Resource Information about Coronavirus (COVID-19) Print In this Article ↓ Frequently asked questions ↓ Medications and RA ↓ Vaccines and COVID-19 treatment ↓ Guidelines – England, Scotland, Northern Ireland and Wales Frequently asked questions Medication and RA 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. 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. 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 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. Flu Vaccine and COVID-19 Vaccines The ComFluCOV trial indicates that co-administration of the influenza and COVID-19 vaccines is generally well tolerated with no reduction in immune response to either vaccine. Therefore, the two vaccines may be co-administered where operationally practical. 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 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. Should I stop taking my medications before, or after, having the vaccine? 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. Advice may vary on a case-by-case basis. In accordance with ARMA, it is advised that patients should not stop taking their immunosuppressant drugs for the vaccine. some drugs such as rituximab have been known to reduce the effectiveness of vaccines such as the seasonal flu jab. For this reason, it is expected that patients will experience the same effect from the covid vaccine. As per the update of the GOV green book on the 21st of January, there is not enough evidence to suggest that it would be disadvantages for patients on immunosuppressants to have the vaccine so should therefore receive it. However, this is general information only and any specific recommendations needs to include a conversation between the patient and their healthcare team, as the benefits and risks need to be considered on an individual basis. Please see the Government Green Book for additional guidance. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/998309/Greenbook_chapter_14a_1July2021.pdf 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.
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.
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.
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.
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.
Flu Vaccine and COVID-19 Vaccines The ComFluCOV trial indicates that co-administration of the influenza and COVID-19 vaccines is generally well tolerated with no reduction in immune response to either vaccine. Therefore, the two vaccines may be co-administered where operationally practical.
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
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.
Should I stop taking my medications before, or after, having the vaccine? 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. Advice may vary on a case-by-case basis. In accordance with ARMA, it is advised that patients should not stop taking their immunosuppressant drugs for the vaccine. some drugs such as rituximab have been known to reduce the effectiveness of vaccines such as the seasonal flu jab. For this reason, it is expected that patients will experience the same effect from the covid vaccine. As per the update of the GOV green book on the 21st of January, there is not enough evidence to suggest that it would be disadvantages for patients on immunosuppressants to have the vaccine so should therefore receive it. However, this is general information only and any specific recommendations needs to include a conversation between the patient and their healthcare team, as the benefits and risks need to be considered on an individual basis. Please see the Government Green Book for additional guidance. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/998309/Greenbook_chapter_14a_1July2021.pdf
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
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
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/
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.
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.