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COVID-19 Vaccination, Hypothyroidism, and Hashimoto's

Learn about COVID-19 vaccination and how it applies to hypothyroid and Hashimoto's patients.
COVID-19 Vaccination, Hypothyroidism, and Hashimoto's

Medically Reviewed by:
Medically Reviewed by:

In this article: 

  • Drug development process
  • How are COVID-19 vaccines made?
  • Who should receive the COVID-19 vaccine(s)
  • Should I get the vaccine if I have Hashimoto's or hypothyroidism?
  • How is the COVID-19 vaccine administered?
  • Possible side effects of the COVID-19 vaccine
  • What to do after vaccination


Coronavirus disease (COVID-19) is a highly infectious disease caused by a coronavirus, SARS-CoV-2, that has caused a global pandemic. The U.S. Food and Drug Administration (FDA) granted Emergency Use Authorization to two vaccines for COVID-19—the Pfizer-BioNTech COVID-19 vaccine on and the Moderna COVID-19 vaccine in December of 2020. Ahead, what to know about these vaccines if you have hypothyroidism or Hashimoto's disease.

Drug development process


There are several stages in the drug development process. Stage 1 is discovery and development, meaning that research for a new drug begins in the laboratory. Stage 2 is preclinical research. This second stage is the step in which medicines undergo laboratory testing to answer basic safety questions. Stage 3 is clinical research, meaning drugs are tested on people to ensure they are safe and effective. In stage 4, the FDA examines all of the submitted data related to the drug or device and decide to approve or not to approve it. Finally, in the fifth, post-market safety monitoring stage in the FDA monitors all drug and device safety once products are available for use by the public.


The Pfizer vaccine gained authorization based on data from an ongoing phase 1/2/3 trial. This trial includes approximately 44,000 participants who are randomized to receive either the Pfizer vaccine or a saline placebo.


The Moderna vaccine gained authorization based on an ongoing phase 3 trial. This trial includes approximately 30,000 participants who are randomized to receive the Moderna vaccine or a saline placebo.


Both vaccines' authorization has been extremely fast, relative to typical FDA approvals. This speedy authorization leaves many of us with questions about the vaccines and who should get the vaccination. The FDA has provided guidelines for both vaccines, including administration to special populations.

Image of a person in a lab holding a vial to illustrate how COVID-19 vaccines are made


How are the COVID-19 vaccines made?


Scientists make vaccines by administering one of the following:

  1. An inactive portion of a virus or an inactive portion of a bacterial toxin
  2. A weakened, live portion of a virus
  3. The genetic code (DNA, mRNA, or vectored viruses) for part of the virus


The Pfizer and Moderna COVID-19 vaccines are both mRNA-based vaccines. mRNA is "messenger" RNA. mRNA is a copy made from DNA that takes the code from the DNA to ribosomes, the cell's protein factories. The cell breaks down the mRNA after it finishes its instructions, and mRNA never enters the cell's nucleus, which is where our DNA (genetic material) lives. 


While mRNA vaccines are a new type of vaccine, the research has been around for decades. Researchers previously studied mRNA vaccines for other infections like the flu, Zika, and rabies. Once the relevant information about the coronavirus that causes COVID-19 became available, scientists started designing the mRNA instructions for our cells to make unique spike protein into an mRNA vaccine. 


A spike protein exists on the surface of the virus that causes COVID-19. COVID-19 mRNA vaccines give our cells instructions to make a piece of this spike protein that triggers an immune response inside our bodies. That immune response make antibodies which protect us from getting infected if the real virus enters our bodies.


Can you get COVID-19 from the COVID-19 mRNA vaccines?

No, you cannot get COVID-19 from the COVID-19 mRNA vaccines. mRNA vaccines do not contain the live COVID-19 coronavirus.

Image of women holding a globe in white lab coat, white face mask, and blue gloves representing the COVID-19 pandemic


Who should receive the COVID-19 vaccine(s)?


The ACIP recommends that everyone is vaccinated regardless of whether or not they have had COVID-19. The vaccine trials included people who had previously been sick with COVID, and results suggest that the vaccine provides stronger immunity than immunity from having COVID in the first place.


Recommendations for who should receive the vaccine first come from the Centers for Disease Control and Prevention (CDC). Each state then makes its own plan accordingly. Visit the CDC website to choose your state or territory to find your health department and specific state's plan.


The CDC's recommendations come from the Advisory Committee on Immunization Practices (ACIP), an independent panel of medical and public health experts. These recommendations aim to:

  1. Decrease death and severe illness as much as possible.
  2. Preserve functioning society.
  3. Reduce the extra burden that the coronavirus has on people already facing disparities.


The CDC recommends the following rollout for the COVID-19 vaccine:

  • Phase 1a - Healthcare personnel and long-term care facility residents
  • Phase 1b - Frontline essential workers and people aged 75 years and older 
  • Phase 1c - People aged 65—74 years, people aged 16-64 with underlying medical conditions, and other essential workers


The ultimate goal is for everyone to easily get a COVID-19 vaccination as soon as there are enough vaccine quantities available. 

What qualifies an underlying medical condition?

People with certain underlying medical conditions may be at increased risk of severe illness (hospitalization, ICU admission, intubation or mechanical ventilation, or death) from COVID-19.


Studies show that adults with the following conditions ARE at increased risk of severe illness from the virus that causes COVID-19:

  • Cancer
  • Chronic kidney disease
  • Chronic obstructive pulmonary disease (COPD)
  • Down Syndrome
  • Some heart conditions
  • Immunocompromised state from solid organ transplant
  • Obesity or severe obesity
  • Pregnancy
  • Sickle cell disease
  • Smoking
  • Type 2 diabetes mellitus


Adults with the following conditions MIGHT be at an increased risk for severe illness from the virus that causes COVID-19:

  • Asthma
  • Cerebrovascular disease
  • Cystic fibrosis
  • High blood pressure
  • Immunocompromised state from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
  • Some neurologic conditions
  • Liver disease
  • Overweight
  • Pulmonary fibrosis
  • Thalassemia
  • Type 1 diabetes mellitus


Am I immunocompromised if I have Hashimoto's (autoimmune thyroiditis)?

The short answer is if you have Hashimoto's disease (autoimmune thyroiditis), you are not necessarily immunocompromised or immunodeficient. 


Immunodeficiency is when the immune system doesn't respond adequately to infection. Autoimmunity is when the immune system is overactive and responds to healthy cells as though they were foreign.


However, sometimes people with an autoimmune condition develop more than one, called polyautoimmunity. So, if you have Hashimoto's, you may be at higher risk of developing another autoimmune condition. Some autoimmune conditions like myasthenia gravis or lupus do cause immunodeficiency.


Similarly, some autoimmune conditions like psoriasis, lupus, rheumatoid arthritis, Crohn's disease, multiple sclerosis, and alopecia areata are treated with immunosuppressant drugs. Immunosuppressants suppress the immune system to reduce the autoimmune reaction, possibly causing immunodeficiency.


So, if you have only Hashimoto's disease, you are not immunocompromised. If you have another illness in addition to Hashimoto's that causes immunodeficiency or requires immunosuppressants, then you may be immunocompromised.

What to know about the vaccine if you have an underlying medical condition

People with underlying medical conditions can receive the mRNA COVID-19 vaccines if they have not had a severe or immediate allergic reaction to any vaccine ingredients. 


For a full list of ingredients, see Pfizer's COVID-19 Vaccine Fact Sheet.
For a full list of ingredients, see Moderna's COVID-19 Vaccine Fact Sheet.


The following groups should still get the vaccine even though there is limited safety data:

  • People who have weakened immune systems
  • People who previously had Guillain-Barre syndrome
  • People who previously had Bell's palsy


Should I get the vaccine if I have Hashimoto's or hypothyroidism?

People with Hashimoto's disease can receive the COVID-19 vaccine. However, you should know that there is currently no data available on mRNA COVID-19 vaccines' safety for Hashimoto's patients. Phase 3 of both vaccines included people with autoimmune conditions with no recorded autoimmune flare-ups. Experts will get more information on the risk of inflammatory response for people living with an autoimmune disease like Hashimoto's as more people get the vaccines. 


How is the COVID-19 vaccine administered?


You receive the COVID-19 vaccine by intramuscular injection—a shot in the upper arm. Both the Pfizer and Modern vaccines require two shots, spaced apart, to get the most protection. The length of time between each shot depends on which vaccine you receive. You should get your second Pfizer dose three weeks (21 days) apart, or your second Moderna dose one month (28 days) apart. Your second dose should come as close to the recommended interval as possible, but no earlier.


Possible side effects of the COVID-19 vaccines  


The most common side effects reported with both COVID-19 vaccines are redness and swelling at the injection site. There may also be pain, tenderness, and swelling of the lymph nodes in the same arm as the injection. Other side effects may include fatigue, headache, muscle pain, joint pain, chills, nausea or vomiting, and fever.


There is a small chance that either vaccine could cause a severe allergic reaction. If this happens, it would usually occur very shortly after getting a dose. Signs of a severe allergic reaction may include difficulty breathing, face or throat swelling, rapid heartbeat, rash all over your body, dizziness, or weakness. 


If you experience a severe allergic reaction, call 9-1-1, or go to the nearest hospital. 

Image of blue face masks to protect yourself from COVID-19

What to do after vaccination

Researchers continue to evaluate the protection that COVID-19 vaccines provide. Until we know more, and more people are vaccinated, you should continue to follow the current guidelines after receiving your vaccination to prevent the spread of COVID-19.


To protect yourself and others, follow these recommendations:

  • Wear a mask over your nose and mouth
  • Stay at least 6 feet away from others
  • Avoid crowds
  • Avoid poorly ventilated spaces
  • Wash your hands often


A note from Paloma Health


If you have specific questions about how the COVID-19 vaccine may interact with your particular thyroid condition and health history, be sure to talk to your doctor. If you need hypothyroid care while you continue to stay home to protect yourself and others, all of Paloma Health's services are still available from the comfort of your home.

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Article updated January 20, 2020.

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