COVID-19 vaccine and lupus
Updated December 12, 2023
When vaccines became available, we gathered some of the most common COVID-19 vaccine questions that our health education specialists have received and answered them below. This page will be updated as necessary and will not be updated frequently.
The American College of Rheumatology (ACR) and the Centers for Disease Control and Prevention (CDC) recommend that people with lupus who meet the age requirements receive a series of COVID-19 vaccines.
The virus has changed and is now easier to catch and transmit, even for people who are vaccinated, but it is much less likely to get it or have a serious case if they are completely vaccinated. Getting vaccinated is still the best way to prevent serious illness and death from COVID-19.
If you have not gotten the vaccine and updated additional doses, please talk to your health care team about why you should receive it.
Now more than ever it is important to have a health care team that you trust. If you don’t currently have a doctor who treats your lupus, or if you need a new one, we can help.
The ACR currently recommends that people with autoimmune and inflammatory rheumatic diseases, which includes people who have lupus, receive the multi-dose mRNA vaccines (Pfizer or Moderna) and the protein subunit vaccine Novavax. The Johnson & Johnson/Janssen COVID-19 vaccine is no longer an FDA-authorized vaccine and is not available in the United States as of May 2023.
The vaccine series for unvaccinated, but are not immunocompromised, includes two to three doses of the 2023-2024 updated mRNA vaccine formula (either Pfizer or Moderna).
The vaccine series includes at least three Pfizer or Moderna vaccines and two of the Novavax vaccine if you are unvaccinated and immunocompromised.
People who are moderately or severely immunocompromised may get additional doses of updated COVID-19 vaccines. Additional vaccine doses are not boosters as the pre-portioned medicine is delivered completely.
Please talk to your healthcare team about how many doses of the vaccines you will need to get the greatest amount of protection.
The vaccines are widely available in every state from local health departments, hospitals and clinics, and retail pharmacies. The vaccine is free to everyone even if they don’t have health insurance and regardless of immigration status. Find a convenient place to get the vaccine.
The Pfizer vaccine and the Moderna vaccine use a new technology that relies on messenger RNA (mRNA) from the virus to teach the body how to protect against COVID-19. These vaccines have now been given to millions of people worldwide.
The Novavax vaccine contains a spike protein that is a piece of the virus that causes COVID-19. It also includes an ingredient called an adjuvant that serves to help the immune system respond to spike protein. After learning how to respond to the spike protein, your immune system will know how to respond against the actual COVID-19 virus.
Vaccines are studied in thousands of people before they are given to the general public. It isn’t possible, however, to study each vaccine in every type of person before it is approved. The FDA, the Centers for Disease Control and Prevention (CDC), and the companies that make the vaccines will continue to study their safety and effectiveness even after they are approved.
The CDC has an overview page about the COVID-19 vaccines available for people in the U.S.
No. It is not possible to get COVID-19 from any of the vaccines that have been approved or are currently being reviewed by the FDA.
The side effects are usually not serious -- one of the most common is a sore or achy arm. Some people develop low-grade fevers or chills and feel tired. This is because the vaccine is working and causing a response from the immune system.
In most cases, these side effects are not dangerous and will go away on their own within a short time. Please call your doctor if these side effects last for more than two days or if you have more severe side effects.
The CDC and FDA will continue to monitor the safety of all COVID-19 vaccines.
It’s important that you talk to your doctor about the number and timing of COVID-19 vaccine doses that are right for you. The CDC recommends that people receive the age-appropriate vaccine product and dosage based on the age at the time of vaccination.
For those not moderately or severely immunocompromised:
- Children aged 5 to 11 who are unvaccinated or received any number of the original mRNA vaccines should get 1 dose of the updated vaccines.
- People aged 12 and older who are unvaccinated should receive 1 dose of the updated formula or 2 doses of the updated Novavax vaccine.
For those who are moderately to severely immunocompromised:
- Children aged 6 months to 4 years who previously received 1 or 2 of the original mRNA vaccines, should complete the 3-dose series with 2 or 1 of the same updated mRNA vaccine. If they received 3 or more of the original mRNA vaccine, they should get 1 dose of the updated mRNA vaccine formula.
- For people 12 years and older who previously received 1 or 2 of the original mRNA vaccines, should complete the 3-dose series with 2 or 1 of the same updated mRNA vaccine. If they received 3 or more of the original mRNA vaccine doses should get 1 dose of any updated vaccine formula.
