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, November 3, 2021.
COVID-19 vaccines are here. If you have diabetes and/or other underlying health concerns, you may have questions about timing, safety and what to expect.
It’s important to remember that having well-controlled diabetes alone does not seem to put anyone more at risk for contracting the novel coronavirus, but other factors like older age, high-exposure employment, consistently elevated blood glucose levels, or other non-diabetes related health factors like obesity and hypertension may increase your risk of infection.
We also know that diabetes care itself is made far more complicated after contracting COVID-19 and protecting anyone with diabetes from getting COVID-19 is our ultimate goal. That’s why we encourage everyone with diabetes to get vaccinated as soon as possible.
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. Some—but not all—people with diabetes are experiencing slightly elevated blood glucose levels. These side effects are typical, indicate the immune system is learning how to fight the virus, and go away within 24 to 48 hours.
Want a deeper dive? Here’s everything you may want to know:
What vaccines are available?
In November 2020, Pfizer and BioNTech announced positive results from the conclusion of their COVID-19 vaccine clinical trials, quickly followed by Moderna. In February 2021, Johnson & Johnson’s announced the same.
Each has 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 90 other vaccines are in various stages of clinical trials.
Each vaccine 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 U.S. Food and Drug Administration (FDA) requires the vaccine to 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 percent of those who received the Pfizer/BioNTech and Moderna vaccines in the trials became immune to the coronavirus. Johnson & Johnson’s vaccine showed 66 percent effectiveness against the virus. Most importantly, all three vaccines provide significant protection against severe outcomes and hospitalization from the virus, no matter the variation.
The Pfizer/BioNTech and Moderna 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. Each of the mRNA vaccines requires two doses, given three to four weeks apart. The Johnson & Johnson vaccine is slightly different, which makes it easier to store and only requires one dose.
Other vaccines—different types of immunizations made by multiple companies —are currently in clinical trials with results expected early (and throughout) 2021. In any trial where participants exhibit worrisome symptoms, the trial is paused and cannot proceed until any issues are corrected.
- More than 90 vaccines are under development worldwide. In the US, the three currently being distributed are from Pfizer/BioNTech, Moderna and Johnson & Johnson, with some others being rolled out in certain countries.
- All three vaccines being used in the US provide protection against severe complications or death from COVID-19. Each vaccine has a slightly different rate of protection against getting the virus at all, but each guarantees protection against the worst outcomes of the disease, across all current variants.
- The Moderna vaccine trials had a slightly more diverse participant group but each vaccine trial 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.
Do COVID vaccines and diabetes mix well?
People with diabetes in each of the vaccine trials have not reported major side effects. 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 the 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 blood glucose (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.
Great, when can I get mine?
If you are 5 years or older, right now! Vaccines.gov is a vetted place to find a convenient vaccination appointment. Most drug stores and pharmacies have vaccines available (some are walk-in, some by appointment). You can also look up your state health department. Each state generally has a special COVID-19 page where they list COVID-19 vaccine locations.
If you aren’t having any luck finding a vaccine appointment, go ahead and reach out to your healthcare provider. Remember to be kind and patient—healthcare providers are carrying an immense amount and they may not have an answer for you immediately.
What about kids with type 1 diabetes (T1D)?
In August 2021, the FDA granted full approval of the Pfizer/BioNTech vaccine for ages 16 and older. In November 2021, the Pfizer/BioNTech vaccine was approved under an EUA (emergency use authorization) for people ages 5 and older. Trials for children and teens were done in separate waves and under equally strict guidelines.
For ages 5 to 11, overall results showed that the vaccine is very well tolerated, with a 90.7 percent efficacy rate (i.e. 90.7 percent of participants were protected against all forms of COVID-19 after receiving the vaccine).
There were a few cases of mild COVID-19 reported among those who got the vaccine, but—similarly to trials in adults and teens—the vaccine was shown to protect 100 percent of those who received it against severe symptoms, long-haul COVID symptoms, hospitalization, or death. About a fifth of trial participants had other health conditions; it is typical to ensure clinical trials include folks who have comorbidities so it can be shown how well the vaccine works when there are other health factors at play.
More trials are currently underway for children ages six months to four years so that they may be safely vaccinated against COVID-19 as well.
Important to note is that children do not seem to be likely to contract coronavirus or have severe outcomes from the disease. However, as we’ve seen throughout the pandemic, disparities are abundant. Native Hawaiian, Pacific Islander, American Indian, Alaskan Natives and Hispanic children have experienced significantly higher rates of infection than their peers. Non-Hispanic Black children with T1D who contract COVID-19 are four times more likely to also experience diabetic ketoacidosis (DKA).
So while generally children are less likely to contract the coronavirus, it is important to remain vigilant and continue practicing measures to protect everyone—like wearing a mask and social distancing—to keep everyone safe until we’re all safe.
Still have concerns?
Some individuals have expressed some hesitation to personal vaccination for COVID-19. Here’s what we know:
- 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 percent 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 effects of their vaccines across groups.
- Black, Native (including Pacific Islander) 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 Malaty 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.
The COVID-19 pandemic 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.