Beta thalassemia is the most common blood disorder caused by a mutation in a single gene. It causes your body to produce a lower-than-normal amount of hemoglobin, the part of your red blood cells that carries oxygen.

People with severe forms of beta thalassemia may be at a higher risk of developing severe illness than people in the general population if they’re infected with the SARS-CoV-2 virus that causes COVID-19. Getting a COVID-19 vaccine can help people with beta thalassemia prevent severe disease and death.

Read on to learn more about why it’s important for people with beta thalassemia to get vaccinated and why beta thalassemia may increase the risk of severe COVID-19 illness.

Thalassemia is a genetic blood disorder caused by an inherited mutation in your HBB gene. This blood disorder causes your body not to produce enough hemoglobin.

Hemoglobin is the iron-containing part of your red blood cells that allows them to carry oxygen throughout your body. Lack of hemoglobin can lead to insufficient oxygen in your bodily tissues. This condition is called anemia.

Thalassemia is classified as alpha or beta depending on the part of hemoglobin your body isn’t producing in adequate amounts. Its severity varies greatly between people. In order of increasing severity, it’s classified as:

  • beta thalassemia minor
  • beta thalassemia intermedia
  • beta thalassemia major

People with beta thalassemia minor usually don’t develop symptoms and have mild anemia. They only have one mutated HBB gene from their parents.

People with the intermedia or major forms of the disease have HBB mutations from both parents. Beta thalassemia major often needs to be treated with regular blood transfusions.

About 1.5% of the world’s population carry HBB mutations that cause beta thalassemia.

The Centers for Disease Control and Prevention (CDC) recommends COVID-19 vaccines for everybody over 6 months of age in the United States. Vaccination can help prevent COVID-19 infection and prevent severe illness if you do.

People with beta thalassemia may be at a higher risk of developing severe disease or death, but studies are conflicting at this time.

In a 2022 study, researchers found that people with beta thalassemia minor had a higher chance of dying from COVID-19 than people in the general population. They also had a higher chance of developing severe symptoms but didn’t have higher rates of ICU admission.

People with beta thalassemia may be immunosuppressed if they have impairment of spleen function or had their spleen removed.

People who are moderate to severely immunocompromised may need additional doses of the COVID-19 vaccine to stay protected. For adults who are immunocompromised, the CDC recommends:

Pfizer-BioNTech/ModernaJohnson & Johnson’s JanssenNovavax
2nd dosePfizer: 3 weeks after 1st dose
Moderna: 4 weeks after 1st dose
A second dose of Pfizer or Moderna at least 4 weeks after 1st dose 3 weeks after 1st dose
3rd doseAt least 4 weeks after 2nd doseAt least 2 months after 2 dose
4th doseAt least 3 months after 3rd doseAt least 4 months after 3rd dose
5th doseAt least 4 months after 4th dose

People with thalassemia were excluded from COVID-19 vaccine clinical trials, so it’s unclear if vaccines are as effective for people with thalassemia as the general population.

The CDC recommends mRNA vaccines for people who are moderately or severely immunocompromised. The Moderna and Pfizer-BioNTech vaccines use mRNA technology. There are no specific precautions or warnings for people with thalassemia receiving these vaccines compared with people in the general population.

The Johnson & Johnson’s Janssen can rarely cause arterial thrombosis, a blood clot in an artery, in people with thrombocytopenia 4 to 30 days after vaccination.

In a 2022 study, researchers found lower rates of vaccine-related side effects among 186 people with thalassemia major than in vaccine clinical trials. A temporary drop in hemoglobin levels was noted 3 months after vaccination. The researchers recommend that people with thalassemia major should be followed closely by a doctor.

In this study, the most common side effects in people with thalassemia were:

First doseSecond dose
Pain at injection siteFever
FeverPain at injection site
HeadachesBody and muscle aches
Body and muscle achesHeadaches

Researchers are still examining how COVID-19 affects people with beta thalassemia. Some researchers hypothesize that thalassemia might be protective against COVID-19 as it is against malaria. However, the results of studies have differed regarding how beta thalassemia affects outcomes.

In a preprint review of studies from late July 2022, researchers examined how beta thalassemia minor affects outcomes of COVID-19. The researchers found that people with beta thalassemia minor had:

  • less susceptibility to developing COVID-19
  • fewer intensive care unit (ICU) admissions
  • higher severity of disease
  • higher susceptibility to dying from COVID-19

However, the researchers didn’t find statistical significance for any of these parameters, so no definitive conclusions can be drawn from the study. These findings may be due to statistical randomness because of the small sample size.

In a very small French study, researchers found that people with thalassemia under the age of 60 had higher rates of severe disease and hospitalization than the general population. Everybody except for 1 of the 16 people in the study required regular blood transfusions. Six had their spleens removed.

In a 2021 pilot study, researchers found a strong association between the presence of beta thalassemia minor and COVID-19 mortality. The results align with the results of other studies from countries around the world.

People with beta thalassemia minor can have anemia so mild they don’t know they have it. People with the most severe form of the disease may require regular blood transfusions. Symptoms of moderate anemia may include:

Beta thalassemia is caused by a genetic mutation inherited from one or both of your parents. Most cases are caused by a mutation in the HBB gene.

If you have potential symptoms of beta thalassemia, a doctor may order a blood test to look for signs of the disease. Most people with beta thalassemia major have symptoms within the first 2 years of life.

Treatment can include:

People with beta thalassemia minor might never know they have the disease. Severe thalassemia used to be fatal by early adulthood, but now people frequently live into their 60s or beyond.

Here are some frequently asked questions people have about beta thalassemia and COVID-19 vaccines.

Who should not get vaccinated?

According to the CDC, people shouldn’t get vaccinated if they have had a severe allergic reaction to a previous dose of a COVID-19 vaccine. They also shouldn’t get it if they have a known allergy to a component of the vaccine. However, severe allergic reactions from vaccines are extremely rare.

Who is exempt from vaccination requirements?

Most states offer religious exemptions from school vaccine requirements, and some provide exemptions on philosophical grounds. Exemptions may be granted for people with severe allergies to COVID-19 vaccines or any of their components.

Should you get the COVID vaccine if you have an autoimmune disease?

The current evidence suggests that the benefits of COVID-19 vaccination outweigh the risk of side effects for most people with autoimmune disease, according to the Global Autoimmune Institute, which reviewed the available scientific literature.

Is the COVID-19 vaccine safe if you have heart problems?

Vaccination is particularly important for people with cardiovascular disease because they’re more likely to develop severe complications from COVID-19 infection. Your doctor can address any particular concerns you may have.

Vaccines can help people with beta thalassemia lower their chances of getting COVID-19 or having severe illness if they do get COVID-19.

Some research suggests that people with beta thalassemia may be at an elevated risk of developing severe illness or death from COVID-19, but research is still mixed. In general, people with severe diseases are at a higher risk from COVID-19.

There are no extra safety precautions necessary for people with beta thalassemia who get vaccinated against COVID-19 when compared with people in the general population. If you have concerns, speak with a doctor or healthcare professional about your individual risks.