COVID-19 Vaccine Response in Those Who Take Biologics

Axial spondyloarthritis (AS) and diseases like inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) are autoimmune diseases. The immune system normally creates antibodies to recognize and fight off infection. In autoimmune disease, some of these antibodies can also target healthy cells.

To treat autoimmune diseases, drugs called biologics can be used to keep the immune system from harming healthy cells. This can be a very effective way to treat the symptoms of autoimmune illnesses. But it can also make your body worse at creating an immune response to fight off infection.

Vaccines train your body’s immune system to fight certain diseases without you ever being infected with that disease. Because biologics decrease immune response, scientists are researching whether the COVID-19 vaccine will be effective in those taking biologics. Early research so far is showing promising results.¹

What are biologics?

Biologics are drugs made from living cells. These cells can come from parts of the blood, proteins, viruses, or tissue. The drug-making process turns the cells into medicine that can prevent, treat, and cure disease.

Biologics can affect the immune system in different ways. They can prevent immune cells from talking to each other by blocking the molecules they use for messages. Biologics can also directly bind to immune cells to stop them from working.²

How does the COVID-19 vaccine work?

There are 2 different kinds of COVID-19 vaccines being used right now. Both kinds use a molecule called mRNA. This is a form of RNA, the molecule that takes the information in your DNA (your genes) and tells your body what to do with it. Your mRNA acts like a set of instructions to teach your body to make your hair brown, your eyes green, or your feet wide. In COVID-19 vaccines, it teaches your immune system to create antibodies to the COVID-19 virus.

If you come into contact with COVID-19 after receiving your vaccine or vaccines, your body will be able to fight off the virus. Getting the vaccine does not guarantee that you will never have COVID-19. However, it greatly reduces your chances of getting it. Like the flu vaccine, it may shorten how long you are sick or prevent more serious symptoms.³

Is the COVID-19 vaccine safe and effective for people taking biologics?

For safety reasons, people living with autoimmune diseases were not a part of the original COVID-19 vaccine studies. Once the vaccines were approved, researchers studied the effects of biologics on the vaccine. Two studies were released in 2021 looking to see if the vaccine was safe and effective.^1,4

The first study looked to see if the vaccines were effective. Experts were concerned that because biologics decrease the immune response, people taking them would not be able to build immunity to COVID-19. Fortunately, people on biologics created as many COVID-19 as those who do not take biologics. This study was small, but the results were reassuring.¹

The second study looked to see if the vaccine was safe. Many people have reported side effects after the COVID-19 vaccine. They generally lasted a few hours to a few days. The most common side effects were arm pain, fatigue, fever, chills, and nausea. Experts were concerned that those taking biologics might have worse side effects. However, study participants on biologics experienced the same mild side effects. In fact, the study found that people on biologics often had fewer side effects!

Vaccine side effects are often caused by the immune system reacting to the vaccine. Researchers believe that since biologics decrease your immune response, they can decrease side effects.⁴

Both studies together have promising results. Though both were small studies, they showed that the vaccines still work in those taking biologics. They also showed that biologics do not increase your risk of vaccine side effects.^1,4

What’s next?

Scientists plan to do more studies looking at COVID-19 and autoimmune diseases. They hope to perform bigger studies for more data. They also are interested in how long COVID-19 vaccines are effective in those with autoimmune diseases and those on biologics.⁴

Experts recommend that those with autoimmune diseases receive a COVID-19 vaccine. It is important because they may be at a higher risk of getting COVID-19 without a vaccine. There are 3 vaccines currently being used today: Pfizer, Moderna, and Johnson & Johnson. They all are very similar. The best vaccine to get is the one that you can get most easily. If you have more questions or are choosing between multiple vaccines, speak to you rheumatologist.³