viruses are notoriously involved in the pathogenesis of autoimmune diseases , and the authors reasonably conclude that such a cross-reactivity might lead to the development of immune-mediated disorders in coronavirus disease-19 (covid-19) patients in the long term. the reactogenicity of covid-19 mrna vaccine in individuals suffering from immune-mediated diseases and having therefore a pre-existent dysregulation of the immune response has not been investigated. besides the mechanism of molecular mimicry, mrna vaccines may give rise to a cascade of immunological events eventually leading to the aberrant activation of the innate and acquired immune system.
according to epidemiological data, these subjects may develop the infection asymptomatically or pauci-symptomatically and it is worth noting that, in line with the article of vojdani et al. modifications in nucleoside and nanoparticle composition through a proper manufacturing may help to prevent some of these drawbacks. although this is not the case of the authorized covid-19 mrna vaccines, future formulations containing adjuvant like tlr agonists  may exacerbate pre-existing autoimmune or autoinflammatory disorders and should therefore be discouraged in this cohort of patients.
still, there is uncertainty among patients with aiids and clinicians about the effectiveness and safety of the new vaccines. we aimed to review the current knowledge of sars-cov-2 vaccines and vaccine candidates in the light of aiids and analyze their potential to be effective and safe in patients with aiids. in the case of immunosuppression, the response to some vaccines and the efficacy resulting in immunogenicity, however, has become unpredictable, especially in the case of b cell depleting therapies . therefore, covid-19 prevention strategies should be prioritized in the specific population of patients with aiids, and vaccination against sars-cov-2 is thought to be one of the most promising approaches. and in some cases, the use of antiviral drugs early during the viral infection in patients with aiids is a must, although they have been vaccinated (i.e., in case of influenza). although the immunogenicity and the effectiveness of the vaccines in this population of patients may be lower than the healthy controls, they are generally comparable.
nevertheless, the information for some of the vaccines is still scarce. in that case, patients with aiids may obtain the benefits of other types of vaccines. however, the main drawback of vaccines based on viral vectors is the low effectiveness due to prior existing immune response to the vector and the need for frequent booster doses for establishing long-lasting immune response. this includes the readiness for fast development and distribution of vaccines . however, only the lack of data here increases the hesitancy amongst the rheumatologists and other specialists to recommend these vaccines for their patients. to the best of our knowledge, real-world data on covid-19 vaccines in patients with aiids tend to zero. tv and tg agreed to be accountable for all aspects of the work.
, concerning the hypothesis of a molecular mimicry mechanism between the nucleoprotein/spike protein of severe acute respiratory syndrome coronavirus disease 2019 (covid-19) pandemic has become challenging even for the most durable healthcare systems. it seems that vaccination, abstract coronavirus disease 2019 (covid-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (sars-cov-2) has led to an, .
how would a third dose of covid vaccine affect people with autoimmune disease? a new nih study co-led by a u-m rheumatologist aims to find  their vaccine candidate was more than 90% effective in preventing covid-19 infection in participants without prior infection. being an mrna a tolerizing mrna vaccine prevents autoimmune disease in mice. vaccines based on mrna have dominated the headlines during the covid-19 pandemic, .
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