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Provocative Advice: Lupus Patients need COVID Vaccines [2021]

Evaluation and recommendations by noted lupus experts: Lupus patients need COVID vaccines

Newspaper on fire about lupus patients and COVID-19 vaccines

Hot off the press from Lupus Science & Medicine
revised 6/13/21: Added mycophenolate, NSAIDs, and Tylenol to the list of drugs that should be held for vaccines

SARS-CoV-2 vaccines in patients with SLE

Link and reference below to the research studiesSummary of some main points (but I encourage you to read the article):

  • Some of the world’s experts in lupus have written this article
  • Dr. Joan Merrill, Dr. Anca Askanase, Dr. Wei Tang, and Dr. Leila Khalili

“… the risks of not receiving the vaccine are far greater at the present time.”

  • The lupus experts also state, “Patients with autoimmune rheumatic diseases should receive the COVID-19 vaccines and should be prioritized before the general population.”
  • Lupus patients have shown that other vaccines are safe.
  • They recommend temporarily stopping or changing the dosing schedule on some drugs, such as cyclophosphamide, methotrexate, mycophenolate (CellCept, Myfortic), rituximab (Rituxan), abatacept (Orencia), JAK inhibitors (Xeljanz, Olumiant, Rinvoq), NSAIDs, and Tylenol.
  • They recommend following the recommendations of the American College of Rheumatology (click on link)
  • They recommend that doctors may want to consider monitoring antibody levels after the vaccine.
  • Since we do not know how well lupus patients, patients with other autoimmune diseases, and immunosuppressed patients will respond to the vaccines, they should continue strict social distancing.
  • The above recommendations do not consider specific research on these RNA vaccines. However, after evaluating all the data, The American College of Rheumatology and these lupus experts recommend vaccination in patients with autoimmune rheumatic diseases. 

What are the risks of COVID-19 infection when lupus patients get infected?

  • They are not at higher risk for infection from the novel SARS-CoV-2 Coronavirus.
  • However, they are at higher risk of hospitalization than the general population.
  • COVID-19 infection may even increase lupus flares.

Please get your vaccine.  I got mine and I recommend it to all my patients.
This is not a substitute for your doctor’s advice. Please check with your physician first. 


Don Thomas, MD: author of “The Lupus Encyclopedia” and “The Lupus Secrets

Tang W, Askanase AD, Khalili L, et al. SARS-CoV-2 vaccines in patients with SLE. Lupus Science & Medicine 2021;8:e000479. doi: 10.1136/lupus-2021-000479​American College of Rheumatology (ACR) COVID-19 Vaccine Clinical Guidance Task Force. COVID-19 vaccine clinical guidance summary for patients with rheumatic and musculoskeletal diseases, Available: https:/// Scholar


  1. Thank you very much for the help regarding the vaccine. This so helpful and I did speak withy Rhuemy and Endocrinologists. So now I’m able to put everything to work and have a good understanding of what to look for when I get the vaccine.
    Have a blessed day and stay healthy.
    Vonetta Grey

  2. So glad it was of help and good luck with getting your vaccine!
    Don Thomas, MD

  3. “The above recommendations are made without research regarding specifically these RNA vaccines. However, after evaluating all the data, The American College of Rheumatology and these lupus experts recommend vaccination in patients with autoimmune rheumatic diseases.”

    So Basically they are guessing. I want research. Lots and lots of research. I personally would rather dies of covid that risk getting yet another life long illness from a vaccine that no one can get rid of.

    • Kerri: So sorry you think that way. Please be open to what I say next…

      A lot of time has passed since this post. At this point in time, the number of research studies regarding the safety and efficacy of the COVID-19 vaccines in people with lupus and other autoimmune diseases is amazing. At this time, the COVID-19 vaccines have been studied more than any vaccine in history. I have unfortunately seen way too many unvaccinated patients die or suffer from horrible long-term problems from COVID-19 infection. One of my cousins is an ER doc. She says it is heartbreaking to hear these very sick patients ask for the vaccine and her having to tell them, “it is too late.” However, I have had absolutely no bad outcomes from my patients who got the COVID-19 vaccines (and I’m proud to say that almost all of my patients are vaccinated).

      Please do not believe anything you read on the news or TV or radio (you really never can tell who really knows what they are talking about. Instead, read it yourself. A simple Google Scholar search for COVID-19 vaccines in people with rheumatic diseases during the past year reveals an amazing number (over 7000). Read those instead. Here is a search:,21

      Educate yourself. This is why you will rarely meet a healthcare provider who takes care of COVID patients is not vaccinated. We have seen the horrors it causes. We have had to talk with the families devastated by their losses.

      Thank you for reading and commenting as this is an important conversation to have.

      Fingers crossed and praying that you’ll consider the vaccine (one less person for me to worry about).

      Donald Thomas, MD

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