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In response to a new wave of COVID-19 cases in the United States, the Food and Drug Administration amended the emergency use authorizations (EUAs) for people who received either the Pfizer or Moderna vaccines. The revision recommends that specific immunocompromised individuals receive a booster of the COVID-19 vaccine. This change is an effort to keep people with poorly functioning immune systems as healthy as possible. So, do thyroid patients need a COVID-19 booster shot per the new recommendations? The answer is maybe. Let’s take a look.
People with an autoimmune condition like Hashimoto’s thyroiditis may wonder if their immune systems are compromised, especially regarding the COVID-19 pandemic. Hashimoto’s is an autoimmune disorder where a person’s immune system attacks healthy tissues in the thyroid gland.
Autoimmunity is not the same as immunodeficiency. In autoimmunity, the immune system is overactive and reacts to your own tissues as though they are foreign. Under normal conditions, the immune system sends out antibodies to attack foreign invaders like viruses and bacteria. However, the immune system sometimes goes rogue and perceives healthy tissues as something that it should destroy.
On the contrary, immunodeficiency is where the immune system does not respond adequately to an infection. People with immunodeficiency often have reoccurring infections that are difficult to treat.
Causes of immunodeficiency
Several conditions can cause a person to be immunocompromised, including:
Acquired Immune Deficiency Syndrome (AIDS)
A chronic condition that comes from the human immunodeficiency virus (HIV). People with AIDS suffer from recurrent infections like pneumonia that can eventually become life-threatening.
Leukemia and lymphoma are two examples of cancers that can affect how your white blood cells (immune cells) function.
People with cancer often receive treatment with chemotherapy, a class of drugs that target rapidly dividing cells in the body. Many of the cells that are accidentally targeted include your white blood cells.
Lupus and myasthenia gravis
Some autoimmune conditions attack cells in the immune system, which can cause a person to be immunocompromised.
Rare congenital disorders
Some babies are born with little to no immune response.
Aside from certain health conditions, aging may cause immunodeficiency as well. Genetic and environmental factors may play a significant role in downplaying our immune response as we get older.
Causes of autoimmunity
Why your immune system may turn against you and attack your tissues is still unclear. Some theories suggest that an early viral or bacterial infection triggers an autoimmune response, while others point to environmental factors. However, because many autoimmune disorders travel in families, there is strong evidence that some are hereditary. Women are also far more likely to have an autoimmune condition compared to men.
Autoimmune disorders can attack a single tissue or organ like the thyroid gland or have system-wide effects. Also, autoimmune diseases often appear in multiples. One person may have at least two or more autoimmune conditions (called polyautoimmunity).
Likely, autoimmune disorders are due to a combination of factors, such as age, sex, environment, and heredity.
People with Hashimoto’s are not necessarily immunodeficient. Indeed, the immune response in most autoimmune disorders is not weakened but rather overactive. However, recall that having one autoimmune condition can put you at risk for another that may attack your immune system, like lupus. Also, everyone has a different medical history, so some people with Hashimoto’s may also have another health condition that causes them to be immunocompromised.
Additionally, there may be a link between autoimmunity and immunodeficiency. Some research shows that people who have a weakened immune system may develop autoimmune disorders. Infections may trigger autoimmunity, and because a person who is immunocompromised cannot fight off infection as easily, a weakened immune system may increase your risk for autoimmunity.
Treatment with immunosuppressants
People with some autoimmune disorders may take immunosuppressant drugs to help decrease the activity of their immune system. However, these drugs are not necessary for treating Hashimoto’s. Instead, the primary medical treatment of hypothyroidism caused by Hashimoto's is thyroid hormone replacement medication.
Immunosuppressant drugs often treat autoimmune conditions like:
- Crohn’s disease
- Rheumatoid arthritis
- Multiple sclerosis
- Alopecia areata
Currently, CDC recommendations indicate that everyone should get a COVID-19 vaccine as soon as possible. Vaccines can help suppress the spread of the virus and keep you and your loved ones safe. Recommendations for the rollout of COVID vaccine boosters are still being determined at the time this article is published. However, boosters will likely be available this fall, starting with high-risk individuals like health care workers and older adults. We recommend you follow the CDC for up-to-date information.
To determine your need for additional doses of the COVID-19 vaccine, contact your health provider. And, for up-to-date information on COVID-19 vaccinations, please visit:
- The U.S. Food and Drug Administration
- U.S. Department of Health and Human Services
- Center for Disease Control and Prevention
A note from Paloma Health
We know that having a condition like Hashimoto’s can cause additional stress and anxiety in the presence of COVID-19, especially with new strains emerging. Take advantage of our thyroid telemedicine options like at-home thyroid test kits, virtual consultations with thyroid doctors, and thyroid prescription refills to decrease your risk for exposure while staying on top of your thyroid health.