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Lupus & Covid-19: Vaccine Updates By Dr. Robert Katz

The following questions were addressed by Dr. Robert Katz this week and originally shared with the Lupus Society of Illinois. Dr. Katz has provided this information to More Than Lupus on COVID-19 and the COVID-19 vaccines.

Robert Katz, MD is a Professor of Medicine at Rush Medical College and Northwestern University’s Feinberg School of Medicine and a leading expert in the field of Rheumatology, with experience in both research and patient care. Dr. Katz was honored to be named in U.S. News & World Report’s Top Doctor rankings, considered to be among the top 1% of doctors in his specialty nationwide.

Would You Recommend That Your Patients Receive The COVID-19 Vaccine?

"It is advisable that people with lupus take the COVID vaccine as soon as it becomes available. None of the vaccines in phase III trials have live COVID virus, so our patients taking immunosuppressive medications and prednisone and those taking biologics should be fine to receive these non-live vaccines."

Does The Vaccine Provide Complete Protection?

"Most vaccines offer incomplete protection against infection, and this is likely to be the case with the COVID-19 vaccines as well. However, even partial protection will be a benefit to our patients and the general public. Weak immunity will make the infection less severe than it would have been otherwise."

How Soon Does The Vaccine Take To Be Effective?

"Following natural infection with COVID-19, immunity with the development of antibodies takes between five and 14 days after the onset of symptoms.
At this time, it remains unclear how long protection against re-infection lasts following natural infection with the COVID-19 virus, or with vaccination. The durability of protection remains to be determined, and even the presence of antibody responses may not confer reliable or durable protection from reinfection. That remains to be seen."

What Are The Differences Between The Vaccines?

"There are five COVID-19 vaccines completing phase III studies, and 50 vaccines in some stage of clinical testing. The vaccines are of several categories. One is messenger RNA vaccines. Messenger (m) ribonucleic acid (RNA) vaccines are part of, but not the complete virus. Another type is an adenovirus vaccine, which is part of a virus that causes the common cold and transports COVID viral material, but not the full COVID virus. Then there are other subunit vaccines.
The messenger RNA vaccines have the mRNA bundled in a fatty outer shell that gets incorporated into human cells upon vaccination. This messenger RNA encodes for the viral spike protein of the COVID-19 virus and instructs the human cell to produce the spike protein, which stimulates an immune response that ultimately provides protection against the COVID-19 virus.
One vaccine in trials uses a defective adenovirus vector that has been altered to code for the COVID spike protein. Once the inactive vector infects the host cell, its DNA enters the cell nucleus. The human host then produces the spike protein from the COVID-19 virus, which produces an immune response against the COVID virus.
Another approach is to use protein subunit vaccines that contain purified viral proteins, often the spike protein. The protein is processed by the immune system to trigger a protective immune response.
The phase III vaccine trials include Pfizer and BioNTech, which is a messenger RNA vaccine that has now been approved by the FDA. Moderna has produced a messenger RNA vaccine that has also just been approved by the FDA. Astra Zeneca reported initial results using an adenovirus vector vaccine. Novavax has a protein subunit vaccine, but results have not yet been released, and Janssen is finishing up a one-dose vaccination study and preparing for a two-dose vaccination study using a viral vector vaccine."

Has the Vaccine Been Tested On Enough People?

"Most of these trials have over 30,000 participants. We’ll see how things progress with these vaccines."
- Robert S Katz. M.D.

As always, More Than Lupus promising to bring you the latest CDC updates, doctor interviews, and clinical trial information. We are in this together!

Thank you Dr. Katz for providing us with this information.

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