A new study from Mass General Brigham suggests that a fourth dose of the COVID-19 mRNA vaccine significantly benefits patients with autoimmune rheumatic diseases, who are at increased risk of SARS-CoV-2 infection and severe COVID-19 outcomes.
Published in The Lancet Rheumatology, this research underscores the importance of additional vaccination for these high-risk individuals.
Enhanced Safety with the Fourth Dose
Researchers used data from the Mass General Brigham healthcare system, analyzing 4,305 patients with autoimmune rheumatic diseases, such as rheumatoid arthritis, who were undergoing treatment with disease-modifying antirheumatic drugs (DMARDs).
They compared patients who received a fourth vaccine dose against those who did not.
The findings were striking: those who received the fourth dose experienced a 41% reduction in infection risk and a 65% decrease in hospitalization or death risk compared to their counterparts.
Crucial Findings for High-Risk Groups
Zachary Wallace, MD, MSc, of Massachusetts General Hospital’s Division of Rheumatology, Immunology, and Allergy, emphasized the significant protection the fourth dose offers against both infection and severe COVID-19.
This study is particularly crucial as DMARDs, while effective for treating autoimmune conditions, can blunt the immune response to COVID-19 vaccines, necessitating additional doses for adequate protection.
The study is part of a broader collaborative effort between Brigham and Women’s Hospital (BWH) and MGH to focus on patients with rheumatic diseases since the pandemic’s onset.
Jeffrey Sparks, MD, MMSc, from BWH’s Division of Rheumatology, Inflammation, and Immunity, highlighted the joint initiative to track the clinical progression of rheumatic disease patients with COVID-19.
Implications and Recommendations
The study’s findings strongly support the U.S. Centers for Disease Control and Prevention’s recommendation for a fourth mRNA vaccine dose for patients receiving DMARDs.
It advocates for these patients to stay current with COVID-19 mRNA vaccines, including boosters, after the primary vaccination series.
This proactive approach is essential for reducing the risk of severe COVID-19 outcomes in a vulnerable patient population.
In conclusion, the study provides compelling evidence that a fourth dose of the COVID-19 mRNA vaccine is crucial for patients with autoimmune rheumatic diseases, offering them enhanced protection against the virus and its severe consequences.
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The research findings can be found in The Lancet Rheumatology.
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