Should Lyme disease patients with an impaired immune system get the COVID-19 vaccine?
The Centers for Disease Control and Prevention (CDC) posted mRNA COVID-19 vaccination considerations for people who have a weakened immune system. “People with HIV and those with weakened immune systems due to other illnesses or medication might be at increased risk for severe COVID-19.”  Individuals with Lyme disease, who may have a weakened immune system, have expressed concern over the vaccine.
People can have an impaired immune system from an overactive and underactive immune response. “A strong immune system responds appropriately to the challenge; a weak immune system may over-respond or under-respond,” explains Kostoff and colleagues in the journal International Journal of Molecular Medicine. 
They added, “A weakened immune system appears to be the main determinant of serious/fatal reaction to viral infection (for COVID-19, SARS, and influenza alike).”
Lupus, rheumatoid arthritis, and Hashimoto’s thyroiditis are examples of an over-response of the immune system. Lyme disease is another example of an overactive immune response. 
The CDC report touched on the risk to individuals with a weakened immune system in developing a severe COVID-19 infection.  It acknowledges that there is limited safety data on the use of the mRNA COVID-19 vaccination in individuals with an impaired immune system. “Information about the safety of mRNA COVID-19 vaccines for people who have weakened immune systems in this group is not yet available.”
The report pointed out that, “People with weakened immune systems should also be aware of the potential for reduced immune responses to the vaccine, as well as the need to continue following all current guidance to protect themselves against COVID-19.”
The CDC guidance report was issued to allow individuals with a weakened immune system to make “an informed decision about receiving the mRNA COVID-19 vaccine.”
The authors point out that there is little information above the vaccine’s impact on individuals with autoimmune conditions. “They should be aware that no data are currently available on the safety of mRNA COVID-19 vaccines for them.” Nevertheless, the authors advised treatment.
Editor’s note: It is clear that COVID-19 can be severe for some individuals. There is a paucity of information on the risks and benefits of the mRNA COVID-19 vaccination for Lyme disease patients. The risk of COVID-19 is far greater than the risks of the mRNA COVID-19 vaccination. I have been advising my patients to take the mRNA COVID-19 vaccination based on a review of the risks and benefits.
- Vaccination Considerations for Persons with Underlying Medical Conditions. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/underlying-conditions.html Last accessed 12/31/20.
- Kostoff RN, Briggs MB, Porter AL, Aschner M, Spandidos DA, Tsatsakis A. [Editorial] COVID19: Postlockdown guidelines. Int J Mol Med. Aug 2020;46(2):463-466. doi:10.3892/ijmm.2020.4640
- Aucott JN, Soloski MJ, Rebman AW, et al. CCL19 as a Chemokine Risk Factor for Posttreatment Lyme Disease Syndrome: a Prospective Clinical Cohort Study. Clin Vaccine Immunol. Sep 2016;23(9):757-66. doi:10.1128/CVI.00071-16
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