Your Questions On The COVID-19 Vaccine

Are you living with Scleroderma and/ or Raynaud’s and are concerned about or have questions in relation to the Covid-19 vaccine. Please check out our FAQs to get the advice you may need. 

Page published on 17 February 2021

Are you living with Scleroderma and/ or Raynaud’s? Do you have questions relating to the COVID-19 vaccine? Read-on to get the advice you need.

The recent rollout of the Pfizer and Astra Zeneca COVID-19 vaccines is a huge step forward in the fight against coronavirus. The current government advice is that vaccination using approved vaccines is the best way to protect the most vulnerable and save lives.

This FAQ was put together using a vaccine toolkit put together by DHSC and other publicly available government guidance and is designed to try and answer any questions that you may have relating to the Pfizer and Astra Zeneca vaccines.

How many vaccines are approved/ in use?

At the time of this update, 3 vaccines are approved for use in the UK. These are the Pfizer BioNTech (Pfizer for short) vaccine, the Astra-Zeneca ‘Oxford’ (Astra-Zeneca for short) vaccine and the Moderna vaccine. There are many other vaccines in advanced clinical trials and this guidance will be updated once these become approved/ in-use.

The Pfizer vaccine and Astra Zeneca vaccines are currently in use across the UK. Vaccinations with the Moderna vaccine are expected to commence in Spring 2021 as supplies become available.

How do these vaccines work – are they safe?  

Vaccines are safe and are the most effective way of protecting us and others from infectious disease. None of the vaccines approved for use in the UK contain ‘active’ COVID-19 virus so there is no risk of catching COVID-19 from vaccination.

They are safe for use in people who may be immunocompromised or immunosuppressed since they cannot cause ‘COVID-19’. The approved vaccines drive an immune response against a part of the COVID-19 virus, the ‘spike protein’, this is used by the virus to enter certain cells in the body and cause illness. The protective immune response generated through vaccination protects us from infection and subsequent illness.  

The Pfizer and Moderna vaccines are mRNA vaccines which use bits of the COVID-19 virus’ genetic code to generate an immune response.

The Astra-Zeneca vaccine is made using a harmless, unrelated virus as a vector to deliver the bit of the COVID-19 virus’ genetic code needed to generate the immune response. This virus has been modified so it cannot grow and cause illness in humans. 

The vaccine is one of the surest ways of preventing severe illness and complications from contracting COVID-19. The benefits that vaccination will offer you is far greater than limited risk of side effects.

You can learn more about how the COVID-19 vaccines were developed so quickly in this helpful short video from the National Institute for Health Research (NIHR).

Who should be vaccinated?

The Joint Committee on Vaccination and Immunisation (JCVI) have advised that the vaccine first be given to care home residents and staff, followed by people over 80 and health and social workers, then to the rest of the population in order of age and risk. 

The full prioritisation list can be found here and is as follows (in order of priority): 

  • Residents in a care home for older adults and their carers 
  • All those 80 years of age and over and frontline health and social care workers 
  • All those 75 years of age and over 
  • All those 70 years of age and over and clinically extremely vulnerable individuals 
  • All those 65 years of age and over. All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality.
  • All those 60 years of age and over 
  • All those 55 years of age and over 
  • All those 50 years of age and over 

The NHS has now asked that those who are over 70 or clinically extremely vulnerable (CEV) and have not yet received a vaccination should now book a vaccination by phoning 119 or book online with the NHS.

If you are aged 65 years to 69 years you can now have a Covid-19 vaccine in England. Also, all those individuals aged between 16 years to 64 years with underlying health conditions would also be contacted, as well as adult carers. The government is urging you to now book a vaccination by phoning 119 or book online with the NHS.

A risk assessment tool has been rolled out to GPs to help them identify which of their patients are CEV and should be prioritised for vaccination. 

If you do not fall into these categories you should continue to await invitation for vaccination. Do not attend a site where vaccinations are being offered without an appointment.  

Will I be able to choose which vaccine I receive?

Current consensus is that individuals will not be able to pick which vaccine they would prefer to receive. Both vaccines have been shown to be safe and effective in protecting against COVID-19. There is currently no available data which supports the use of one vaccine over another in people with certain conditions. 

Who shouldn’t receive the vaccines?

The vaccine is currently only approved for use in those aged 16 years and over. As is routine for all vaccinations you should inform the doctor, nurse or pharmacist whether you have any pre-existing health conditions so you can receive the best advice and treatment at your vaccination appointment. 

There are some groups for which vaccination is currently not recommended. These include: 

  1. Those who are pregnant/ breast feeding

Women who are intending to become pregnant, are pregnant or breast feeding are currently advised not to receive the Pfizer vaccine. The Astra Zeneca vaccine can be given in situations where the benefits outweigh the risks (i.e. for those pregnant with severe underlying health conditions). If you are called to receive a vaccine and you are in this category then you should inform your health professional who will provide the appropriate advice. The JCVI will be reviewing data as the vaccines are deployed and will advise the Government when vaccines should be extended to this group.

The latest COVID-19 vaccine guidance for pregnant and breastfeeding women can be found here. We recommend discussing further with your healthcare professional. 

2. Those with a history of severe allergy

People who suffer from severe allergies (anaphylaxis) in general or who may be allergic to one or more of the Pfizer vaccines ingredients (see section 6) have been advised not receive the Pfizer vaccination. These people generally have a history of anaphylaxis and carry epi-pens at all times for this reason.

Prior to receiving either vaccine you are advised to inform the medical professional if you have any known allergies or past serious reactions to vaccination.  

Anaphylactic reactions occur quickly after vaccination, the chances of this happening are extremely low if you do not have history of these. All those receiving the vaccine are monitored immediately after receiving vaccination, should a reaction like this occur you will receive immediate care. If you do suffer any type of allergic reaction following the first dose you will be told not receive a second dose. 

3. Ongoing severe Infection

A mild cold or infection is not a reason to delay vaccination but if you have a severe infection with a temperature of 38˚C or higher you should not receive the vaccination and should reschedule your appointment. Likewise, if you have any symptoms of COVID-19 you should not present for vaccination.

4. Elective surgery

It is recommended that you should not receive vaccination within 7 days of either undergoing or having undergone elective surgery. This is to ensure any symptoms or side effects resulting from surgery are not attributed to vaccination or vice versa.

How will I receive the vaccine?

Both vaccines are given as an injection into your upper arm requiring two doses. You will receive some short-term protection after the first dose but two doses are required to achieve longer term protection. 

There is a 3 to 12 week interval between doses of the Pfizer Vaccine. 

There is a 4 to 12 week interval between doses of the Astra Zeneca vaccine. 

Unless there is a medical reason not to, you must complete your course and receive your second dose of vaccine to get the best possible protection from COVID-19. 

What side effects could occur? 

Vaccines like other medicines can cause side-effects. The side-effects reported from both vaccines are in line with those experienced from other vaccines and include: tenderness in the injected arm, tiredness, headache, general aches and pains/ flu-like symptoms for a day or two.  

You may have seen reports of possible allergic reactions to the Pfizer. These occurred in individuals who were already known to have severe allergic reactions and carried epi-pens for this purpose. Allergic reactions happen soon after immunisation meaning that the individuals affected were received medical care in the setting where they received the vaccine.  

If you do have any known allergies, please advise the person giving the vaccine prior to injection. 

The MHRA is committed to monitoring the safety of all drugs and vaccines introduced to combat coronavirus. The MHRA Yellow Card reporting scheme allows members of the public to report any suspected side effects of any COVID-19 vaccine in current use or any other COVID related treatments. 

If you would like to read about the experiences of Scleroderma and Raynaud’s patients being administered the COVID-19 vaccines, please take a look at our online community forum.

Can you still infect others once you have been vaccinated?

We have robust clinical data showing that the vaccines are effective at preventing illness from COVID-19, but we do not yet know whether those who have been vaccinated can carry the virus and transmit it to others. For this reason you are advised to follow the most up-to-date rules on social distancing and respect public health messages such as hands-face-space.   

How much protection does the vaccine provide? 

No vaccine is ever 100% effective. All vaccines approved for use in the UK have met the effectiveness criteria set by the MHRA to show that they can protect against serious illness from COVID-19.

