Should I get the COVID Vaccine if I’m Diabetic?

COVID-19 vaccines are here. The vaccine roll-out has left many with questions about timing, safety, and what to expect – particularly those with diabetes or other underlying health concerns. Is the vaccine safe for diabetics?

Here’s what you need to know about the COVID-19 vaccines:

WHAT VACCINES ARE THESE?

In November 2020, Pfizer and BioNTech announced positive results from the conclusion of their COVID-19 vaccine clinical trials, quickly followed by Moderna. The former has received approval for emergency use in the US, Canada, the UK, and the EU, with approvals pending in other countries. The latter has been approved for emergency use in the US. Worldwide, more than 50 other vaccines are in various stages of clinical trials. 

Both the Pfizer/BioNTech and Moderna vaccines went through the standard three phases of clinical trials – Phase 1, where it is administered to a small number of people to show initial safety, Phase 2 to hundreds of people split into groups by things like age, ethnicity, and background to show how different types of people react to the vaccine, then Phase 3, in which it is given to tens of thousands of people, tested against a placebo. Because of the speed needed for development, both vaccines were approved to go through animal clinical trials at the same time as human Phase 1 clinical trials.

To be approved, the FDA requires the vaccine work in at least half of those who receive it. Early analysis from the National Institutes of Health independent data review board (DSMB) saw that 94-95% of those who received the Pfizer/BioNTech and Moderna vaccines in the trials became immune to the coronavirus.

Both of these frontrunner vaccines are mRNA vaccines, a type of immunization that does not use the real virus in the vaccine, but instead employs a piece of genetic material to create antibodies against the novel coronavirus. Important to note – because none of the vaccines undergoing approval in the US have any strain of the real coronavirus in them, it is not possible to get COVID-19 from the vaccines themselves. Each vaccine requires two doses, given three to four weeks apart.

Other vaccines – different types of immunizations made by multiple companies – are currently in clinical trials with results expected early (and throughout) 2021. 58 different vaccines are currently going through human clinical trials; in any trial where participants exhibit worrisome symptoms, the trial is paused and cannot proceed until any issues are corrected. 

DO COVID VACCINES AND DIABETES MIX WELL?

People with diabetes in both the Pfizer/BioNTech and Moderna trials have not reported major side effects (read this T1Ds experience in the Moderna COVID-19 vaccine trial). Overall, some clinical trial participants have reported mild side effects of the vaccines, much like how some people experience injection-site soreness, mild lethargy, a low-grade fever after other vaccines. These mild reactions some people experience after vaccines are typical and not cause for alarm – they are a result of the immune system going into action as purposely triggered by the vaccine, creating the ability to fight against the actual virus were a person to be exposed to it.

In the UK, two healthcare workers who received the Pfizer/BioNTech vaccine during initial general population rollout experienced severe allergic reactions for which they administered adrenaline autoinjectors. Both individuals had a history of severe anaphylactoid reactions for which they carry adrenaline autoinjectors anyway, so if you are a person who does tend to experience severe allergic reactions, it is recommended that you not receive the Pfizer/BioNTech vaccine at this time. Other vaccines may be better indicated for your use. If you do not have a history of severe allergic reactions, there is no reason to expect you will experience one from a vaccine.

Because of the mild symptoms experienced by some, it is important to stay vigilant about blood sugar levels for the first 24 to 48 hours after receiving the vaccine. The symptoms may impact your BG, so check your levels frequently, stay hydrated, and be familiar with your sick day routine. The mild symptoms you may experience after the vaccine are significantly safer and more easily managed than potentially getting COVID-19 itself.

As we currently understand, you are not more at risk to catch the novel coronavirus if you have diabetes, but if you do catch the virus, you may be more at risk for more severe complications from COVID-19, particularly if you have been experiencing consistently elevated blood sugar levels. 

If you have specific concerns or worries, make sure you speak to a healthcare provider you trust (or keep tuning into Beyond Type 1 coverage of COVID-19 to hear from the healthcare providers we trust, like Dr. Anne Peters).

Read this T1Ds experience in the Moderna COVID-19 vaccine trial

GREAT, WHEN CAN I GET MINE?

When you will get access to a COVID-19 vaccine depends on where you live, what you do for work, and your risk-level for acquiring or experiencing severe symptoms of COVID-19. People with diabetes are considered to have COVID-related health-risks. Many countries across the world will not be getting enough vaccines for their population for at least a couple years. Other countries – like the US and UK – have already invested in large amounts of vaccines, with more coming quickly over the next months and year. 

