The two vaccines currently available against COVID-19 (manufactured by companies, Pfizer and Moderna) are both using a new vaccine technology called mRNA. mRNA is like an instruction booklet for making a part. The vaccine gives your cells the instructions on how to make a protein that lives on the COVID-19 virus, called the “spike protein.” The “spike protein” is like a flag on the surface of the COVID-19 virus that identifies it to your immune system. The spike protein is NOT the virus. The mRNA vaccine does not have a piece of the COVID-19 virus in it; it does not even have the “spike protein” in it. The mRNA vaccine is simply the instruction booklet for the “spike protein.” So, after taking the vaccine, your cells will know how to make the flag that identifies COVID-19. The only thing your cells will make from the vaccine is the flag–not the virus. And that flag will stimulate your immune system to recognize the virus by the flag and make antibodies against the virus. Any side affects you get from taking the vaccine is NOT from COVID-19; it is simply your immune system recognizing and responding to the flag that it sees. So, the most common reactions to the vaccine are a sore arm at the vaccination site and sometimes a headache or body aching that typically resolves in 24-36 hours.

While rheumatology patients were not part of the trials for the vaccine, based on our understanding of how the vaccine works, the rheumatology community–including Dr Suneya–believe that the mRNA vaccine is safe for rheumatology patients. The vaccine should work in rheumatology populations, similar to the general population. However, in order to give your immune system the best chance to recognize and respond to the vaccine and make the flag, Dr. Suneya recommends that any patient taking methotrexate or leflunomide skip 2 weeks (the week of and the week after vaccination) of those medicines when taking the vaccine. This gives your immune system the best chance to have a full response to the vaccine, giving you the best chance at long-lasting immunity. In addition, any patient taking Benlysta or Rituxan needs to call the office to discuss the timing of the vaccine, relative to the dosing of those two medicines. If you have any other questions about your specific situation or medications, please reach out to us and we can discuss your specific case.

It is absolutely essential that you take both doses of the vaccine to get the best result and best chance of benefit. The COVID-19 vaccine is our best chance to put this pandemic behind us. When you are eligible to take the vaccine, please do so. The mRNA vaccines are safe and effective. They have been studied in many racial groups and in large populations in the trials. They have been shown to work well. The benefit outweighs the risk, and we all have to work together to protect ourselves, our loved ones, and our community. Let’s each do our part!