Abstract
The current approach to COVID-19 vaccination of patients with immune-mediated inflammatory diseases is largely extrapolated from existing data relating to other vaccines. It is well recognised that methotrexate impairs humoral responses to both influenza and pneumococcal vaccines,1,2 and a temporary discontinuation of therapy for 2 weeks enhances influenza vaccine immunogenicity in patients with rheumatoid arthritis.3 These data were used as a surrogate for COVID-19 vaccination responses, prompting the American College of Rheumatology (ACR) to recommend temporary interruption of methotrexate for 1 week after each vaccine dose.
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