I am taking immunosuppressants for my condition, are the vaccines safe and effective? 

Immunosuppressant drugs dampen the immune response and are prescribed to help manage autoimmune conditions like scleroderma. The approved vaccines are safe to use in those undergoing treatment with immunosuppressant medications. But those taking these types of treatments may generate a lower level of protection in response to COVID 19 vaccination compared with the general population. It is still very important that you get vaccinated as it will offer you a certain amount of protection against catching COVID-19. It is important that you receive two doses of the vaccine to maximise the protection that vaccination offers you. 

If you are due to start a scheduled immunosuppressive therapy (e.g. biologics such as rituximab) you may be advised by your Doctor to delay treatment so that you may receive one or both vaccine doses before commencing your treatment cycle. This should allow your immune system to make a better response to vaccine. Alternatively, your Doctor might suggest an alternative treatment which may improve the protection offered by the vaccine. 

If you are currently taking oral corticosteroids or ‘steroids’ such as prednisolone to manage your condition it is safe to receive the vaccine. The current advice is that vaccination should not be delayed for those who are taking, have received or are due to receive steroids in any form. 

If you are on a waiting list to receive a high dose steroid injection such as methylprednisolone or triamcinolone then you and your Doctor may discuss whether you should delay having your injection by two weeks in order to get the best possible response from the vaccine.  

You should not stop your immunosuppressants or any other medications that you may be taking to manage your condition on our own. Any decision to defer immunosuppressive therapy or to delay possible benefit from vaccination until after therapy should be made in partnership with your medical professional considering fully the risks from both COVID19 and your underlying condition(s). 

Are the vaccines tested on people with autoimmune conditions like scleroderma?

Given the rarity of scleroderma it is unlikely that any of the vaccine trial volunteers are people living with this condition. 

Some of the vaccine developers have not excluded people with autoimmune conditions from participating in their trials unless they have a weakened immune system because of the ‘immunosuppressive’ medicines they are receiving as treatments. This is likely to be because these individuals would have lower antibody responses used as a readout to measure the effectiveness of a vaccine. 

There is currently no data suggesting that the vaccine performance would be different in people with autoimmunity and the Government advise that those with autoimmunity and who are taking immunosuppressants to present for vaccination. 

Should I receive either vaccine as a patient with scleroderma? 

COVID-19 can be an extremely serious illness in certain groups of the population including the elderly, or those who are clinically extremely vulnerable with serious underlying health conditions. If you are within one of these groups, and you are concerned about receiving the vaccine you should discuss this with your medical practitioner. 

Vaccination is currently the surest way to reduce your chances of becoming seriously unwell if you contract the coronavirus. The government has provided the following information which gives more advice on who should be first offered the vaccine.  

Should I receive either vaccine if I suffer with Raynaud’s? 

As mentioned above, COVID-19 can be serious in groups in the elderly and/ or the clinically extremely vulnerable. If you are older and/ or have other health issues as well as Raynaud’s you may be invited to receive vaccination. As mentioned above, vaccination is currently, the surest way to protect against serious illness from COVID-19. 

If you are younger, and are in relatively good health i.e. you not have any health issues in relation to your Raynaud’s which would make you clinically vulnerable you will follow the same guidance as per the general population and may not be invited to receive a vaccine against COVID-19 for some time. Furthermore, by the time you are invited for immunisation there may be additional vaccines approved for use in the UK by the MHRA. We recommend you follow our posts on our website as we will be updating our guidance as more information becomes available.

I have remaining questions

If you continue to have unanswered questions please contact either our helpline on 0800 311 2756 or email us where we will endeavour to respond to your question. 

Further Reading: 

NHS – Coronavirus (COVID-19) vaccine

NHS – Coronavirus Vaccination – What happens at your appointment

UK Government – COVID-19 vaccination: Guide for older adults

ARMA – Principles for COVID-19 Vaccination in Musculoskeletal and Rheumatology for Clinicians

Public Health England – COVID-19 Vaccination Programme – Information for Healthcare Practitioners

British Society for Rheumatology – COVID-19 Guidance

The Green Book – COVID-19 Chapter 14a

Department of Health & Social Care – UK COVID-19 vaccines delivery plan