The American College of Rheumatology (ACR) released a recommendation on vaccination in people with autoimmune disorders: “It appears that patients with autoimmune and inflammatory conditions are at a higher risk for developing hospitalized COVID-19 compared to the general population and have worse outcomes associated with infection,” according to the ACR.

Taking this knowledge into account, the college believes that the benefits of vaccination outweigh the risks for new autoimmune reactions or existing disease flare ups.

What are autoimmune diseases?

Autoimmune diseases involve an overactive immune system that attacks itself. Their causes are often unknown but genetics play a part. Autoimmune disease ranks fifth in disease prevalence after obesity, cancer and other diseases, affecting about 3 to 8% of people in the United States. Diagnoses are also more prevalent in women than in men.

Autoimmune diseases include:

• Systemic Lupus Erythematosus
• Rheumatoid Arthritis
• Multiple Sclerosis
• Inflammatory Bowel Disease
• Type 1 Diabetes

COVID-19 and Autoimmune Disease

Neither Pfizer nor Moderna have included patients taking immunosuppressive therapies (common in people with autoimmune disease) in their trials, nor has there been any sub-group data showing the side effects of vaccination in those with autoimmune disease. Despite the lack of research, the consensus is that patients with autoimmune diseases are safer getting the vaccination.

Studies have found that there are higher odds of respiratory failure requiring ventilation in people with rheumatic and musculoskeletal diseases than in the general population. In Black, Latino, and Indigenous (BIPOC) patients with autoimmune disease, the risk of both hospitalization and mechanical ventilation is almost three times higher than in Caucasian patients.

People with autoimmune diseases can readily receive vaccinations. One stipulation of getting the vaccine is to delay autoimmune disease medication for one week after vaccination in order to maximize effectiveness. These medications may include:

• Methotrexate
• Janus Kinase (JAK) Inhibitors – Baricitinib (Olumiant®), Tofacitinib (Xeljanz®), Upadacitinib (Rinvoq™)
• Cyclophosphamide 

Despite this caveat, the benefit of being vaccinated still outweighs the risk of hospitalization and other complications from a COVID-19 diagnosis in those with autoimmune disease.

*Stone, J. (2021, February 17). Covid-19 Vaccines And Autoimmune Disease. Forbes. https://www.forbes.com/sites/judystone/2021/02/17/covid-19-vaccines-and-autoimmune-disease/?sh=7f18d92a4892 

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions. 

This content is only meant to serve as information and should not, in any way, be taken as medical advice. Patients should discuss all issues regarding vaccines, treatment, symptom management, and other condition-related factors with their physician or a qualified healthcare provider before making a decision regarding their care.