Asthma and COVID-19 Vaccines — Answers to Your Top Questions

As millions of Americans receive COVID-19 vaccines each week, people with asthma may wonder when their turn will come. Are there vaccine side effects people with asthma should be on the lookout for? Is it okay to get the vaccine on a day when you’ve had an asthma attack?

Here are the answers to the questions people with asthma may be asking about the COVID-19 vaccines.

1. When Will I Be Able to Get the Vaccine if I Have Asthma?

Exactly when people with asthma became eligible to get the vaccine varied by state and even by community, according to availability. President Joe Biden directed that all states make the vaccine available to all adults by April 19. The best way to find out when you can receive the vaccine is to check with your state health department, or take a look at the useful map of the United States with links on the American Lung Association (ALA) website. You can also call your doctor’s office or local hospital.

Some states are including people with asthma among those with an underlying medical condition that raises the risk of serious coronavirus infection. This may give them priority access to the vaccine, even once the general public is eligible for it. Meanwhile, other states, like Texas and Florida, have left the door open for doctors, hospitals, and counties to decide whether to include people with asthma in this category.

“Eligibility varies according to each state and their own distribution process,” says David R. Stukus, MD, an associate professor of pediatrics in the division of allergy and immunology at Nationwide Children’s Hospital in Columbus, Ohio, and a member of the Asthma and Allergy Foundation of America’s medical scientific council.

RELATED: What You Need to Know About the New Coronavirus if You Have Asthma

2. Why Is It Important to Get the Vaccine if You Have Asthma?

To protect yourself from coronavirus infection and to lower your risk of severe symptoms if you do become infected, it’s important for people with asthma to get the COVID-19 vaccine when eligible. “It is important for everyone to receive a COVID-19 vaccine as soon as they are eligible, as this is the best path towards preventing severe illness,” Dr. Stukus says.

Vaccination also protects others by helping build “herd immunity,” which controls the spread of the virus. Vaccinating everyone is the pathway toward ending the pandemic, according to the American College of Allergy, Asthma, and Immunology.

3. Are the Vaccines Safe and Effective for People With Asthma?

Yes. People with mild to severe asthma were included in clinical trials for the Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) vaccines currently being distributed in the United States, according to briefings from the U.S. Food and Drug Administration (FDA).

For example, in a Moderna vaccine clinical trial with more than 27,000 people, 22 percent had underlying health conditions including moderate to severe asthma, according to an FDA briefing report dated December 17, 2020. The report notes that safety and efficacy for participants with mild to severe asthma were on par with results for the vaccine group as a whole.

On April 13, the Centers for Disease Control and Prevention (CDC) and FDA recommended a pause in administering the Janssen vaccine due to 6 reported cases in the United States of a rare type of blood clot linked to the Janssen vaccine, out of more than 6.8 million doses given. This action, the agencies announced, was taken “out of an abundance of caution” while they investigated these cases and to ensure that when vaccinations resume, healthcare providers have the tools they need to recognize and treat these rare adverse events.

On April 23, the CDC recommended the pause be lifted and vaccination with the Janssen shot resume.

There are no specific health concerns or contraindications for people with asthma when it comes to the Janssen vaccine, according to Mitchell H. Grayson, MD, a professor and the chief of the division of allergy and immunology at Nationwide Children’s Hospital in Columbus. Regarding blood clots, he says: “It appears that people with asthma are at the same risk as the general population for any of these extremely rare events.”

4. Is One of the Three Available Vaccines a Better Choice for People With Asthma?

There is no reason to prefer any one of the available vaccines for someone with asthma, according to Dr. Grayson. “I continue to tell patients that the best vaccine is the one they can get sooner,” he says. “There isn’t anything special about asthma that would lead to a preference of one vaccine over the other.”

5. What Side Effects of the Vaccine Should People With Asthma Pay Attention To?

People with asthma may experience the same relatively mild side effects people often report after receiving the vaccine, such as a headache, chills, a sore arm, achiness, fatigue, or fever. “Those reactions are more common after the second dose [of the Moderna and Pfizer-BioNTech vaccines],” says Grayson. The Janssen vaccine requires only one dose.

