PGIMER doctors say immune suppressive medications may impact Covid-19 vaccination

Chandigarh:  In a first systematic study, the Postgraduate Institute of Medical Education and Research (PGIMER) here has evaluated that the Covid-19 vaccine response to various antirheumatic and immune modulating drugs is less compared to the others.

It says the response to the vaccination in patients, who have underlying immune mediated inflammatory diseases and are on immune suppressing medication, is a significant global concern.

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The immune mediated inflammatory diseases are a group of disorders which result from malfunction of the body's immune system and include many common diseases like inflammatory bowel disease, rheumatoid arthritis, systemic lupus erythematosus and vasculitis.

Anuraag Jena and Shubhra Mishra, the lead co-authors for the paper, suggested the patients with these disorders could be candidates for testing for response to the double dose of Covid vaccine.

Further studies are required to assess the need for booster diseases in improving the efficacy of vaccination in this subgroup of patients.

Rheumatologist Aman Sharma said the care of patients with autoimmune disorders has been challenging during the pandemic and the issues of vaccine efficacy have been a major concern amongst rheumatologists globally.

There has been some evidence of early fall in antibodies in such patients after vaccination, which is concerning.

Vishal Sharma, the senior author, said while some drugs do not seem to impact response to double dose of vaccines like infliximab, adalimumab, 5-aminosalicylates and vedolizumab.

However, certain drugs like rituximab, steroids and immunomodulators reduced the immune responses to the vaccination even after the double dose. Such patients should continue Covid appropriate behaviour, including physical distancing and use of masks, even after complete vaccination.

The systematic review has been published in Autoimmunity Reviews, a high impact Elsevier journal.

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