Can You Take Rituxan and Get a COVID-19 Vaccine?
Key takeaways:
Rituxan (rituximab) is a medication that alters the immune system. It’s used to treat cancer and autoimmune diseases.
Rituxan prevents people’s immune systems from responding well to the COVID-19 vaccines. This means they’re more likely than other people to get infected even after being fully vaccinated.
Being vaccinated a few weeks before your next Rituxan dose may help boost your immune response to the COVID-19 vaccine. Discuss this timing with your healthcare provider.
Over the past year, COVID-19 vaccines have been given to millions of people across the U.S. But one of the many things we’ve learned is that they may not offer as much protection for people with weakened immune systems. Certain medical conditions and medications can cause a weakened immune system.
Medications that weaken the immune system are called immunosuppressants. One medication, called Rituxan (rituximab), can weaken your immune system. Rituxan belongs to a group of medications known as CD20 antibodies. It’s FDA-approved to treat a few cancers and autoimmune diseases.
Experts have raised concerns that Rituxan may interfere with how well the COVID-19 vaccines work. This has prompted more research to determine how severe this interaction is.
Here, we’ll discuss whether Rituxan interacts with the COVID-19 vaccines and if it’s recommended to get vaccinated while receiving this medication.
Does Rituxan (rituximab) make COVID-19 vaccines less effective?
In short, yes. Rituxan weakens your response to the mRNA COVID-19 vaccines (Pfizer’s and Moderna’s vaccines). However, this isn’t surprising. It’s been known that Rituxan weakens people’s immune responses to other vaccines as well.
A small study showed that close to half of those receiving Rituxan created no antibodies after receiving two doses of the mRNA COVID-19 vaccines. Antibodies are infection-fighting proteins our immune systems make after getting sick or vaccinated. They’re important for building immunity to a germ. In the study, the percentage of people who didn’t make antibodies rose to about 60% if they received Rituxan less than 6 months before being vaccinated.
These findings are worrying. They mean many people using Rituxan are still vulnerable to COVID-19 after vaccination. However, the most recent Rituxan study is more promising. It shows that people’s immune responses improve with an additional (third) COVID-19 vaccine dose.
It’s important to note that this information is very recent. It hasn’t been published in medical journals yet. This means these findings haven’t been fully reviewed by experts.
Still, more research is needed to see if people on Rituxan should get boosters regularly. Researchers have also not investigated how Rituxan affects the Johnson & Johnson (J&J) COVID-19 vaccine. But it’s likely that this issue applies to the J&J vaccine as well.
How does Rituxan affect the immune system?
Rituxan attaches to a protein found on certain immune cells called B cells. Once Rituxan attaches to the B cells, those cells are destroyed by other immune cells.
In some cancers, B cells grow in the body without stopping. Rituxan helps get rid of these cancerous immune cells.
When a person has an autoimmune disease, the immune system attacks their own body. Rituxan is thought to help stop this immune attack by lowering the number of B cells.
Why does Rituxan trigger worse immune responses to COVID-19 vaccines?
B cells create antibodies in response to a vaccine. If you come into contact with a germ after being vaccinated for it, your B cells can create those antibodies again very quickly. But without enough B cells, your body can’t properly respond to germs or learn from vaccines.
As just discussed, Rituxan works by lowering the number of B cells. Because this key part of the immune system is being weakened by Rituxan, the body’s response to vaccines is also weaker. This includes the COVID-19 vaccines.
If you’re taking Rituxan, should you still get vaccinated?
Yes.
Both the American College of Rheumatology (ACR) and National Comprehensive Cancer Network (NCCN) recommend that people using Rituxan get their COVID-19 vaccines and boosters. But it’s a good idea to speak with your healthcare provider first about the best time to get your vaccines.
What can you do to increase your immune response to the COVID-19 vaccine?
In between doses of Rituxan, your body will begin to make B cells again. It’s thought that receiving COVID-19 vaccine doses when you have more B cells present may allow your body to have a better immune response. But finding this sweet spot for vaccines can be tricky and varies for every person using Rituxan.
The exact timing for your COVID-19 vaccine or booster should be discussed with your healthcare provider first. You may be recommended to get your vaccine a few weeks before your next Rituxan treatment.
Some providers may choose to run a blood test to see how many B cells are present. Depending on that test, they may or may not recommend you get vaccinated. But this isn’t considered necessary by either the ACR or NCCN.
Should you get vaccinated for COVID-19 if you have an autoimmune disease?
Yes.
People with autoimmune diseases have a higher risk of severe illness from COVID-19. Vaccines are the best defense we currently have against this infection. It’s recommended that those living with these health conditions get vaccinated, wear a mask, and continue to take extra precautions suggested for people who are unvaccinated or not fully vaccinated.
The bottom line
Rituxan is a medication that lowers the amount of immune cells called B cells. Because of its effects on the immune system, COVID-19 vaccines may not work as well for people using Rituxan. Still, it’s recommended that you receive these vaccines and any boosters even if you use this medication.
Getting your vaccines a certain amount of time before a dose of Rituxan may help boost your response to the COVID-19 vaccines. Discuss how best to time your vaccines and Rituxan doses with your healthcare provider.
Why trust our experts?
References
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