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Covid-19 Primary Care Resources

DMARDs and the Covid vaccine

Guidance for vaccinating individuals on treatment with DMARDs

This information is sourced from ARMA, Versus Arthritis, Specialist Pharmacy Service (SPS) and The Green Book Chapter 14a :

  • GPs may need to discuss with secondary care regarding the timing of the dose around the vaccine
  • Rituximab is known to reduce the effectiveness of seasonal flu jab so theoretically may reduce the efficacy of the Covid vaccine (for up to 6 months from last dose or while on maintenance)
  • Roche the Rituximab manufacturer advise 4 weeks between dose and vaccine but the Green book states “at least 2 weeks”
  • The benefit of delaying Rituximab depends on the severity of clinical condition
  • The ARMA has published guidance on how to time rituximab for those with milder disease
  • Ocreluzimab may be treated in a similar way to Rituximab in that it may be advisable to delay a first administration until 2 doses of vaccine have been received (with the shortest dose interval licensed) as effectiveness of the vaccine can be reduced by up to 50%
  • Alemtuzumab and Cladribine may reduce immune response to vaccines so 3 months should pass before receiving the vaccine

Written by Dr Carrie St John Wright

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