Even though physical and social distancing, shielding, and self-isolation are effective measures aimed to prevent the quick spread of the respiratory viruses in the population, vaccination is still the most powerful tool that enables us to subdue and eventually end the pandemic. However, many resources mention autoimmune diseases as a potential contradiction for COVID-19 vaccination. That is why we decided to explore this topic and provide you with a synthesis of the information from the most reliable sources in this matter.
Brief summary
According to the currently available data and recommendations, patients with autoimmune thyroid diseases should not fear the COVID-19 vaccination. Clinical trials have been carried out on thousands of patients and have shown no serious side effects. There is no reason to suspect any specific potential harm for any type of thyroid patients. Since thyroid disorders are common it is certain that the clinical trials have unintentionally included patients with thyroid diseases. No specific safety concerns were identified in subgroup analyses by age, race, ethnicity, medical comorbidities, or prior SARS-CoV-2 infection.
However, some experts mention that the developed immune response in those who are immunocompromised (which is a state present in some patients with autoimmune diseases) may be weaker than in the general population, which may require additional vaccination needed in the future.
More data will be available as the research progresses. The decision about vaccination of immunocompromised patients requires extra consideration, thus, it is better to discuss it with your doctor beforehand.
General overview
According to the CDC, there are two vaccines authorized to prevent COVID-19 in the U.S. at the moment: one developed by Pfizer/BioNTech, and another one by Moderna. Both vaccines utilize mRNA, or messenger RNA, technology, which teaches cells to make a protein that prompts an immune response. There are many other vaccines being developed and tested, thus, hopefully, the list of vaccines authorized for use in the U.S. will grow soon.
Both Pfizer and Moderna‘s vaccines have proved to be remarkably effective in trials, with more than 94% efficacy rates of protection against COVID-19. Both vaccines have to be administered twice, 21 days apart for Pfizer and 28 days apart for Moderna. Pfizer was authorized for use in people of age 16 and above, while Moderna can be injected into those who are 18 and older. Both vaccines were effective in different races, genders, and people with some underlying medical conditions.
COVID-19 vaccination and autoimmune thyroid diseases
First of all, it is important to differentiate autoimmune disease from immunocompromisation or immunodeficiency. When your immune system fails to respond adequately to infection, it’s called an immunodeficiency. It can be primary (inborn, often hereditary) and secondary (caused by diseases such as AIDS or cancer, medications, environmental factors, malnutrition, etc.) People may also suffer from the opposite condition, where an overactive immune system attacks healthy cells as though they were foreign bodies, and that is called an autoimmune response. Both scenarios can create potentially life-threatening conditions and, unfortunately, may even be present together in the same person. However, it is important to understand that these are two different groups of patients in the studies.
The list of contraindications for both vaccines is rather short as they don’t contain any live parts of the virus. You should not get any of the COVID-19 vaccines only if you had a severe allergic reaction to a previous vaccine or its ingredient.
Thus, people with autoimmune conditions or who are immunocompromised are not excluded from the recommendation of getting the vaccine. Both trials included the patients with HIV and no special side-effects or reactions have been observed. However, the efficacy of the vaccines yet to be identified for people with different diseases in the following stages of research.
You may have already read that people with autoimmune disorders and immunosuppression (except HIV) did not take part in the clinical trial on which the emergency use authorization of COVID-19 vaccines was based. Is this a reason to worry? Not really. It is common to exclude people on medications that can affect the immune system (oral corticosteroids, chemotherapy, radiation, immunotherapy, disease-modifying antirheumatic drugs, and others) from vaccine clinical trials. The researchers need to understand how the vaccines work in a general population with an average immune response first to have more accurate efficacy calculations.
Currently, there is no reason to think that the Moderna and Pfizer’s vaccines would be less safe for people with autoimmune conditions based on the previous studies of vaccines with a similar mechanism of action. However, there may be concerns about it being less effective in people with compromised immunity, as their antibody production is altered.
At the American Society of Hematology’s latest meeting, the nation’s leading infectious disease expert Anthony Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases (NIAID), encouraged people with compromised immune systems to get vaccinated when they have the chance.
“It is clear that if you are on immunosuppressant agents, history tells us that you are not going to have as robust a response as if you had an intact immune system that was not being compromised,” Dr. Fauci stated at the meeting. “But some degree of immunity is better than no degree of immunity. So, for me, it would be recommended that these people do get vaccinated.”
Most of the population will have to wait for several months before getting vaccinated, and the trials keep running 24/7. Thus, by the time it is your turn to get a shot, there may be more data about the vaccine’s efficacy in patients with autoimmune diseases and compromised immunity as well as a particular regimen of injections or dosages to ensure a more robust immune response (if needed).
We hope that this information has helped you to clarify possible questions about the COVID-19 vaccination. Stay safe!
