Having an autoimmune disease means that your immune system isn’t working as it should. It’s attacking your own body rather than just foreign items.

Autoimmune diseases affect 24 million people in the United States. There are more than 80 different autoimmune diseases, including:

These chronic conditions can affect your health and well-being. Many require drugs that suppress your immune system. So how do vaccines, such as the COVID-19 vaccines, affect people with autoimmune diseases?

When COVID-19 vaccines first became available, more than a third of people with an autoimmune disease were hesitant to get them. Data was scarce, and people with autoimmune diseases were excluded from vaccine trials. Now that more than 200 million people in the United States are fully vaccinated, more information is available.

This article will answer some common questions about autoimmune diseases and the COVID-19 vaccines.

The Global Autoimmune Institute endorses COVID-19 vaccines for most people with autoimmune diseases.

The positive effects of the vaccine outweigh any side effects. According to the Centers for Disease Control and Prevention (CDC), you may be at increased risk of moderate to severe illness from COVID-19 if you have an autoimmune disease and take certain medications.

Getting vaccinated is especially important if you take drugs that suppress your immune system. You’re at a higher risk of severe illness from COVID-19 if you take this type of drug.

Initial research suggests that autoimmune diseases don’t make you any more susceptible to side effects from the vaccines. A 2021 survey found that people with systemic autoimmune diseases and multiple sclerosis reported similar side effects to those without these conditions.

Side effects of the vaccines indicate an immune response. These can include:

  • tenderness or redness near the injection site
  • fever
  • muscle aches
  • tiredness
  • headaches
  • joint discomfort
  • skin rash

These can last for a few days.

There have been reports of flares in people with certain autoimmune diseases after they’ve received the vaccine. But these were relatively rare, mild to moderate in severity, and responded well to treatment. A 2021 study of 2,860 people found that while 44 percent had concerns about flares, fewer than 5 percent had a flare that required medication changes.

A doctor may discourage the vaccine if you have allergies to the ingredients. But this is rare.

If you have an autoimmune disease and already had the virus, you should still get vaccinated for COVID-19. Talk with a doctor about when it’s appropriate to get vaccinated after an infection.

Currently, there are three COVID-19 vaccines approved for adults and authorized for teenagers and children in the United States:

The American College of Rheumatology endorses the two mRNA vaccines (Moderna and Pfizer) approved in the United States over the one-dose vaccine (J&J). The CDC now recommends that all people choose the mRNA vaccines. This is due to serious but rare side effects from the J&J vaccine.

None of the COVID-19 vaccines approved in the United States are live vaccines. Live vaccines use a weakened form of the virus and can be harmful to some people with certain autoimmune disease treatment plans.

Learn more about how the COVID-19 vaccines work.

A doctor may recommend an additional full dose of the vaccine if you take drugs that affect your immune system. More research is underway to determine the effect of these drugs on the vaccine. Some initial studies indicate that vaccines may be less effective if you take these medications.

If you take immunosuppressants, a doctor might make the following recommendations based on your primary vaccination series:

  • If you initially had the Pfizer or Moderna vaccine: A third full-dose mRNA vaccine. This is in addition to booster shots. You’re eligible for a third mRNA vaccine 28 days after the second vaccine. You can get a booster five months after the first sequence. You may be able to get a second booster shot later.
  • If you initially had the J&J vaccine: A full-dose mRNA vaccine. You can then receive booster mRNA vaccines.

The normal vaccine series may be fine if you don’t take these drugs as part of your treatment.

The current vaccines may not work as well if new variants of the virus emerge. Updated versions of the vaccines may become available at a later date, so talk with a doctor about the timing of any additional shots.

The COVID-19 vaccines are still relatively new. But researchers don’t believe that the vaccines interfere with most medications that treat autoimmune diseases.

A doctor may recommend adjusting the timing of your treatment when you get the vaccine. This allows you time to look for side effects or allergic reactions as well as increase your immune response to the vaccine. It’s best to talk with a doctor prior to vaccination and not make these decisions on your own.

Remember that the vaccines will work against serious cases of COVID-19, so it’s important to get them. This is especially true if you take medications that suppress your immune system.

There’s no definitive research linking vaccines to autoimmune diseases at this time. Some emerging studies address this topic, but there’s still a very small amount of research available.

A 2022 study discusses reports of some people developing autoimmune diseases after vaccination. But there’s no confirmation that this is due to the vaccine.

Autoimmune diseases develop over years and decades due to genetics, the environment, hormones, and your health history. Your immune system begins to attack your own body.

An mRNA vaccine doesn’t have that effect on your body. An mRNA vaccine will leave your body within a few days. Your body has very minimal exposure to it.

More medical research will emerge over time about COVID-19 vaccines and autoimmune diseases. For now, medical experts continue to stress the importance of getting vaccinated.

Most people with autoimmune diseases should get vaccinated for COVID-19. The benefits of vaccination far outweigh the risks. Vaccination is the most effective way to protect you from the virus.

Talk with a doctor about which vaccine they recommend, when you should receive it, and what reactions you may experience. Keep in touch with a doctor to make sure you receive booster shots when needed.

Be aware that guidelines for COVID-19 vaccines may change as researchers continue to learn more about them.