Some lupus medications affect how the vaccine works. In some cases, particularly for those who take immunosuppressant drugs, your doctor may have special instructions for you so that you can get the greatest possible benefit from the vaccine. Your doctor may also recommend that you continue to wear a mask or social distance as much as possible even after becoming fully vaccinated.
Please check with your doctor about how the vaccine fits into your treatment plan.
In the United States, there are three medications available to treat people who get COVID-19.
- Nirmatrelvir with Ritonavir (Paxlovid) is meant for people aged 12 and older. It can be taken at home by mouth.
- Remdesivir (Veklury) is meant for children and adults and is given through IV infusion over three days.
- Molnupiravir (Lagevrio) is meant for adults and can be taken at home by mouth.
The FDA approved Olumiant (baricitinib) and Actermra (tocilizumab), immune modulators, for certain adults hospitalized with COVID-19. Please first check with your doctor because the vaccines may still be useful for you. Medications used to treat COVID-19 must be prescribed by your health care provider and should be prescribed five to seven days after symptoms appear.
Since January 2023, Evusheld is no longer an authorized treatment for COVID-19 in the U.S. The FDA previously issued an emergency use authorization for Evusheld that can help prevent COVID-19 for up to six months in people who have not been exposed to the virus.
It is unlikely that many people with lupus were included in the clinical trials for the vaccines. There is no evidence, however, that people with lupus should not receive the vaccine.
According to the CDC and recent research, there is no reason to think that taking a vaccine that uses mRNA will result in an inflammatory response (flare) for a person with lupus or other autoimmune disease.
There is strong evidence from the clinical trials that taking the vaccine greatly reduces the chance that a person will get COVID-19, which can be a serious or sometimes fatal illness. There are some studies underway on how COVID-19 and the vaccines affect people with lupus.
The American College of Rheumatology COVID-19 Vaccine Clinical Guidance recommends that people with autoimmune and inflammatory rheumatic disease (which includes lupus) get the vaccine unless they have an allergy to an ingredient in the vaccine. Your doctor may recommend temporarily adjusting or stopping some of your lupus medications so that you can receive the greatest possible benefit from the vaccine. Talk to your doctor about how the COVID-19 vaccine fits into your treatment plan.
Additionally, please continue to follow our COVID-19 and Lupus page for more updates as information is made available.
Yes, it is. The CDC recommends the COVID-19 vaccine for everyone 12 years and older, including those who are pregnant or breastfeeding. People who are pregnant or have recently been pregnant are at higher risk of severe illness from COVID-19 than those who are not or have not recently been pregnant.
If you are pregnant and have lupus, talk with your doctor about getting the COVID-19 vaccine.
If you’re planning to become pregnant, evidence shows that there are no vaccines that lead to issues with fertility in women or men.
Everyone aged 5 years and older should get one dose of an updated COVID-19 vaccine. Children aged 6 months to 4 years should get multiple doses of the vaccines and at least 1 dose of the updated vaccine.
Since the creation of vaccines and COVID-19 treatments, fewer people are wearing masks in public places. Wearing a mask is a proven way to greatly reduce your risk of getting COVID and of giving it to others. You should consult with your health care team whether it’s safe for you to not wear masks in public places, even if you have been vaccinated.=
Your health care team may advise that you continue to follow these recommendations to protect yourself and your family:
- When you do go out, wear a mask, avoid crowds, wash your hands often and sanitize surfaces.
- Stay in touch with your health care team and continue to follow your lupus treatment plan.
- Take care of your mental and emotional health.
Current recommendations are that you should get the vaccine even if you have already had COVID-19. Please talk to your doctor about when you should get the vaccine if you have already had COVID-19.
It is not likely that the COVID-19 vaccine could cause lupus and there have not been any reports of that happening. We don’t know exactly what causes lupus, but most scientists believe it is a combination of hormones, genetics, and environmental factors. The vaccine stimulates the immune system, but it does so in a very specific way that does not trigger an autoimmune response.
The CDC and the ACR recommend that people with lupus and other autoimmune conditions get the vaccine, including an additional dose and a booster shot. Studies have also shown that the vaccine generally does not lead to increased disease activity in people with lupus.
Most importantly, and this cannot be stressed enough, please be sure to talk with your health care team about the vaccines and your treatment plan, since it can vary from person to person.
Participate in a Lupus and COVID-19 reseach study
A research team led by Dr Rebecca Sadun (Duke University) is conducting a study into how individuals with lupus feel about the COVID-19 vaccine. Participation involves completing a 10-15 minute online survey about your thoughts on the COVID-19 vaccine and whether you have gotten or plan to get the vaccine. Get further information and access the survey here.