As promised, please see the definitive Behcet's Centres of Excellence statement on COVID-19 vaccine via the attached link. It states "The three centres of excellence recommend the Pfizer/BioNTech Covid-19 Vaccine for patients with Behcets." and then gives the justification why.
The exception is for women who are pregnant who should not have the vaccine since, as stated elsewhere nationally, there is currently insufficient research evidence to make a positive recommendation.
I’m not a qualified doctor so you must defer to your treating clinician – and indeed depending on the ‘expertise there’ you could suggest that he or she consult with one of the three Clinical Directors at the Centres of Excellence. However, what their guidance states is that yes, those on immunosuppressants should have the Pfizer/BioNTech Covid-19 Vaccine (particularly as it is not a live vaccine).
Each vaccine will be judged independently when they become available – particularly applicable to some Behçet's patients (and by no means that many) who can have a bad reaction to live vaccine (which presumable is the case with you).
Fundamentally, and I’m quoting from detail sent me:
“… one of the unknowns is that an immunocompromised person, including individuals receiving immunosuppressant therapy, may have a diminished immune response to the vaccine. Detailed information is not yet available. As a general principle, patients should not stop their immunosuppression”.
This (immune response) is precisely what the vaccine is trying to encourage to help protect you, and evidence will be accumulated very rapidly on this issue as the vaccine is administered on a massive scale.
“Cautions are the same for Behçet’s patients as per the general population e.g. patients who have a history of immediate-onset anaphylaxis to a vaccine, medicine or food should not receive the Pfizer/BionTech COVID-19 mRNA Vaccine BNT162b2, do not administer in individuals suffering from an acute severe febrile illness.”
There are specific considerations regarding the use of rituximab and I recommend anyone on that, and is not being treated at one of the Centres of Excellence in England, should have their treating clinician speak with Professor Robert Moots at the Liverpool Centre of Excellence. behcets@aintree.nhs.uk
Basically, it is to do with ‘timing’.
“If a patient needs to start a new DMARD/biologic but has not been vaccinated, it may be appropriate to consider selecting an alternative DMARD / biologic medication to rituximab, if available and appropriate, e.g. in patients with rheumatoid arthritis.”
Again, I emphasise, anyone in this situation have their consultant speak with Prof Moots.
Hope that helps clarify the logic behind all this Kezzle, but any further concerns you have you must speak again with your treating clinician please.
As I recommended at the outset, if they are not an expert in Behçet’s, suggest that they may wish to "seek a second opinion from a specialist at one of the CoE, who are studying/monitoring the issues in detail" - and they support hundreds of patients, so they have the clinical evidence. This conforms to General Medical Council - Good medical practice: "The duties of a doctor registered with the General Medical Council - Recognise and work within the limits of your competence".
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