Fourth Dose of COVID-19 Vaccine Increases Protection in Rheumatic Disease Patients

A new study led by Mass General Brigham researchers suggests that the U.S. Centers for Disease Control and Prevention recommendation that patients receiving disease-modifying antirheumatic drugs (DMARDs) receive a fourth dose of the mRNA vaccine in addition to the three-dose primary series to protect against COVID-19 saves lives and reduces hospitalizations among patients in this high-risk group.

In the study, the researchers used observational data from the Mass General Brigham healthcare system to compare rheumatic patients taking DMARDs who received a fourth dose of the mRNA vaccine to those who did not. The study included data from 4,305 patients. They found that patients who received the fourth dose had a 41 percent reduction in risk for infection and a 65 percent reduction for admission/death compared to those who did not.

“A fourth dose of COVID-19 mRNA vaccine provides considerable protection against any SARS-CoV-2 infection and severe COVID-19 among patients with systemic autoimmune rheumatic diseases using DMARDs,” said co-corresponding author Zachary Wallace, MD, MSc, of the division of rheumatology, immunology and allergy at Massachusetts General Hospital, a founding member of the Mass General Brigham healthcare system. “These patients should be encouraged to stay up to date with COVID-19 mRNA vaccines, including boosters after the primary vaccination series.”