What to Expect from a COVID-19 Vaccine If You Have a Chronic Condition

What to Expect from a COVID Vaccine If You Have a Chronic Condition
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  • People with autoimmune diseases, such as rheumatic or neuroinflammatory diseases, have expressed concern that the COVID-19 vaccines could aggravate their symptoms.
  • Health experts widely believe the benefits of the vaccine outweigh the risks of a potential reaction or flare-up.
  • People may need to work with their physician to adjust the timing of their medications around their vaccination.

Many patients with autoimmune diseases, such as rheumatic or neuroinflammatory diseases, have expressed concern that the COVID-19 vaccines could aggravate their symptoms or trigger a flare-up.

The American College of Rheumatology (ACR) believes the benefits of the vaccine outweigh the risks of a potential reaction or flare-up, considering how people with chronic conditions face an increased risk of a severe form of COVID-19 and hospitalization.

The ACR recently released recommendations for patients with autoimmune diseases who are concerned about how they may react to the vaccines.

The recommendations explain how certain immunocompromised people may need to work with a doctor who can adjust the timing of their medications to improve the efficacy of the vaccines.

How does the vaccine affect people with chronic conditions?

“Vaccine side effects have more to do with an individual’s immune system and the reaction of that individual’s immune system to the vaccine than their chronic disease state,” said Dr. Ramin Ahmadi, the chief medical officer for Graduate Medical Education Global LLC.

The vaccines haven’t been widely tested in people with autoimmune conditions, so the data regarding their safety and efficacy of the vaccines Trusted Source in this group is limited.

People who are immunosuppressed, such as those on chemotherapy or people who have had a bone marrow transplant, may mount a less robust immune response, compared with the general population, but the vaccine is believed to still provide protection.

Health experts widely believe the benefits of being vaccinated outweigh the risks, since people with chronic conditions typically have a higher risk of a severe form of the disease.

Patients with autoimmune and inflammatory rheumatic diseases face a higher risk of hospitalization from COVID-19.

Every person will react differently to the vaccines.

“What’s important to keep in mind is that all diseases of the immune system were not created equally. Some may impact the development of vaccine-mediated immunity, and some stand to benefit a great deal from the vaccine,” Ahmadi said.


 

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Could the vaccine cause a flare-up?

Many patients with autoimmune conditions fear the vaccine could trigger a flare-upTrusted Source.

“There may be a risk of a flare-up after the COVID vaccination in some individuals with severe disease,” said Ahmadi, noting this risk is theoretical.

But the benefits of being vaccinated against COVID-19 far outweigh any risks, experts say.

Though the data on the COVID-19 vaccines in immunocompromised individuals is limited, past research on other vaccinesTrusted Source has shown that vaccination rarely causes adverse events in patients with autoimmune inflammatory rheumatic disease.

recent studyTrusted Source published in The Lancet Rheumatology says that given this past data, the theoretical potential for an adverse event to occur shouldn’t be a reason to advise patients with autoimmune disorders against vaccination, especially when they are at an increased risk of a severe form of COVID-19.

Dr. David Cutler, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, California, says getting vaccinated during a flare-up is generally OK.

Because steroid medications can suppress the immune system, it’s often advised that people taking such medications avoid them for 2 weeks before or after vaccination, says Cutler.

That said, you definitely don’t want to delay getting vaccinated against COVID-19, so talk with your doctor about the timing of your medications and disease state prior to vaccination.

Some of the side effects that occur after vaccination, such as fever, muscle aches and pain, and fatigue, may resemble symptoms related to an underlying condition.

The reactions can also be localized. For example, some people may develop lymph gland enlargement after vaccination, says Cutler.

“These reactions are generally mild, short-lived, and self-limited,” Cutler said.

Cutler says it’s OK to take Tylenol or ibuprofen for pain or Benadryl for itching after the vaccine if need be.

“The most important thing is getting the COVID vaccine as soon as you become eligible because this will reduce your chance of getting COVID, transmitting COVID, or experiencing any of the long-term effects of even asymptomatic COVID infection,” Cutler said.

The bottom line

Many patients with autoimmune diseases, such as rheumatic or neuroinflammatory diseases, have expressed concern that the COVID-19 vaccines could aggravate their symptoms or trigger a flare-up.

Health experts widely believe the benefits of the vaccine outweigh the risks of a potential reaction or flare-up, since immunocompromised people have an increased risk of a severe form of COVID-19.

People may need to work with their physician to adjust the timing of their medications around their vaccination.

Special Guests

Lesley Stahl, Correspondent, CBS 60 Minutes

Lesley Stahl has worked at CBS News since 1972 when she covered the Watergate scandal, during the Nixon Administration. She was the CBS White House Correspondent during the Carter, Reagan and much of the George H. W. Bush years. From 1972-91 she also moderated Face the Nation on Sunday mornings. She has been at 60 Minutes since 1991. She has authored two books: Reporting Live and Becoming Grandma. She’s married to author and screenwriter Aaron Latham. They have a daughter and two granddaughters. Ms. Stahl developed COVID-19 in Spring 2020.

D.L. Hughley, Comedian and Author

D.L. Hughley is an astute and politically savvy standup comedian, author, and host of multiple network shows, including the “The D.L. Hughley Show” which is syndicated in over 60 cities in the U.S. Harper Collins recently released D.L.’s fourth book Surrender, White People. His two previous satirical titles Black Man, White House: An Oral History of the Obama Years and How Not to Get Shot…And Other Advice From White People, became New York Times bestsellers. D.L. also created and starred in the satirical documentary special for Comedy Central D.L. Hughley: The Endangered List, which was honored with the prestigious George Foster Peabody Award at the 72nd Annual Peabody Awards. D.L. developed COVID-19 in Summer 2020.

Brian Stokes Mitchell, Tony Award-Winning Actor

Tony Award-winner Brian Stokes Mitchell has been dubbed “the last leading man” by The New York Times. His career spans more than 40 years of television, film, Broadway, recordings and concerts. A passionate champion of the arts, Mr. Mitchell is the chairman of The Actors Fund, serves on the Board of Americans for The Arts and is a founding member of Black Theatre United. Mr. Mitchell developed COVID-19 in March last year and later thrilled New Yorkers with his nightly acapella rendition of “The Impossible Dream” from his Upper West Side apartment window.

Alyssa Milano, Actor and Activist

Alyssa Milano is an actor, producer, host, activist, entrepreneur, humanitarian and New York Times best-selling author. In addition to starring in more than 20 films and numerous TV shows, Ms. Milano hosts a weekly podcast “Sorry Not Sorry” that tackles social, political and cultural issues. As an activist, Ms. Milano has advanced #MeToo that sparked a viral movement of women fighting against sexual harassment and assault, and she has been involved in TimesUp since its inception. For 15 years she has been a UNICEF National Ambassador, receiving its Spirit of Compassion Award. Her novel Hope: Project Middle School is a New York Times bestseller and the first in a multi-part series. Ms. Milano developed COVID-19 in Spring 2020.

Paula Green-Smith and Philip Hamilton

Paula Green-Smith and Philip Hamilton are Detroit public health professionals who live the healthy lifestyles promoted in the chronic disease prevention programs they deliver through Urban Health Resource, a partner organization of the Black Women’s Health Imperative (BWHI). Ms. Green-Smith also serves as BWHI’s Chief Training Officer. Together, the couple developed COVID-19 and have made sharing their experience part of their mission to inform, educate, and increase awareness to improve the health of their community.

Healthline Moderators

Erin Petersen, Healthline.com Editor in Chief

Erin Petersen oversees Healthline.com’s team of 200+ writers and editors who produce articles and videos for America’s #1 most visited digital health and wellness brand. Erin is based in the San Francisco Bay Area.

Dr. Elaine Hanh Le, Healthline Media Chief Medical Officer

Dr. E. Hanh Le leads Healthline Media’s Medical Affairs internal team of 10 and external network of 100+ doctors, clinicians and specialists who ensure Healthline Media’s content is evidence-based and medically approved. Hanh is based in the San Francisco Bay Area.

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Steve Swasey, Healthline Media Vice President of Communications

Steve Swasey oversees external communications for Healthline Media, the #1 digital health publisher whose brands include Healthline.com, MedicalNewsToday.com, Greatist.com and PsychCentral.com. Steve is based in the San Francisco Bay Area.

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