IL1A and macrophage activation syndrome: There are also three observations supporting to continue IL-1 blockade in patients with AIIRD during COVID-19 vaccination: i) presence of very high IL-1 levels caused by disease activity itself, ii) additional elevation of IL-1 in patients with COVID-19 associated cytokine storm, and iii) better survival rates in patients with macrophage activation syndrome when treated with anakinra (51–53).