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COVID-19 Vaccine Boosters and Additional Doses for People With Spondylitis: Current Guidelines

Posted on October 05, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Alison Channon
Article written by
Victoria Menard

  • The Centers for Disease Control and Prevention (CDC) has recommended Pfizer COVID-19 vaccine booster shots for adults over 65 and other high-risk individuals at least six months after their second dose.
  • People who are immunocompromised may be eligible to receive a third dose of the Pfizer and Moderna vaccines 28 days after receiving their second dose.
  • Individuals with spondylitis may be considered immunocompromised depending on the medications they take.

People with spondylitis may be eligible to receive a third dose of either the Pfizer or Moderna COVID-19 vaccine shot, depending on their medications. Additionally, they may be eligible for a booster shot of the Pfizer vaccine if they’ve received the two-dose Pfizer series.

On Aug. 12, the U.S. Food and Drug Administration (FDA) amended the Pfizer and Moderna vaccines’ emergency use authorizations to allow a third vaccine dose at least 28 days after the second dose for certain immunocompromised individuals. There is not yet guidance from the FDA or CDC on additional doses for immunocompromised people who received the Johnson & Johnson vaccine.

Individuals defined as immunocompromised include:

  • People currently receiving cancer treatment for tumors or blood cancer
  • People who received a stem cell transplant in the last two years
  • People who are organ donor recipients and taking immunosuppressive drugs
  • People taking high-dose steroids or other immunosuppressive drugs, as well as those with certain other health conditions

How Spondylitis Drugs May Affect Immunity

Having spondylitis does not necessarily mean that someone is immunocompromised. However, many people with the disease are prescribed medications that suppress immune system activity, such as biologics and corticosteroids.

As noted by the Spondylitis Association of America, the CDC has recommended an additonal dose of the messenger RNA (mRNA) COVID-19 vaccines for those taking high-dose corticosteroids (20 milligrams or more per day of prednisone or an equivalent), tumor necrosis factor (TNF) blockers, or other immunomodulatory biologic drugs.

Vaccine Booster Shots

If a person with spondylitis doesn’t qualify for a third dose of the vaccine 28 days after their second Pfizer or Moderna shot, they may be eligible to receive a Pfizer booster shot under new guidelines from the CDC. These boosters are intended for those who received the two-dose series of the Pfizer vaccine but then experienced a drop in immunity over time.

On Sept. 24, the CDC recommended booster shots of the Pfizer COVID-19 vaccine at least six months after a second dose in the following groups:

  • People 65 and older
  • Residents of long-term care facilities
  • People ages 50 to 64 with underlying medical conditions that place them at high risk for severe COVID-19

The CDC recommendations state that people ages 18 to 49 with underlying medical conditions and people ages 18 to 64 who are at risk of COVID-19 exposure due to their work or living arrangements “may receive a booster shot” of the Pfizer vaccine “based on their individual benefits and risks.”

The CDC’s list of underlying medical conditions does not specifically include spondylitis or inflammatory arthritis conditions. Some of the underlying conditions listed are chronic lung diseases, heart disease, diabetes, and pregnancy. The agency recommends individuals consult their doctors to determine if a third dose is appropriate for them.

The CDC and FDA did not release recommendations about the Moderna vaccine or the single-dose Johnson & Johnson vaccine. Both companies have submitted data on booster shots to the FDA for review.

Learn More About COVID-19 Vaccines

MySpondylitisTeam interviewed Dr. Siddharth Tambar in March about COVID-19 vaccinations for people with spondylitis. Dr. Tambar is a rheumatologist at Chicago Arthritis and Regenerative Medicine.

“The vaccine helps prevent getting the infection, but more importantly, it really does a great job in terms of preventing very bad consequences from COVID infections,” Dr. Tambar told MySpondylitisTeam in March. “You should speak with your physician if you have an autoimmune condition, but with very few exceptions, I would say the vast majority of our patients should be getting vaccinated.”

Talk To Your Doctor

If you are concerned that you are immunocompromised due to your spondylitis treatments, ask your doctor whether you might benefit from a third dose or booster of an mRNA COVID-19 vaccine.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Alison Channon has nearly a decade of experience writing about chronic health conditions, mental health, and women's health. Learn more about her here.
Victoria Menard is a writer at MyHealthTeam. Learn more about her here.

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