Vaccination in Patients on Simponi (Golimumab)
Yes, patients on Simponi (golimumab) should receive both flu and COVID-19 vaccinations without delay, and in most cases should continue their biologic therapy without interruption around the time of vaccination. 1
COVID-19 Vaccination
Primary Recommendation
- Patients on TNF inhibitors like Simponi should receive COVID-19 vaccination as soon as it becomes available to them, regardless of disease activity (except for life-threatening illness requiring ICU care). 1
- There is no need to delay or adjust the timing of Simponi administration around COVID-19 vaccination. 1, 2
- Continue Simponi therapy through the vaccination period in most cases. 3
Vaccine Selection
- No preference exists between available COVID-19 vaccines (mRNA or other platforms) for patients on TNF inhibitors. 1
- Patients should receive whichever vaccine is available to them. 1
- Complete the full vaccine series (both doses for two-dose vaccines) with the same vaccine type. 1
Important Considerations
- While the vaccine response may be somewhat blunted compared to immunocompetent individuals, the expected benefits of vaccination far outweigh theoretical risks in patients on biologics like Simponi. 1, 4
- The risk of severe COVID-19 in immunosuppressed patients makes vaccination particularly important, even if antibody response is reduced. 4
- Household members and close contacts should also be vaccinated to create a "cocooning effect" for additional protection. 1
Influenza Vaccination
Primary Recommendation
- Patients with rheumatic diseases on systemic medications including TNF inhibitors should receive the seasonal inactivated influenza vaccine annually. 3
- This is especially critical during the COVID-19 pandemic to reduce the burden of dual respiratory infections and preserve healthcare capacity. 3, 5
Timing Considerations
- Discuss optimal timing of influenza vaccination with respect to Simponi dosing to potentially optimize vaccine response, though vaccination should not be significantly delayed. 3
- For TNF inhibitors specifically, the American College of Rheumatology guidance indicates no need to delay or adjust vaccine administration timing. 1
Safety Profile
- Both influenza and COVID-19 vaccines are inactivated (not live) vaccines and are safe to administer to patients on immunosuppressive therapy like Simponi. 1
- The usual prohibitions against live vaccines in immunosuppressed patients do not apply to COVID-19 vaccines, including adenoviral vector vaccines which are replication-deficient. 1
- Serious adverse events related to vaccination in immunosuppressed populations are rare. 4
Common Pitfalls to Avoid
- Do not delay vaccination waiting for "optimal timing" - the risk of infection while unvaccinated outweighs concerns about potentially reduced vaccine response. 1
- Do not discontinue Simponi around vaccination time unless specifically discussed with the treating rheumatologist, as disease flare risk may outweigh marginal improvements in vaccine response. 3, 1
- Do not order routine antibody testing post-vaccination to assess immune response, as there is no established correlate of protection and results would not change management. 1
Post-Vaccination Guidance
- Patients should continue following public health measures (masking, distancing) even after vaccination, as vaccine efficacy may be reduced in immunosuppressed individuals. 1
- Monitor for typical vaccine side effects (injection site reactions, fever, myalgias), which can be managed with acetaminophen or NSAIDs after symptoms develop (not prophylactically). 1