Researchers at the University of Hong Kong have reported that clinicians may need to be aware of special considerations for vulnerable patients with ophthalmic conditions, including those with inflammatory eye diseases and some autoimmune disorders. Literature has suggested that there may be a potential for lower vaccine efficacy in pharmacologically immunosuppressed patients. In addition, clinical ophthalmologists may need to be aware of the possibility of vaccine-induced antibody-dependent enhancement for pre-existing inflammatory eye diseases. Regardless of the status of the vaccine roll-out in many jurisdictions, preventive measures need to be sustained to maximise the protective protocols to support clinicians and their patients, even after vaccination.
It is now over a year (March 11th, 2020) since the World Health Organization declared a global pandemic and as of March 14th 2021, there are over 119M cases of COVID-19, including 2.6M deaths. However, there is now clear optimism that COVID-19 vaccinations are in reach, and in fact as of last week, >300M vaccine doses have been administered in several parts of the world. In addition, as of March 2021, there are 96 vaccine candidates in progress with 266 clinical trials – 29 in phase I, 40 in phase II and 27 in phase III (https://covid19.trackvaccines.org/vaccines/). More importantly, there are now 12 approved vaccines— BNT162b2 (BioNTech/Pfizer), Sputnik V (Gamelaya), mRNA-1273 (Moderna), ChAdOx1 (University of Oxford), BBIBP-CorV (Sinopharm), Covishield (Serum Institute of India), Covaxin (Bharat Biotech), CoronaVac (Sinovaac), Ad5-nCoV (Cansino Biologics), EpiVacCorona (FBRI), Sinopharm (Wuhan) Inactivated (Vero Cells) and Jannsen (Ad26.COV2.S).
In the current report, researchers commented that “patients who are pharmacologically immunosuppressed constituted a significant group of vulnerable patients for ophthalmologists during the pandemic. Immunosuppressive therapy is increasingly used to manage ocular inflammation, which is a major cause of ocular morbidity. The dilemma over the use, timing, dosage and duration of immunosuppression in patients with COVID-19 persists. The conundrum will likely extend to COVID-19 vaccine administration given the limited safety and efficacy data”. Importantly, EURETINA has provided valuable information at the Society’s website on similar topics (www.euretina.org/covid-questions/euretina-qr-covid-19-phase-2-2/). Given that different countries across Europe have different rates of infection, it is recommended that all national guidelines follow the advice provided by the competent agencies. Lastly, a word of thanks to Prof. Mario Romano in Milan for providing detailed and relevant insights on the EURETINA website.