It’s important to follow medical advice given to the general public: Stay at the place where you receive your vaccine for 15 to 30 minutes afterward in case you develop a rare allergic reaction that could lead to anaphylactic shock, according to the CDC.

“The risk for serious allergic reaction [to COVID-19 vaccines] is between two and five per one million people,” Grayson says. Asthma itself does not raise that risk, he adds. And there’s no evidence that the vaccine worsens asthma, he says.

6. I Have Allergies: Should I Worry About Getting the Vaccine?

Seasonal allergies (like pollen allergies) as well as allergies to food, latex, and inhaled triggers (like dust and pet dander) do not raise your risk of an allergic reaction to the vaccine, according to the ALA and the American Academy of Allergy, Asthma, and Immunology (AAAAI). But if you have a history of severe allergic reactions, have a drug or vaccine allergy, know you’re allergic to the chemical polyethylene glycol or to any other ingredient in the vaccines, talk to your doctor.

7. Should I Keep Taking My Daily Asthma Controller Medications Before and After I Get the Vaccine?

Yes. “It’s important to keep taking your regular asthma controller medications,” Grayson says. ACAAI notes that there is no contraindication for any OTC or prescription allergy or asthma medicine and getting a COVID-19 vaccine.

If you have questions or concerns about your medications and receiving the vaccine, talk to your doctor, Stukus says.

8. What if My Asthma Flares Up on or Before My Vaccine Day?

Reschedule your vaccine if you have an asthma attack or exacerbation on the day you’re scheduled to get it, Grayson suggests. “If you’re ill you probably shouldn’t have the vaccine,” he says. “If your asthma is not controlled and you’re having an exacerbation you should get it under control first.”

If you have questions about whether your symptoms could interfere with the vaccine, talk with your doctor.

9. Can I Get a COVID-19 Vaccine the Same Day I Get My Allergy Injection, Xolar, Other Biologic, or Gamma Globulin Infusion?

Interactions between the COVID vaccine and other immunizations or biologic drugs has not been studied. ACAAI recommends not getting a COVID vaccine injection on the same day as an immunotherapy shot to help control allergies or on the same day that you receive an infusion of a biologic drug.

And AAAAI currently recommends against getting the vaccine and an immunotherapy shot within 48 hours of each other. “The main reason not to receive these medications close together is that if you have a reaction, your doctor won’t be able to tell what caused it,” Grayson says. If you’re planning to receive any other vaccinations, the CDC recommends not getting them in the 14 days before or after a dose of the COVID-19 vaccine.

10. Where Can I Get a COVID-19 Vaccine Once People With Asthma Are Allowed to Get It?

You may be able to get vaccinated at your doctor’s office, at a local health clinic or hospital, or at a vaccination site set up in your community or nearby. There are also drive-through vaccination centers in some states.

Pharmacies including CVS, Walmart, Walgreens, and others were scheduled to start receiving the vaccine in February, too, according to the CDC. Find out more about options near you by using the CDC’s vaccine locator tool. Call before you go to a vaccine site to make sure you’re eligible, that the vaccine is available, and to check if you need an appointment.

11. Are COVID-19 Vaccines Free for People With Asthma?

Yes, vaccines are free for everyone, whether you have private insurance, Medicaid, Medicare, or are uninsured. Providers may charge a fee for administering it, but that’s covered by your insurance or by the federal Health Resources and Services Administration’s Provider Relief Fund. No one can be denied a vaccine if they are unable to pay the vaccine administration fee, according to the CDC.

12. What Should People With Asthma Discuss With Their Healthcare Teams About the COVID-19 Vaccines?

“Ask in advance what you should do if your asthma flares up or if you’re receiving immunotherapy shots or biologic infusions,” Stukus says. Your healthcare providers can help determine what’s right for you. “Each individual should discuss these specific scenarios with their own allergist, if it pertains to them,” he says.

RELATED: Who Should Be on Your Asthma Treatment Team?

13. How Should People With Asthma Prep Before Getting the Vaccine?

“People with asthma should be excited to start their pathway towards immune protection,” Stukus says. Other than that, individuals with asthma should be aware of the common side effects in case they need to plan for time off work the day after they receive their vaccine. Most expected adverse effects occur in the first 48 hours and are very mild and short-lived, Stukus explains.

Additional reporting by Quinn Phillips.

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