If you live in the US, this NY Times Calculator will provide an idea of your “place in line” to get access to the COVID-19 vaccine. As voted upon by the US Centers for Disease Control and Prevention’s Advisory Committee for Immunization Practices, healthcare workers and nursing home residents are being prioritized first, with up to 24 million likely receiving their vaccine in December 2020, followed by other essential workers, including first responders and teachers, and people over the age of 74 in early 2021. 

People who are not essential workers but live with COVID-related health risks – like those over the age of 65 and/or with heart disease, cancer, diabetes, obesity or other immunocompromising conditions – may be able to receive the vaccine in early to late spring. All others – those who are otherwise healthy and children (as clinical trials for the COVID-19 vaccine in children are just starting) – will likely need to wait until late spring, summer, or into the fall.

In the US, individual states are responsible for their rollout plans. The vaccines are being made available at no cost to hospitals and clinics, with the federal government paying the vaccine developers directly. They will likely be available in many of the places flu shots are typically distributed – drug store and grocery pharmacies, medical offices, and possibly school clinics.

These locations may set a fee for administering the vaccines, but those fees must be run through your health insurance. If you do not have health insurance, the federal government has set up a fund for the uninsured to receive their vaccines for free as well. Your distribution location should have details.

To find out when you may get your vaccine, visit your state’s health department website, and talk to your doctor. Your endocrinologist or other healthcare specialist in particular may have the most information on your potential place in line given your health background.

STILL HAVE CONCERNS?

Individuals have expressed some hesitation to personal vaccination for COVID-19. This is an understandable feeling – vaccines do not typically make it through development and approval this quickly.

Particularly for Black, brown, and indigenous people in the United States and across many places in the world, deep-rooted medical racism and exploitative medical experimentation, including with past vaccines like the Tuskegee syphilis experiments, has led to understandable distrust in vaccine administration and the healthcare system at large. 

Here’s what we know:

1. The speed with which the vaccines were developed was unprecedented. However, the clinical trials these vaccines had to go through were strict and the reporting of their safety and efficacy had to be unequivocally proven and replicated. Three phases of clinical trials, including a Phase 3 with tens of thousands of participants, had to prove safety and effectiveness of the vaccines. Phase 3 of the clinical trials were also double-blind, meaning neither the trial participants nor the company that created the vaccine knew if participants were receiving the vaccine or a placebo. Data was reviewed by the National Institutes of Health independent data review board, and final approval for the vaccines must be provided by the FDA’s Vaccines and Related Biological Products Advisory Committee, composed of scientists who have no ties to the companies by which the vaccines were produced.
2. The Moderna COVID-19 vaccine trial in focused on creating a diverse trial participant group, knowing that this is vital to ensuring the vaccine works as intended across populations. 37% of the trial’s participants were from communities of color, which is similar to the US population. The Pfizer and BioNTech trial had less representation, and many of the ongoing trials are not reporting diversity numbers at all. It is vital that each and every trial not only focus on recruiting diverse – across age, race, ethnicity, health background, and more – trial participants to prove safety and effectiveness, but also proactively communicate the affects of their vaccines across groups.
3. Black, Native, and Latinx communities have been hit hardest by COVID-19 because of systemic and medical racism, with Black Americans dying from COVID-19 at twice the rate of white Americans. Ensuring equitable distribution of the COVID-19 vaccines is vital to work against the deep impact of systemic and medical racism, but this must be coupled with understanding distrust due to violent medical racism throughout the US’s history. 
4. We don’t know for sure what percentage of the population needs to be vaccinated in order to achieve herd immunity, but we do know that the more people who are immune to carrying or spreading the virus, the better. Those who are willing and able to take the vaccine are helping to protect everyone in their community.
5. If, after doing research from reputable, science-based sources (we recommend science communicators like Jessica Malty Rivera for easy-to-digest and accurate information), you are still not comfortable taking the vaccine as it becomes available to you, continue to practice safe health measures to protect yourself and others from the novel coronavirus. Until the majority of the population is vaccinated, we cannot rely on herd immunity. We must keep those most vulnerable among us safe until we’re all safe, practicing simple actions like wearing a mask and social distancing to do so.

2020 has been hard; at many times, scary and filled with grief. Working toward getting our communities safe and healthy is important for a multitude of reasons, and will take a united effort. Ensuring you have a plan for when you will get vaccinated once you can is vital to keep yourself and those most vulnerable among us safe until we’re all safe.

Source: beyondtype1.org