Rheumatologist Dr. Domingues Discusses Vaccine Concerns Among Immunocompromised Patients That Providers Should Be Aware Of

The end of the COVID-19 pandemic may be in sight, and the light at the end of the tunnel has taken the form of a vaccine. Immunocompromised patients may have concerns about receiving the vaccine, so DocWire News interviewed Vinicius Domingues, MD, a rheumatologist in Daytona Beach, Fla., and medical advisor to CreakyJoints, to discuss what some of the top concerns have been among these patients as well as what information providers can give to these patients.

For more information about vaccinations to share with your immunocompromised patients, click here to read Getting a COVID-19 Vaccine: What to Know If You’re Immunocompromised.

DocWire News: What are the primary concerns among immunocompromised patients regarding vaccination?

Dr. Domingues: I think one of the top concerns is, “Is this going to give me the disease? A COVID vaccine, can that give me COVID?” And the answer to that is obviously not. The current two vaccines that are more promising—Pfizer is approved for emergency use, Moderna will probably get approved today or tomorrow*–they use the technology called RNA Messenger, and there’s nothing live there. It is just a piece of a protein, the piece of something that makes the protein of the virus. So that’s, I think, question number one. “Am I going to get the disease from the vaccine?” and the answer is obviously not.

The second most common question I see is, “Can I have [the vaccine], am I even going to be able to mount an immune response?” And that gets a little bit more complicated. Depending on the medication you’re on, you’re not going to have as a robust of a response as you would if you didn’t. But at the end of the day, it is what it is. Some response is better than no response. So, while we have strong data on the influenza vaccine, that some medications that we use may make the response a little lower, it doesn’t really matter because you get some response. That’s probably the second most common one that we see all the time. But, at the end of the day, the recommendation is for everybody to yes, get vaccinated.

DocWire News: What are some of the main differences between the Moderna and Pfizer vaccines, and the AstraZeneca vaccine that has not yet been approved?

Dr. Domingues: Those are basically identical, to be honest with you. They both use this novel technology called RNA Messenger, the Pfizer and the Moderna vaccines. AstraZeneca, which it’s not yet to be approved, it’s not that advanced yet, that uses a virus vector, which is completely different technology.

But I think one of the things that to highlight is that this technology has never been used before, so that’s what the skepticism of a lot of the skeptics is, probably. It had never been used in mass scale, but it is what it is. We conquered a vaccine in nine months, and can we tell that this is safe very long-term? We cannot. But at this point, the way I see it, it’s our civic duty to take it, so we can end this crazy world that we’re in right now.

DocWire News: Are there any different safety signals for immunocompromised patients getting the vaccine?

Dr. Domingues: It doesn’t appear that there is any. But don’t forget, we’re only six months in, so we don’t have more information, and that’s one of the concerns, obviously.

DocWire News: How can healthcare providers educate their immunocompromised patients on the COVID-19 vaccines?

Dr. Domingues: I think transparency is the best thing. So we do need to acknowledge that we do not have long-term safety with either vaccine—we don’t, we simply don’t. However, the short-term safety evidence appears to be very safe. And the only way we can finish this pandemic is if everybody does it. So obviously, the frontline [workers], the healthcare providers, and the nursing home [staff and residents] are already being vaccinated. I think the way for us to agitate it is transparency, and be very skeptical about who you listen and who you re-trump, because there will be a lot of misinformation out there.

*This interview was conducted on Dec. 18.