3. If You’re Immunocompromised or take Immunosuppressive Medications
People on other medications like immunomodulatory agents should speak to their health care provider and weigh the risks vs. benefits of vaccination.
“It’s not that the vaccine will harm them, it’s that they may not make a good response to the vaccine,” Dr. Nachman says. “Those immunomodulating agents don’t hurt you when you’re taking the vaccine, but they lower your ability to make a good immune response,” she says.
Dr. Nachman says that means you may not get that “bang for your buck” because these medicines are a substance that stimulates or suppresses the immune system. “That’s not to say you shouldn’t take [the vaccine], you should take it, but you may not make as good a response as someone who’s not on those medicines,” she says.
The CDC says there’s no data currently available on the safety and efficacy of COVID-19 vaccines in persons with autoimmune conditions, though these persons were eligible for enrollment in clinical trials. (Here’s the science on whether COVID-19 can trigger autoimmune reactions.)
According to the CDC, immunocompromised people may receive the COVID-19 vaccination if they have no history of allergic reactions to vaccination. However, they should know about the unknown vaccine safety profile and effectiveness in immunocompromised populations.
People who received the COVID-19 vaccine during chemotherapy or treatment with other immunosuppressive drugs are not currently recommended for re-vaccination or additional doses, per the CDC.
2. If You Have a History of Bell’s Palsy or Guillain–Barré Syndrome
According to the CDC, there were cases of Bell’s palsy, or sudden weakness in the muscles on one half of the face, reported after vaccination in both the Pfizer-BioNTech and Moderna COVID-19 vaccines clinical trials.
That said, the FDA has not found that these cases were causally related to vaccination. “There is no relation to the vaccine itself as Bell’s palsy occurred at same incidence as in the general population,” Dr. Parikh says.
People can still experience or develop other medical problems during or at the same time as they get the vaccine or when they are doing the trials, she says. These medical problems that arise may not be necessarily due to the vaccine. And contracting COVID-19 and other viruses cause Bell’s palsy, so the risk may be higher not taking the vaccine, according to Dr. Parikh.
“Bell’s palsy is a very benign and a self-resolving condition in general and should not be a deterrent to obtain the vaccine,” she says.
Anyone with a history of Bell’s palsy may receive a COVID-19 vaccine, unless they have a history of a severe or immediate allergic reaction to the components of the vaccine, according to the CDC.
Dr. Parikh adds that those with a history of a neurological disorder called Guillain-Barré syndrome (a condition in which the immune system attacks the nerves) may also want to consult their allergist or physician before proceeding with vaccination. (Can COVID-19 harm your brain?)
1. If You Are Under a Certain Age
People 18 or older can receive the Moderna vaccine, and people 16 or older can receive the Pfizer-BioNTech vaccine. According to the CDC, neither COVID-19 vaccine is approved for children. The Pfizer trial did include kids aged 12 to 15, but they made up only a small number (266) out of a total of more than 40,000 participants. More research is necessary.
The vaccine is considered safe for most adults. The people who need to consult with their doctors before receiving the vaccine are pregnant women and immunocompromised people or those who take immunosuppressive medications.
If you have a history of a severe or immediate allergic reaction to the vaccines’ ingredients, you should not take the vaccine or the second dose until there is an alternative.
People who currently have COVID-19 should wait for vaccination until after they are finished with quarantine and have recovered. Those who received COVID-19 antibodies should also wait for the vaccine for the best results.
As new research develops, these guidelines may change, but the good news is we’re getting somewhere.