Diabetes + COVID Vaccines: What You Need to Know
Editor’s Note: We have a simple goal: tap into the power of the global diabetes community to save lives. Visit coronavirusdiabetes.org to learn more about what you can do as a person with diabetes to keep yourself and others safe from COVID-19 until we’re all safe. This article was last updated Wednesday, January 13, 2021.
For information on when you can expect to receive your vaccine and the US phased rollout process, including how to lend your voice to ensure people with any type of diabetes are included in Phase 1c, click here.
Here’s what you need to know about the COVID-19 vaccines:
The biggest takeaways
Not looking for a deep dive? Here are the top 5 things you need to know:
- While not absolute, it is generally agreed upon among the medical community that at least more than 70% of the population must get vaccinated before society can begin getting back to a more normal state. At least until then, wearing masks, physical distancing from those not in your household, and avoiding indoor gatherings are still vital to slow the spread of COVID-19.
- More than 50 vaccines are under development worldwide. The first two being distributed are from Pfizer/BioNTech and Moderna, with some others being rolled out in certain countries.
- Both leading vaccines showed a 95% effectiveness rate of protecting adults against the coronavirus in trials. Children have not yet been included in trials, nor have pregnant women (although a handful of participants got pregnant during the trials and none have experienced negative impacts from the vaccines), but some trials are expected for these populations in 2021 to prove safety and effectiveness.
- The Moderna vaccine trials had a slightly more diverse participant group but both leading vaccine trials included participants from across races and ethnicities, age ranges, health conditions including Type 1 and Type 2 diabetes, etc. No specific populations experienced any major issues with the vaccines.
- Immediate side effects from the vaccines are similar to many people’s experience with the flu shot – soreness at the injection site, general muscle aches, some nausea, and tiredness. These are typical, indicate the immune system is learning how to fight the virus, and go away within 24 to 48 hours. Very few people who received the Pfizer/BioNTech vaccine experienced an allergic reaction – each were people who have a history of severe allergic reactions for which they already carried EpiPens.
Want a deeper dive? Here’s everything you may want to know:
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. Both have now been approved for use in multiple countries across the globe, with a few other vaccines rolling out on a country by country basis. 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).
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. 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 have been prioritized first, 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 other immunocompromising conditions – may be able to receive the vaccine in early to late spring 2021.
Currently, the CDC only included people with Type 2 diabetes as part of this health risks category due to ongoing scientific evidence of severity, but JDRF is advocating for people with any type of diabetes to be included in a priority rollout. If you have Type 1 diabetes, you can learn more about when you may expect to receive the vaccine here. All others will likely need to wait until late spring, summer, or into the fall of 2021.
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, you can find more information here, 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:
- 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.
- The Moderna COVID-19 vaccine trial 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.
- 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.
- 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.
- 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.
- Read this T1D’s experience in the Moderna COVID-19 vaccine trial
- Watch this December 2020 interview with endocrinologist Dr. Anne Peters on the status of COVID-19 and her thoughts on the vaccines