Can a patient on Simponi (golimumab) receive flu and COVID-19 vaccinations?

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
• Continue Simponi therapy through the vaccination period in most cases. 1

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, 2
• The risk of severe COVID-19 in immunosuppressed patients makes vaccination particularly important, even if antibody response is reduced. 2
• 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. 1
• This is especially critical during the COVID-19 pandemic to reduce the burden of dual respiratory infections and preserve healthcare capacity. 1, 3

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. 1
• 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. 2

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. 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