Should You Get the COVID Vaccine If You Have Diabetes?
An endocrinologist weighs in on what we know—and don’t yet know—about the new vaccines and diabetes.
The COVID vaccines are here, and they’re being distributed by the millions. Chances are, you know at least one person who has received one. But as welcome as these long-awaited shots are, they’re also stirring up some controversy—especially among those in the chronic community, who (understandably) have some questions. Like are these vaccines safe for everyone? And will they interact with my medications? Also, what are the side-effect risks?
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We hear you. And we’re taking your questions straight from our Facebook pages to the desks of top chronic disease experts as part of our original series #ChronicVaxFacts. Today we’re speaking to Matthew Freeby, M.D., an endocrinologist and director of the UCLA Gonda Diabetes Center in Los Angeles, about what people with diabetes should know before they get the shot.
HealthCentral: Could the COVID vaccine raise my blood sugar?
Matthew Freeby, M.D.: The short answer is yes. Side effects of the vaccine can include pain, swelling, redness at the injection site, chills, fatigue, headaches, and general viral illness-like symptoms. Although the vaccine is not causing COVID, the symptoms related to a virus-like syndrome or pain can often raise blood sugars. I would not expect blood sugars to remain elevated for longer periods of time—it would just be during that brief period in which one may not be feeling quite as well. The recommendation for people is to stay hydrated, and if their sugars are rising quite high, to reach out to their provider.
HC: Will it interact with my diabetes medications in any way?
Dr. Freeby: I don’t have enough information to tell you, “No, without a doubt,” but it is unlikely that the vaccine would have an interaction with any medications we use for diabetes.
HC: Is one vaccine better than the other for people with diabetes?
Dr. Freeby: If you look at the data surrounding the two mRNA vaccines from Pfizer and Moderna, they look relatively comparable. They work in a similar mechanism of action, so it’s hard to believe that one would benefit patients with diabetes more than the other.
The Johnson & Johnson COVID vaccine appears to be both safe and efficacious. Safety data suggests very few negative reactions, and the outcomes data suggests it to be quite effective in reducing risks related to hospitalization and mortality. Unfortunately, at this point, we can't compare the vaccines, given the differences in clinical trial design and timing of rollout, especially as new variants have been seen regionally and internationally.
HC: Should I stop taking any of my medications before getting the vaccine?
Dr. Freeby: I don’t typically tell my patients to withhold any medications for diabetes prior to their vaccine.
HC: Do I need to be worried about severe side effects from the COVID vaccine, since I am already considered at high risk of serious infection from the virus?
Dr. Freeby: I am not privy to specific side effect profiles of the vaccine for people living with diabetes. But to my knowledge, I don’t believe there are excess side effects for people living with type 1 or type 2 diabetes who receive the vaccine. For the Pfizer and Moderna vaccines, 8% to 10% of each of those clinical trials had people with type 1, type 2, or gestational diabetes enrolled. We don’t have—or at least I have not seen—any data surrounding side effect profiles for people living with diabetes in those clinical trials, but nothing has been reported of excess concerns.
HC: How have people with diabetes done with this vaccine so far?
Dr. Freeby: At this point, I have not seen data related to specific outcomes for people living with diabetes, but given the high proportion of subjects with diabetes in the clinical trials, I have to assume that these vaccines will benefit patients with diabetes just as much as anyone who doesn’t have it. To put it a different way, patients with diabetes are at excess risk for severe COVID-19 infection: Hospitalization rates are three to fourfold higher, odds of death are higher. So there are a lot of risks in getting COVID for people living with diabetes, and if you were to get the vaccine and reduce that risk—I think it’s something people with diabetes will really benefit from.
For more details about when you might be eligible to receive the vaccine, visit the American Diabetes Association's COVID-19 Vaccination Guide, which includes state-by-state information about vaccine rollout and eligibility.
- ADA COVID Vaccination Guide: American Diabetes Association. (n.d.). “COVID-19 Vaccination Guide.” diabetes.org/coronavirus-covid-19/vaccination-guide