ASK THE DOCTORS
Those with weakened immune systems can get COVID-19 vaccine
Hello, dear readers, and welcome to another yes-we’re-still-talkingabout-the-vaccines column. Your questions on the topic continue to fill our mailbox, and we’ll keep answering as many as we can.
— We have heard from a number of readers with weakened immune systems or who are living with immune system disorders such as lupus, rheumatoid arthritis and HIV. They are asking if it’s safe for them to get the vaccine. The Centers for Disease Control and Prevention states that this group of people can get vaccinated with the same caveats as the general population — that they have not had an allergic reaction to other vaccines, and they are not allergic to the ingredients of the coronavirus vaccine. (These are available at the FDA website, FDA.gov.) Due to their impaired immune systems, however, not everyone in this category will have a robust response to the vaccine. It’s important to continue protective behaviors — masks and distancing — when in public and among people outside of the immediate circle.
— In that same vein, we’ve had questions from pregnant women as to whether or not it’s safe for them to get the vaccine. Based on a recent survey of 35,691 pregnant women between the ages of 16 and 54 who received the vaccine and were monitored afterward, the answer, so far, is yes. Pregnant women did report a higher incidence of injection site pain, but no other adverse effects were seen. Neither the Moderna nor Pfizer vaccines contain a live virus, and the mRNA in the vaccine does not alter human DNA or cause genetic changes. The American College of Obstetricians and Gynecologists urges pregnant women who are uncertain about the vaccine to talk to their doctors about any concerns they may have.
— Several readers have written to say they worry about the rapid release of the coronavirus vaccine, that it was developed too fast. Although it’s true that the vaccine against COVID-19 became available quickly, the mRNA technology that the vaccine is based on has been in development for decades. This includes mRNA vaccines that targeted other coronaviruses, including the SARS and MERS viruses. In those instances, the outbreaks quickly subsided, and vaccines were not needed. Unlike in previous vaccine development, this was a global effort. The genetic code of this particular coronavirus was released within days of sequencing, and the money that flooded into vaccine development allowed all aspects of the process to proceed at a rapid pace. Testing followed the usual rigorous process, with unprecedented numbers of volunteers asking to take part.
— Some readers are worried that because they took over-the-counter pain meds prior to receiving the vaccine, they won’t be fully protected. Although the CDC counsels against taking NSAIDs (nonsteroidal anti-inflammatories) in a bid to avoid side effects, the advice arises out of an abundance of caution. There is no hard evidence that doing so will blunt the efficacy of the vaccine. If you did, don’t worry. But it’s still advised that you don’t.
— Many of you asked if booster shots will be needed. It appears that yes, this is a possible scenario. We’ll keep an eye on this topic and share with you what we learn.
(Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.)