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First, I need to make an important disclosure. This is not medical advice. This is anecdotal information gleaned from my own research, discussions with RA advocates and medical professionals. You should always seek appropriate input from your healthcare team when making a medical decision.

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Like so many of us, I’ve watched the development of the COVID-19 vaccine and counted the days until I thought my “group” would be in line for the first of the injections. My husband and I, grounded from travel for the first time in decades, carefully review the 2021 calendar wondering when (and where) we might feel safe traveling.

But, as with all new things, there come questions.

People with autoimmune conditions (either suppressed due to disease or medication, or overactive — such as often occurs in conditions such as diabetes and untreated rheumatoid arthritis) fall directly in the “questions” category.

I’ve spent the last few weeks researching, conferring with other RA patient advocates about what they have been told, and have had conversations with my own healthcare team. What I’ve learned surprised (and dismayed) me. Having witnessed first-hand the positive effects of small pox, polio, measles and other vaccines, I have great hopes for the COVID-19 version. But at this time (and I emphasize at this time – until we get further data) the input I’ve received is that people with compromised immune systems should not yet get the vaccine. Since we’re some of the most vulnerable, this just seems so wrong. (And, again, I encourage you to talk to your own doctor about your own circumstances.)

There seems to be three recurrent reasons for this guidance:

  1. People with suppressed immune systems may not develop sufficient immune response for the vaccine to be effective.
  2. People with compromised immune systems were not included in the test groups in sufficient quantities to have good data on effects and effectiveness.
  3. People with overactive immune systems are at risk for elevated inflammatory response, including possible cytokine storms.

In addition, the timing of any medical treatments (like biologics) that impact the immune system must be considered when taking the vaccine. Delaying biologics or similar medications can have a two-fold effect. First, the underlying condition (like RA) goes untreated/uncontrolled. Second, delaying the medications allows the immune system to resume a hyperactive state, which raises the risk for adverse effects from the vaccine (see #3 above – cytokine storm).

Based on the current rollout rate of the vaccines, many of us will have time to assess the data and get additional guidance from our medical teams before “our turn” comes up. But there are others (including those in my close group) who work in hospitals, schools, and other high-exposure environments who are balancing not only health concerns, but job issues.

Bottom line: We need this because we are highly vulnerable, but we shouldn’t have this. (?????????)

I’m blessed that I can continue to hide at home and monitor the data that is already starting to flow. I offer my support to those of you who are in more immediate circumstances.

A final word on the immediate vaccines. I’m used to the vaccines that inject a dead or weakened form of the virus (flu, mumps, shingles, etc.). The vaccines being administered at the moment work differently. These vaccines are messenger RNA (or mRNA) vaccines. And while they’ve been extensively tested over the years with good safety records, they’ve never been rolled out on a wide-scale basis before. If you’re interested in how they work, here’s a link to a good article from MedPage Today. It’s a bit technical but there’s enough general information that almost anyone can get an overview of the vaccine’s mechanism. https://www.medpagetoday.com/podcasts/trackthevax/90085

As we close out the truly amazing year that 2020 has proven to be, I want to wish us all a safe, healthy, and more prosperous year in 2021. Thank you for checking in.