Resource Information about Coronavirus (COVID-19) Print In this Article ↓ Frequently asked questions ↓ Am I at risk? ↓ Medication ↓ Shielding and clinically extremely vulnerable ↓ Vaccines and COVID-19 treatment ↓ General information about COVID-19 vaccine ↓ Guidelines – England, Scotland, Northern Ireland and Wales ↓ Brexit ↓ Employment & benefits Frequently asked questions When will I get my vaccine? You can find out below who is currently being offered the vaccine, and details of the booking websites, in each of the four nations of the UK. England Find out who is currently being offered the vaccine: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine/ If you are eligible, you can use the COVID-19 vaccine booking service here: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/. Northern Ireland Find out who is currently being offered the vaccine: https://www.nidirect.gov.uk/articles/get-covid-19-vaccination-northern-ireland If you are eligible, you can use the COVID-19 vaccine booking service here: https://covid-19.hscni.net/get-vaccinated/ Scotland Find out who is currently being offered the vaccine: https://gov.wales/covid-19-vaccination-programme-weekly-updates If you are eligible, you can use the COVID-19 vaccine booking service here: https://nhsnss.org/services/our-covid-19-response/covid-19-vaccination-helpline-and-booking-service/ Wales Find out who is currently being offered the vaccine: https://www.nhsinform.scot/covid-19-vaccine/invitations-and-appointments/who-will-be-offered-the-coronavirus-vaccine If you are eligible, you can use the COVID-19 vaccine booking service here: https://gov.wales/get-your-covid-19-vaccination-if-you-think-you-have-been-missed Am I safe to resume normal activities? / How do I know if the vaccine has given me protection? There is no simple answer to these questions and you will need to make a personal judgement. Some useful information to consider: Cases of COVID-19 in the community are much lower than during the height of the pandemic, so much so that Professor Neil Ferguson has said we are moving from ‘pandemic’ into an ‘endemic’ phase of COVID-19. Research so far underlines that everyone with RA should be encouraged to receive a COVID-19 vaccine. This is regardless of their treatment regimen or underlying diagnosis. The benefits of the COVID-19 vaccination outweigh the risks and by having the vaccine, this will reduce the risk of developing severe complications due to COVID-19. Those in doubt should seek advice from the relevant health care practitioner. Some people are asking whether taking an antibodies blood test can tell them whether they have protection from COVID-19. Professor Iain McInnes CBE PhD FRCP FRSE FMedSci and Professor Stefan Siebert MBBCh PhD say the following: “There is understandable concern as to how well COVID-19 vaccines are working in people with RA. At present studies are underway to answer just this question. It is difficult to recommend to people whether or not to have an antibody test performed to see if they have responded, since a test is only as good as the amount of information it gives us to help us make a clinical decision – e.g. do I shield, do I need another boost? Current antibody blood tests only tells us about one aspect of the immune system/response to vaccines, so this type of test is not sufficient to give a definitive answer. At the moment we do not know what the ‘level of antibody’ in a blood sample really means for ‘how well protected we are’. If you are considering getting an antibodies blood test, it might be worth waiting a little longer until evidence allows us to offer better advice based on data.” Vaccine side effects Dr June Raine, MHRA Chief Executive says: “We ask anyone who suspects they have experienced a side effect linked with their COVID-19 vaccine to report it to the Coronavirus Yellow Card website.” There have been over 200,000 Yellow Card reports, most for mild side effects. You can read an article in Rheumatology on COVID-19 vaccination and antirheumatic therapies via the Oxford University Press here. What mental health support is available? The Mental Health Foundation has tracked the impact of the COVID-19 pandemic on our mental health and emotional wellbeing. They found that anxiety, worries and loneliness have been a feature of the pandemic for many of us. We have put together a page of resources to help you take care of your mental health. Being physically active can help with physical and mental fatigue and improve your feelings of emotional wellbeing and vitality. Levels of COVID-19 have now fallen to very low levels in all parts of the UK. I’m worried about going back to work You can find information about working safely during coronavirus (COVID-19) here: England: https://www.gov.uk/guidance/working-safely-during-coronavirus-covid-19?priority-taxon=5ebf285a-9165-476c-be90-66b9729f50da Northern Ireland: https://www.nibusinessinfo.co.uk/content/coronavirus-guide-making-workplaces-safer-and-priority-sector-list Scotland: https://www.gov.scot/publications/coronavirus-covid-19-returning-to-work/ Wales: https://gov.wales/keep-wales-safe-work-html The Citizens Advice website has information on returning to work, including advice if you feel unsafe returning to work. They say: ‘If you think your employer is treating you badly, you can talk to an adviser.’ Citizens Advice also says: You have the right to be safe at work whether you work full time or have a zero-hours contract. Your employer must take steps to protect you from coronavirus if they ask you to return to work. These include: letting you travel to work at quieter times of the day reducing how much face-to-face contact you have with the public making sure that staff stay at least 2 metres apart in your workplace If you can’t safely use public transport to get to work due to COVID-19, you may be eligible for the government’s Access to Work scheme to pay for a taxi to take you to work. Your employer doesn’t have to make changes to protect people you live with, but you should still ask your employer what they can do to help. If you care for someone vulnerable, Citizens Advice says you should explain your situation to your employer as soon as possible. Government guidance says you can ask to be furloughed. For the latest information about the furlough scheme, see here. The scheme has been extended until 30th September 2021. The government has produced 14 guides for working safely during COVID-19, which you can access here. If you are disabled, your employer may have to make ‘reasonable adjustments’. What is ‘reasonable’ will vary from employer to employer, varying on your situation and the size of the organisation. Together with other patient organisations, NRAS is asking the Vaccines Minister for more information on this and we will update this page if and when we have further information. Am I at risk? Are people on biologic/biosimilars/ advanced therapies at higher risk than those on conventional DMARDs? (If you are not sure about the distinction between these types of medicines you can order, for free, our Medications in RA booklet or visit our medication section.) It really depends if you are on mono-therapy biologic therapy or on combination therapy. Mono-therapy would be a biologic e.g. adalimumab without also taking methotrexate whereas combination is with another medication e.g. methotrexate. If you are on monotherapy and have no other underlying conditions or on high dose steroids you will NOT be in the ‘shielding’ group. How many patients on immunosuppressants have had severe disease or died from coronavirus globally? This level of data is not yet available however there is a Global Registry that has just launched and NRAS urges people with RA and JIA to participate. The Global #Rheumatology Alliance needs to understand how coronavirus affects rheumatic, autoimmune and autoinflammatory diseases in Europe. If you are an adult or child with RA or JIA please join the registry at www.jarproject.org/covid. There is also lots of other COVID19 research and data gathering happening very rapidly to find out more read the latest COVID-19 updates and COVID-19 research opportunities. Medication Should I stop taking my RA medications? It is vitally important to keep your RA as well controlled as possible. If you come off your medication(s) you have a very high likelihood of going into RA Flare. Due to the massive impact of this virus on the health service you would more than likely be unable to get to see your GP or rheumatology team for any sort of speedy intervention. You may be advised to pause your medications if you are showing symptoms of COVID-19 but you should seek proper medical advice from speaking to 111 and ideally your rheumatology team. Is it the RA or the immune suppressing medications that heightens my risk? This is a difficult question to answer because there is such a spectrum of expression of RA. But broadly speaking, RA does increase vulnerability and particularly if it is active. Again why it is so important to keep your RA as under control as possible by adhering to taking your medications AS prescribed. Most RA treatments are immunosuppressant, some more than others depending on dosage. Vaccines and COVID-19 treatment Watch our Facebook Live from 21 December on COVID-19 Vaccine and Rheumatoid Arthritis (RA) here. NRAS do our very best to bring you the most up to date and evidenced-based reliable information and guidance.Here is what we know so far about COVID-19 vaccination for people with inflammatory arthritis. There will be further updates over the coming weeks and months as new information becomes available and things are moving so rapidly in this space– please check back here frequently. People with RA or JIA often have very different symptoms as well