People living with rheumatic diseases face extra challenges when it comes to infections like COVID-19, especially if they take medications that affect the immune system. Several new studies presented at the American College of Rheumatology (ACR) meeting offer helpful insights into how different treatments and vaccines may influence risk—and what clinics can do to keep patients safer.
In this study of adults with Rheumatoid arthritis (RA) who contracted COVID‑19, those treated with biologic disease-modifying antirheumatic drugs (DMARDs) prior to infection had worse outcomes compared to those treated with conventional DMARDs. After matching patients by age, comorbidities and other factors, the biologic-treated group showed significantly higher risks of needing a ventilator, dying, and developing pulmonary fibrosis—at 30 days, 90 days and one year after COVID-19. The authors suggest that the more targeted immunosuppression of biologics may undermine immune defenses against COVID-19 more than the broader, less-specific suppression of conventional DMARDs.
In a rheumatology clinic caring for patients on immunosuppressive therapy, the team found that vaccination rates for influenza and pneumococcal disease were quite low initially. After introducing a simple intervention—asking patients about their vaccine status via questionnaire at each visit, training clinic staff on vaccine importance, and using electronic alerts to identify care gaps—the number of flu vaccines administered more than doubled and pneumococcal vaccinations increased dramatically. This suggests that a coordinated, clinic-based strategy with patient engagement and staff education can significantly boost preventive care in high-risk populations.
In people with autoimmune rheumatic diseases, receiving a booster or the newer 2023-24 updated COVID-19 vaccine significantly reduced the chance of being hospitalized after testing positive for COVID-19 compared to being unvaccinated or only having the initial vaccine series. The study of over 54,000 patients found that the odds of hospitalization were about 70 % lower for those who got the booster or updated shot. Older age, having more health issues, being male, using certain immune-suppressing medications, or being from a socially vulnerable background all raised the risk of hospitalization.
If you live with RA or another autoimmune condition, staying up to date on vaccines—especially COVID-19 and flu—can make a meaningful difference in your health. Talk with your rheumatologist about timing vaccines around your medications, and don’t hesitate to ask what your clinic is doing to support vaccination and infection prevention.
