We have received questions regarding the timing of seasonal vaccines if you are taking B-cell depleting medications. TMA medical advisor Dr. Adam Schiffenbauer shared the following recommendations from the American College of Rheumatology (ACR).
If you are living with a rheumatic muscle disease like myositis and receiving B‑cell depleting medications (such as rituximab or ocrelizumab), vaccines remain an important part of protecting your health. The timing and type of vaccines matter, however, because these medications reduce your body’s ability to make antibodies. This means your body won’t respond as well to the vaccine, so the vaccine may not work as well if it’s given right after you receive the treatment.
The following advice about how to time your seasonal vaccines is based on the 2022 ACR vaccination guidelines and related expert recommendations.
Influenza (Flu) Vaccine
The annual flu vaccination is strongly recommended, even if you are immune suppressed or taking B-cell depleting medication. The high‑dose or adjuvanted flu vaccine is preferred for all patients on immunosuppressive therapy, because they produce a stronger immune response.
Flu vaccine should be given on schedule, even if you are currently receiving rituximab. If possible, delay your next rituximab dose for at least two weeks after vaccination to allow your body time to respond.
COVID‑19 Vaccine
Expert consensus supports vaccination for COVID‑19. Individuals on B‑cell depleting therapy should try to receive this vaccine at least four weeks before starting rituximab. If you’re already on rituximab, the best immune response occurs when vaccination is timed about six months after your last infusion and before the next dose. Even if it’s less than six months, though, it’s still recommended to get the vaccine during the season. The next dose of rituximab should be given at lease two weeks after the vaccine to give it time to start working.
Vaccination remains one of the most effective ways to protect yourself from serious infections. Even if you can’t get this timing perfect, get the shot; some protection is better than none. And be sure to consult with your healthcare team to be sure your treatment plan is optimal for you.
Read the full report from the ACR