Overlake Arthritis and Osteoporosis Center – COVID-19 Vaccine Response (updated 02/09/2022)

To our dear patients,

We understand that there are questions you may have about the COVID-19 vaccines.

Currently, the Overlake Arthritis and Osteoporosis Center does not administer any of the approved COVID 19 vaccines.

We are currently recommending that all our patients get the COVID 19 vaccines . This is consistent with the message from the American College of Rheumatology (ACR).

We are providing a summary of our recommendations here per CDC and ACR guidelines:

  • The risk of the COVID-19 infection is higher than the risk of getting a vaccine.
  • There are many benefits of getting vaccinated for COVID-19 and doing so will help end the pandemic.
  • We still need to wear masks, practice physical distancing, and wash our hands to prevent the spread of the coronavirus.


Per American College of Rheumatology (updated 02/02/2022) the following are the guidelines for timing considerations for the immunomodulatory therapy and vaccination:

  1. For patients on methotrexate, sulfasalazine and mycophenolate, leflunomide, azathioprine, hold medication for one- two weeks AFTER each COVID vaccine dose.
  2. For Acetaminophen and NSAIDS (such as ibuprofen,naproxen,meloxicam) hold for 24 hours before the COVID injection.
  3. Hold JAK-Inhibitors such as Xeljanz, Rinvoq and Olumiant for one- two weeks AFTER each COVID vaccine dose.
  4. Hold Benlysta SQ injection (only for injection, not infusion)one week after each COVID vaccine dose.
  5. For patients using ORENCIA subcutaneous injections, hold Orencia injection for one-two weeks AFTER each COVID vaccine dose.
  6. For patients on ORENCIA IV Infusion, time vaccine administration so that the COVID vaccination occurs one week prior to the next dose of IV Orencia.
  7. For patients on Rituxan, the COVID vaccine dose must be provided 2-4 weeks before the next anticipated Rituxan dose.
  8. For all other biologics, there are no specific recommendation as those biologics do not interfere with the response to the vaccine. However, our recommendation for our patients getting infusions is to get the vaccine one (1) week prior to next infusion.

Who is eligible for the fourth dose/ booster COVID vaccine dose?

Per the revised guideline from the Center for Disease Control (02/04/2022), people who are 12 years of age or older, have a condition or are taking medications or treatments that moderately or severely weakens their immune system and has received the three-dose series of either the Moderna or Pfizer is eligible to receive the booster dose/4th dose of COVID vaccine THREE months AFTER the third vaccination.

What about the people who received the Johnson and Johnson vaccine?

Per the revised guideline from the Center for Disease Control (02/04/2022), patients who are immunocompromised and received the first dose of Johnson & Johnson COVID-19 vaccine can get an additional dose at least 28 days after the 1st dose. The booster dose for J&J vaccine is at least two months after the 2nd dose of J&J.

Where can I get my fourth dose/ booster COVID vaccine dose?

Please check with your local pharmacies, hospitals and community health centers if they offer the booster dose of COVID-19 vaccines. If possible, look for a site that offers the same vaccine brand as your first three doses (Moderna or Pfizer).

What about the monoclonal antibody products such as EVUSHELD (tixagevimab/cilgavimab)?

Evusheld is one example of a monoclonal for pre-exposure prophylaxis against SARS COV-2 in moderately-severely immunocompromised patients .The revised guideline from CDC states that a passive antibody product such as EVUSHELD  should be given for at least two weeks after COVID-19 vaccination. Please note that this monoclonal antibody is not widely available. We are working with suppliers and local hospitals; once available, we will inform the patients that will benefit from this additional therapy. EVUSHELD does not replace getting the COVID 19 vaccinations or booster. It is also only recommended for patients on Rituxan.