaccinations before receiving this new bivalent one so what is a bivalent vaccine what does that mean anyway so the original covid-19 vaccine is effective against the original coronavirus strain so what we were dealing with back in early 2020. at that time when it first came out and this is early 2021

That original covid-19 vaccine was very good at preventing infection and it reduced risk of severe complications for those who did get infection however as we’ve been experiencing more variants of the covid-19 virus that has changed where the original vaccine is not nearly as effective at preventing infection although certainly is still very important and a

Powerful tool to prevent severe complications so still certainly worth getting however moderna has developed a bivalent vaccine which is now by meaning two effective against two strains of coronavirus so the bivalent covid-19 vaccine is still effective against their that original strain but what’s been added is a vaccine against a more recent variant so the

Ba1 strain or what is really the original omicron variant that we were seeing earlier in 2022 which is much closer to a match of what we’re seeing right now so is this new vaccine effective so there has been a study done in people on this new vaccine 814 person study and it compared the original vaccine with the new bivalent vaccine and it found the bivalent

Vaccine had a much better response against the ba1 strain in an equal response with the original strain so good results as i alluded though to the ba1 strain currently is not the predominant strain that we’re seeing right now we’re actually on ba4 or 5. but note that that is still closer than the original vaccine meaning it’s very likely that this new bivalent

Vaccine is more effective not necessarily again at preventing covid but at preventing severe complications and for those who have arthritis for those who have other rheumatic conditions that is very important foreign if you have a choice at this stage likely getting the bivalent vaccine would be your first choice but if you don’t have a choice and you’re it’s

Time to get a vaccine and you’re worried about your risk getting the original one is still better than not proceeding at all and will still help reduce your risk of getting severe complications if you get coveted so getting vaccinated regardless of what it is is still a good thing to do keep in mind just as a brief review for those with autoimmune diseases

And on our medications a third dose is recommended as part of an initial primary series meaning three doses for the rheumatology population is equivalent to two doses compared to the healthy population so we strongly recommend three doses at this stage if that’s two doses bivalent vaccine that’s great as we said vaccines are very effective to reduce the risk

Of hospitalization and death there’s some efficacies we’ve talked about before that the vaccines are less effective after six months and maybe this is different in our population but really emphasizes the need to stay on top of vaccination in our current environment the other important thing to keep in mind both with the original but still with the by valent

Vaccine is we do have to consider the medications that we’re on so folks who may be taking rituximab or who are on higher doses of prednisone we know the response your body will have to the vaccine is going to be poor meaning that you really will not see much benefit still safe but no benefit of getting the vaccine unless we get the timing just right so really

Important to coordinate the timing with your rheumatologist for a bunch of other medications that folks may be taking it may blunt the response a little bit but it’s depends on your situation whether or not it’s important to hold that medication for a short amount of time or not and that’s something to discuss with your rheumatologist in many cases it would

Be perfectly fine to get the vaccine continue your medications as is for those who are on tnf lockers il-17 il-6 blockers for these there’s only a small concern and we could proceed as normal aside from the vaccines again as a brief review we have antiviral treatment available for those who get covet so a medication called paxilavid this while it’s not readily

Available in the general population and is available for those with rheumatic diseases and again on treatment if you contact albert health and the contact information is on our website they will assess your eligibility in that moment but it’s important that you start the medication within first five days of contracting covet if you’re on a jack kinase inhibitor

This is contraindicated to take packs of it however we would strongly recommend that all our patients hold a jack kinase inhibitor most of their medications if you get an active covid-19 infection meaning that taking paxilvid would not be a problem because you would stop one to be able to start the other and finally pcr testing while not as readily available

Right now you can get a prescription from your rheumatologist your family doctor to get pcr testing if you think you have covid a rapid test while positive likely means that you do have covid be a negative result really is less reliable and you if you want to be sure particularly to see if you might be eligible for packs of it getting pcr testing may be a good

Idea so lots going on bottom line though still remains that the available vaccines are effective at reducing the risk of severe covenanting infection including the need hospitalization and they are safe for those in rheumatology and on our medications as we said at the beginning this information is up to date as of september check back here as well as on our

Website for more information as we continue to post

Transcribed from video
Bivalent Vaccine UPDATE for those with Arthritis and Rheumatic Conditions By AlbertaRheumatology