as different treatment pathways and potentially living with other conditions. It is therefore impossible for us to give any advice on a case-by-case basis, your own rheumatology team who know you and your full medical history should be consulted if the following frequently asked questions don’t answer your query fully. Should people with RA have the vaccine, even if they are on immunosuppressant medication? All people with RA should be encouraged to receive one of the COVID-19 vaccines. This is regardless of their treatment regimen or underlying diagnosis. The benefits of the COVID-19 vaccination outweigh the risks and by having the vaccine, this will reduce the risk of developing severe complications due to COVID-19. The guidance for those in doubt is to seek advice from the relevant health care practitioner. Can I get information on vaccines in languages other than English? NHS England has vaccine in a number of different languages. You can access this information at https://www.england.nhs.uk/london/our-work/covid-19-vaccine-communication-materials/?priority-taxon=774cee22-d896-44c1-a611-e3109cce8eae Should I stop my medications? Patients should not stop their immunosuppression. Frequently, the immune response of people on immunosuppressants to these vaccine antigens is not as good as that of people who are not. However, a reduced response is safer than no response. People on rituximab need to speak to their rheumatology team to discuss the timings of the vaccination and your infusion of rituximab. Which vaccine is best for people with RA? The Pfizer/BioNTech, Oxford/Astra Zeneca and Moderna vaccines are considered safe for immunocompromised persons, as they are not live vaccines. Vaccine name Live or not live (MHRA classification?) Date approved by MHRA Approved for Dose administration Pfizer/BioNTech COVID-19 mRNA Vaccine BNT162b2 Not live 03/12/2020 16 years and older 2 doses up to 12 weeks apart Oxford/Astra Zeneca (ChAdOx1 nCoV-2019) vaccine Not live* 30/12/2020 18 years and older 2 doses up to 12 weeks apart Moderna Not live 08/01/2021 18 years and older 2 doses *This vaccine contains a live adenovirus vector but it is non-replicating so cannot cause infection and is therefore safe for people who are immunosuppressed. This information is taken from the Arthritis and Musculoskeletal Alliance (ARMA) website. You can read more here: http://arma.uk.net/covid-19-vaccination-and-msk/ If I have had COVID-19 already, do I still need to have the vaccine? Yes – as to date we don’t know yet how long immunity will last after contracting coronavirus. I am about to have my flu jab will this be a problem if I’m offered the COVID19 vaccine? There should be at least 14 days between having the flu jab and getting the COVID vaccine. It is still really important to get your flu jab so if you are being offered the flu vaccine now then we would strongly recommend you attend for vaccination as it may be sometime (weeks or months) before you’re invited to get the COVID19 vaccine. Why should I have the vaccination? The COVID-19 vaccination will reduce the chance of you getting severe COVID-19 disease and therefore it is generally recommended that people with inflammatory arthritis should have the vaccine. It may take a week or two after the second dose for your body to build up protection. No vaccine is 100% effective – some people may still get COVID-19 after having a vaccination, but this should be less severe. Should I stop taking my medications before, or after, having the vaccine? Advice may vary on a case-by-case basis to maximise the chance of effect from the vaccine whilst managing your disease activity. It is important to discuss the timing of your vaccine with your consultant if you are due to have an infusion of rituximab. Be aware that there may be a sub-optimal response to COVID-19 vaccines, especially for people within six months of the last dose of rituximab, or those who must have maintenance treatment due to their underlying clinical condition. I have had an anaphylactic reaction in the past, what should I do? Following close surveillance of the initial roll-out, the Medicines and Healthcare products Regulatory Agency (MHRA) has advised that individuals with a history of anaphylaxis to food, an identified drug or vaccine, or an insect sting CAN receive any COVID-19 vaccine, as long as they are not known to be allergic to any component (excipient) of the vaccine. If you have a known anaphylactic (severe allergic i.e. if you regularly carry an epipen) reaction to any of the components of the vaccine, please discuss this with you GP and notify the centre where you receive the vaccine. Generally, you should not be given the vaccine if you have had a previous systemic allergic reaction (including immediate-onset anaphylaxis) to: a previous dose of the same COVID-19 vaccine any component (excipient) of the COVID-19 vaccine You can find further information on the ARMA website here: http://arma.uk.net/covid-19-vaccination-and-msk/ Does the vaccine contain animal products? The PETA UK website says, ‘The vaccines made by Pfizer/BioNTech, Oxford/AstraZeneca and Moderna that were recently approved for use in the UK do not contain any animal-derived ingredients.’ Where can I get more information? There is more information about vaccination on the NHS website here: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/ The Arthritis and Musculoskeletal Alliance (ARMA) website gives further detail on some of the information above and you can read this here: http://arma.uk.net/covid-19-vaccination-and-msk/ The latest guidance for clinicians from the British Society for Rheumatology on this topic can be found here: https://www.rheumatology.org.uk/practice-quality/covid-19-guidance Guidelines – England, Scotland, Northern Ireland and Wales England Where can I access up-to-date information on COVID-19 for England? The Government website has the latest updates here: https://www.gov.uk/coronavirus. What are the restrictions in my area? In England, COVID-19 restrictions depend on what Tier your area is in. You can find this out using the postcode checker here: https://www.gov.uk/find-coronavirus-local-restrictions The restrictions for each Tier are available to read here: https://www.gov.uk/guidance/local-restriction-tiers-what-you-need-to-know Scotland Where can I access up-to-date information on COVID-19 for Scotland? The Scottish Government website has the latest updates here: https://www.gov.scot/coronavirus-covid-19/. What are the restrictions in my area? In Scotland, COVID-19 restrictions depend on the local protection level in your area. You can find this out using the postcode checker here: https://www.gov.scot/check-local-covid-level/ You can find out about the current restrictions in your area here: https://www.gov.scot/publications/coronavirus-covid-19-protection-levels/ Wales Where can I access up-to-date information on COVID-19 for Wales? The Welsh Government website has the latest updates here: https://gov.wales/coronavirus. Northern Ireland Where can I access up-to-date information on COVID-19 for Northern Ireland? The Department of Health website has the latest updates here: https://www.health-ni.gov.uk/coronavirus. What are the current restrictions? You can see the latest restrictions in Northern Ireland here: https://www.nidirect.gov.uk/articles/coronavirus-covid-19-regulations-guidance-what-restrictions-mean-you. Employment & benefits What is the Government Coronavirus Job Retention Scheme? (furlough) This is the government’s key scheme to support employees who cannot work through Coronavirus pandemic. The Chancellor has extended the scheme until 30 September 2021. ‘If you and your employer both agree, your employer might be able to keep you on the payroll if they’re unable to operate or have no work for you to do because of coronavirus (COVID-19). This is known as being ‘on furlough’.’ – gov.uk An employee on furlough leave is paid 80% of their usual wages, up to a monthly cap of £2,500. The Employer can if they are able and choose to do so, pay the 20% to bring pay up to the full 100%. For some lower-paid employees, if the remaining 20% is not covered by the employer, they may also be eligible for Universal Credit. If you’re furloughed, you are allowed NOT allowed to work for your employer who is claiming this funding however you are allowed to work for and be paid by another company. You are also allowed to volunteer to support local help hubs etc. The minimum time you can be on furlough leave is three weeks. Employers can read more about furlough here: https://www.gov.uk/guidance/claim-for-wages-through-the-coronavirus-job-retention-scheme What if my employer is insisting on some written evidence that I need to self-isolate? People who need to stay home because of coronavirus can now get an online “isolation” note. The notes mean people can provide evidence to their boss that they’ve been advised to self-isolate due to the virus and can’t work. In an effort to reduce pressure on GP surgeries, the notes can be obtained without contacting a doctor or even leaving the house. Anyone who claims Universal Credit or Employment and Support Allowance because of coronavirus will not be required to provide a fit note or isolation note. The new isolation notes can be accessed through the NHS 111 online website. You can go straight to the isolation note page here: https://111.nhs.uk/isolation-note. Can my employer sack me if I don’t work despite offering proof that I am following Government guidelines i.e have an isolation note or shielding letter? If your employer dismisses you as a result of you being unable to work due to you being the shielding group or high risk group with an isolation note, then you may have a claim for automatic unfair dismissal.