Is It Safe for Patients with Vasculitis to Get the AZ Vaccine?

Is it suitable for individuals with vasculitis to receive the AZ vaccine?

Individuals with a history of vasculitis, which is an autoimmune disease, may have concerns regarding vaccination.
Among those advised against receiving the AstraZeneca (AZ) vaccine are individuals with compromised immune systems.
Therefore, if someone has a history of vasculitis, it is important to consult with a healthcare professional to determine the appropriateness of receiving the AZ vaccine based on their specific health status and immune function.
Thank you.

064, 40~49 year old female. Ask Date: 2021/06/10

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your message.
Currently, the Taiwan Society of Rheumatology has reached a consensus and provided recommendations for patients with autoimmune diseases.
Of course, these recommendations will continue to be adjusted over time as more evidence accumulates.
In principle, except for certain disease factors and considerations regarding medication use, patients with rheumatic diseases should be able to receive the COVID-19 vaccine, although the effectiveness in generating immune protection may be somewhat reduced.
Here are some important points to note:
1.
If you are taking Methotrexate (MTX), please discontinue this medication for one week after receiving the vaccine.
Other oral immunomodulatory drugs can be continued.

2.
If you are using targeted therapies, this is a more complex issue, especially for vasculitis patients who may be using injectable targeted therapies like Rituximab.
The timing for receiving the vaccine can be complicated, so it is important to discuss this with your rheumatologist.

3.
Regarding disease factors, be cautious with certain rheumatic diseases that are prone to thrombosis, particularly when receiving the vaccine, especially the AstraZeneca vaccine.
Some forms of vasculitis may be more likely to cause thrombosis, so it is advisable to discuss this with your rheumatologist.

The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, cares about you.

Reply Date: 2021/06/10

More Info

When considering the safety of COVID-19 vaccination, particularly the AstraZeneca (AZ) vaccine, for patients with a history of vasculitis, it is essential to evaluate both the nature of the condition and the current guidelines regarding vaccination.

Vasculitis is an autoimmune condition characterized by inflammation of the blood vessels, which can lead to various complications depending on the severity and the specific vessels involved. Patients with vasculitis may have an altered immune response, and some forms of the disease can indeed compromise the immune system. This raises legitimate concerns about vaccination, especially with vaccines that may provoke an immune response.

The current consensus among health authorities, including the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), is that individuals with autoimmune diseases, including those with a history of vasculitis, can generally receive COVID-19 vaccines, including the AZ vaccine. However, there are several important considerations:
1. Consultation with Healthcare Providers: It is crucial for individuals with a history of vasculitis to consult their healthcare provider before getting vaccinated. This is particularly important if they are currently on immunosuppressive therapy, which may affect their immune response to the vaccine.

2. Risk Assessment: The benefits of vaccination, especially in the context of the COVID-19 pandemic, often outweigh the risks for most patients with autoimmune diseases. The risk of severe illness from COVID-19 is significant, particularly for those with underlying health conditions. Therefore, vaccination is generally recommended to protect against severe outcomes.

3. Monitoring for Side Effects: Patients with a history of vasculitis should be aware of potential side effects from the vaccine. While most side effects are mild and temporary, such as soreness at the injection site, fatigue, or mild fever, it is essential to monitor for any unusual symptoms, especially those that may relate to their underlying condition.

4. Timing of Vaccination: If a patient is experiencing an active flare of vasculitis, it may be advisable to delay vaccination until the condition is stable. This is to ensure that the immune response to the vaccine is optimal and to avoid exacerbating the autoimmune condition.

5. Immunosuppressive Therapy: For patients on immunosuppressive medications, the timing of vaccination may need to be adjusted. Some studies suggest that vaccination may be more effective when administered during periods of lower immunosuppression, but this should be discussed with a healthcare provider.

6. No Contraindications Specific to Vasculitis: There are no specific contraindications for patients with a history of vasculitis to receive the AZ vaccine, provided they are not currently experiencing a severe flare or are not on medications that would contraindicate vaccination.

In summary, while there are considerations for patients with a history of vasculitis regarding the AZ vaccine, it is generally deemed safe for them to receive it. The key is to have an open dialogue with healthcare providers to assess individual risks and benefits, monitor health status, and ensure that vaccination is timed appropriately. The overarching goal is to protect these patients from the potentially severe consequences of COVID-19 while managing their underlying autoimmune condition effectively.

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