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COVID Vaccine & Autoimmune Disease FAQ

With the roll-out of innovative and promising COVID-19 vaccines comes the hope that the pandemic may be nearing an end. Alongside this newfound hope are questions and concerns about vaccine risks for those living with autoimmune disease.

As access to the vaccine has increased, the team at Global Autoimmune Institute has received an influx of questions from the autoimmune disease community. While we are unable to provide medical advice or guidance about individual health plans, we would like to share our answers to our most frequently asked questions!

I have an autoimmune disease - is it safe for me to get the COVID vaccine?

From what the Global Autoimmune Institute has reviewed in the scientific literature in regards to COVID-19 vaccination and autoimmune disease, the evidence available at this point indicates that the benefit of COVID-19 vaccination outweighs the risk of side-effects.

The CDC website also states that “COVID-19 vaccines may be administered to most people with underlying medical conditions. This information aims to help people in the following groups make an informed decision about receiving a COVID-19 vaccine.”

I have an autoimmune disease - will the Covid vaccine work for me?

The current understanding is that COVID-19 vaccine efficacy may be decreased for people who take immunosuppressant drugs, which includes many being treated for autoimmune disease. There is currently no concrete data to elucidate how the immune system responds to the vaccine specifically in those with autoimmune disease. However, the CDC states that people with autoimmune conditions were eligible for enrollment in COVID-19 vaccine clinical trials and that “no imbalances were observed in the occurrence of symptoms consistent with autoimmune conditions or inflammatory disorders in clinical trial participants who received COVID-19 vaccine compared to placebo.”

This finding suggests that people with autoimmune conditions may safely receive any FDA-authorized COVID-19 vaccine. Regarding those with autoimmune disease who take immune system-altering medications, the American College of Rheumatology released a recommendation to delay taking such medications for one week after vaccination – under the direction of their doctor. Doing this may allow their immune systems to create a stronger antibody response and combat the drop in vaccine efficacy seen in those on immunosuppressants.

I take medications for my autoimmune disease - how will they interact with the COVID vaccine?

Certain medications with antimetabolite agents are known to suppress immune response across the board – including to a vaccine (1, 2). Other immunosuppressive drugs – such as corticosteroids, hydroxychloroquine, or biologics – may also inhibit a robust immune response to vaccination.

The primary recommendation from the American College of Rheumatology is to delay certain medications for one week after vaccination. These include:

  • Methotrexate
  • janus kinase (JAK) inhibitors – baricitinib (Olumiant), tofacitinib (Xeljanz), upadacitinib (Rinvoq)
  • Cyclophosphamide 

Longer delays are recommended for biologics – abatacept (Orencia), rituximab (Rituxan).

I have an autoimmune disease - am I at risk of experiencing a flare-up from the vaccine?

There is a risk that flare-ups may occur. That being said, it has been observed that people living with autoimmune and inflammatory conditions are at higher risk of experiencing severe symptoms from a COVID-19 infection. Due to this concern, the American College of Rheumatology has stated that “the benefit of COVID-19 vaccination outweighs any small, possible risks for new autoimmune reactions or disease flare after vaccination.”

Additionally, one study from Cedar’s Sinai Medical Center evaluated a longitudinal vaccine registry and reported that the Covid-19 vaccine was found to be safe for patients with immune-mediated inflammatory diseases, such as IBD. Adverse event frequency and type were similar to that of the general population. Moreover, authors have reassured IMID patients that the risk of adverse events is “likely not increased, and may be reduced, while on biologics.”

Prominent autoimmune disease organizations also share a common consensus: that the benefits of the vaccine outweigh possible risks of experiencing new autoimmune reactions or flare-ups.

I have an autoimmune disease, was vaccinated, and have experienced side effects - what do I do now?

Speak with your doctor. They will have your complete medical history as well as current medical profile, and will be able to guide you through side effects you may be experiencing.

You can also submit your side effects to the Vaccine Adverse Effects Reporting System (VAERS). Scientists at the CDC and FDA monitor VAERS to decide which adverse events merit further investigation. There may be others experiencing similar side effects to you; submitting them to VAERS provides the best chance for the CDC and FDA to know and study side effects from the COVID-19 vaccine.

Where can I find clinical trial data on people with autoimmune diseases getting the COVID vaccine?

People living with autoimmune disease and those on immunosuppressive therapies were not included in initial clinical trials for the COVID-19 vaccine. This is due to the fact these population groups can skew efficacy data.

That being said, the NIH is currently recruiting participants with autoimmune disease for a new clinical trial testing the Immunological Response to COVID-19 Vaccine in Patients With Autoimmune and Inflammatory Diseases Treated With Immunosuppressants and/or Biologics.

I have an autoimmune disease - which vaccine should I get?

Speak with your doctor – they will have a broader understanding of which vaccine suits you and your medical history. Want to understand and compare the world’s leading vaccines? Check out our Vaccine Comparison Chart.

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Researchers around the world are creating and testing close to 100 vaccines in an effort to combat the novel coronavirus. The above chart breaks down leading vaccines which have shown promise through pre-clinical data, completed Phase 1/2/3 clinical trials, and have been authorized for emergency use.

Preclinical data is collected when testing a vaccine on cells and animals. If an immune response is detected, the study moves forward as a Phase 1 safety trial by testing the safety of the vaccine on a select number of people (typically around 20-80 people).

If the dosage is deemed safe and effective, the trial progresses to a Phase 2 expanded trial, in which hundreds of people receive the vaccine. At this stage, participants are split into groups to observe the vaccine’s efficacy and safety across a spectrum of ages.

Phase 3 efficacy trial tests for vaccine efficacy against volunteers who receive a placebo. Thousands of participants are included in the trial, and an efficacy rate is determined for the vaccine against a virus.

Due to the nature of the coronavirus, some vaccine trials underwent combined phases (e.g. Phase 1/2) in order to accelerate development.

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The information shared on this page is accurate to the best of our knowledge. Because the COVID-19 pandemic is rapidly evolving, as is the scientific community’s understanding of this virus, information and insights are constantly updating. Please read resources provided by the CDC, WHO, and public health authorities to stay informed, and seek professional medical advice for best practice pertaining to your medical plan.

 

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