COVID-19 Vaccine And Lupus

Reviewed by: HU Medical Review Board

The COVID-19 pandemic has led to uncertainty for many. Fortunately, researchers have been working hard to learn more about the virus, ways to treat it, and potential vaccines. However, with new vaccines making their way to the market, many with lupus have concerns. Is the vaccine safe for people with lupus? Will lupus or its medicines change the effectiveness of the vaccine?

Although the information is changing daily, what we know right now about these issues is discussed below.

The Pfizer and Moderna vaccines

Two approved vaccines are the Pfizer and Moderna vaccines. Both vaccines received Emergency Use Authorization (EUA) from the FDA. This means that their approval process was accelerated because their potential benefits greatly outweigh any risks.

Even though their approval was faster than usual, both vaccines were extensively tested in clinical trials. Both the Pfizer and Moderna vaccines are messenger RNA (mRNA) vaccines. These vaccines require 2 doses.1-3

What is an mRNA vaccine?

Typically, vaccines contain inactivated (killed) parts of a virus. In some cases, they may even contain a weakened, live version of a virus. However, new COVID-19 vaccines are unique. They carry mRNA instead. This mRNA is a set of genetic material that acts as instructions. When injected into the body, it tells a person’s cells to make a specific protein. The protein our cells are told to make is called a spike protein.1-3

This spike protein plays a role in how COVID-19 infects humans. When our body makes this protein without being infected with COVID-19, it also makes antibodies. These antibodies help protect us from COVID-19 infection if we are exposed to the actual virus later on.1-3

The Johnson & Johnson Janssen vaccine

The Johnson & Johnson Janssen (J&J) vaccine was also given EUA by the FDA. However, in April 2021, the CDC and FDA recommended a pause in the J&J vaccine because of a low risk of blood clots. Before the pause, over 7.5 million doses of the vaccine had been given in the United States.4

After considering the risks, the CDC and FDA lifted the pause and recommended the continued use of the J&J vaccine. When reviewing the data, they decided the benefits of the vaccine outweighed the potential risks.4

The J&J vaccine is a type of vaccine called a viral vector vaccine. This type of vaccine works similarly to the mRNA vaccine. It also causes our bodies to make the same spike protein, which then causes our bodies to produce antibodies. However, the viral vector vaccine uses a modified version of a harmless virus to pass instructions to our cells, instead of mRNA. The J&J vaccine only requires 1 dose.5

What to expect from the COVID-19 vaccine

Because none of the vaccines contain any live virus, they cannot cause COVID-19. However, there are still some side effects that can occur. These are mostly related to the actual injection of the vaccine, like arm soreness or redness. Other potential side effects are related to the body making protective antibodies and are not dangerous. These include body aches, low-grade fevers, chills, and fatigue.1-3

The results from the clinical trials on these vaccines show that they are both very effective and that side effects typically go away within a few days.1-3

Safety of the vaccine in those with lupus

When a new product is being tested in clinical trials, the primary goal is to determine safety and efficacy in the general population. This means those with medical conditions are not the focus of initial studies. We do not have data on how the vaccine might affect people with lupus, including whether it triggers lupus flares. We also do not know how well the immune system of someone with lupus responds to the vaccine when it comes to giving future protection.1-3

However, we know that severe COVID-19 infection can be serious. The risks of getting the vaccine, regardless of underlying medical conditions, are low. This has led experts to suggest that the potential benefits of vaccination outweigh the minimal risks.1-3

Moving forward, studies will focus on those who might react differently from the people in the first clinical trials. This includes those with underlying medical conditions like lupus. This will help us to figure out the vaccine’s effects in the future.

Lupus drugs and the COVID-19 vaccine

Many people taking drugs that affect the immune system may have concerns about their responses to the vaccine. There has been some concern that people taking these drugs may not develop a full immune system response and may not be protected from the virus as others.1-3

This is especially of concern for people on lupus drugs like Benlysta (belimumab). However, at this time, we do not think that anyone taking these drugs (or other immune system suppressants) will have different responses.1-3

Even if a person on these drugs did have a weaker immune response, many experts believe that a partial immune response to COVID-19 is still a good thing. A partial response is better than no immune response at all.1-3

Remember to talk to your doctor

The decision to get vaccinated depends on many factors. If you are considering getting the COVID-19 vaccine, talk with your doctor. They can help you determine whether the vaccine is right for you.1-3

For the latest updates from the CDC on COVID-19 and vaccines, please see Lupus and COVID-19.

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