Guide: Immunodeficiency, Autoimmunity and COVID-19 Vaccination

Update 20 September 2021 :   

This Guide has been developed by ASCIA, based on current knowledge regarding immunodeficiency, autoimmunity and COVID-19 vaccines, and is updated when new information is available.

ASCIA HP Guide Immunodeficiency Autoimmunity COVID-19 Vaccination 2021-09-2096.68 KB

COVID-19 vaccines listed below are not live-attenuated vaccines and are safe for people with immune system disorders, including immunodeficiency and autoimmune conditions:

• Pfizer/BioNTech Comirnaty mRNA-based COVID-19 vaccine – available in Australia and New Zealand for adults and children 12 years and over.
• Moderna Spikevax mRNA-based COVID-19 vaccine – available in Australia for adults and children 12 years and over.
• AstraZeneca/Oxford Vaxzevria viral vector COVID-19 vaccine – available in Australia for adults 18 years and over.

In Australia the vaccines listed above have all been provisionally approved by the Therapeutic Goods Administration (TGA), which is part of the Australian Government Department of Health. www.health.gov.au/initiatives-and-programs/covid-19-vaccines

In New Zealand the Pfizer/BioNTech Comirnaty vaccine has been provisionally approved by Medsafe. www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-vaccines

COVID-19 vaccines have initially been tested in healthy adults, before being tested on more vulnerable people, to provide confidence that the vaccine is safe for use in the general population.

There is no evidence that people with primary or secondary immunodeficiencies and autoimmune conditions are at any greater risk of vaccine allergy than the general population.

Treatments for immunodeficiencies and autoimmune conditions should not be stopped:

• People with certain pre-existing medical conditions have been identified as one of the initial priority groups for COVID-19 vaccines, including people with immunodeficiencies and autoimmune conditions, who are immunocompromised. It is important that treatments for immunodeficiency and autoimmune conditions are continued, as stopping the treatments can place people with these conditions at greater risk from COVID-19.
• COVID-19 vaccination should occur on a different day (if possible) from regular infusion treatments, such as immunoglobulin replacement therapy or immunosuppressant infusions. For example, people on monthly intravenous immunoglobulin (IVIg) may be advised by their specialist to be vaccinated two weeks after an IVIg infusion. This avoids confusion about the cause of side effects or allergic reactions if they occur in response to the COVID-19 vaccine or the infusion treatment.
• People with immunodeficiencies and autoimmune conditions should follow the usual advice from their clinical immunology/allergy specialist or rheumatologist regarding vaccinations or ask for specific advice regarding the COVID-19 vaccine. 

COVID-19 vaccine side effects indicate the start of an immune response, not an allergic reaction:

• Some people will get mild, short-term side effects from vaccination, including injection site reactions, fever, joint pain, muscle aches, fatigue, headaches, or worsened eczema a day after vaccination.
• These common side effects indicate the start of an immune response, not an allergic reaction, which are rare. Side effects do not usually require treatment other than paracetamol for fever or discomfort.

For more information refer to the ASCIA website: www.allergy.org.au/members/covid-19#cd1

© ASCIA 2021

ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand.