Is it safe for individuals with sickle cell disease to receive COVID-19 vaccinations?
The American Society of Hematology (ASH) and the Centers for Disease Control and Prevention (CDC) strongly advise people with Sickle Cell Disease (SCD) to receive the COVID-19 vaccine. This recommendation stems from the increased risk of severe COVID-19 outcomes for individuals with SCD.
People with SCD have a higher chance of complications from respiratory infections, including COVID-19. Vaccination is crucial to reduce the risk of hospitalization and severe disease.
For those with SCD, the recommended vaccination schedule is similar to that of immunocompromised individuals. This typically involves a 3-dose primary mRNA vaccine series, followed by booster doses, including the updated 2024–2025 COVID-19 vaccines, to maintain protection. An 8-week interval between the first and second mRNA doses is generally advised, optimizing immune response while balancing safety.
Children with SCD, aged 5–11, should receive a 3-dose vaccine series, with at least one dose being the current season's COVID-19 vaccine. Dosing and spacing may be adjusted based on individual clinical judgement.
Healthcare providers, including pharmacists, are encouraged to educate and facilitate vaccination in SCD patients, managing scheduling for series completion and addressing any hesitancy.
No specific contraindications are noted for COVID-19 vaccines in people with SCD. Routine monitoring for adverse reactions is recommended as per standard protocols. Vaccines can be administered alongside other recommended vaccines, such as influenza and pneumococcal vaccines, which are also advised for this vulnerable population.
SCD affects more than 100,000 people in the United States, with a higher prevalence among people of African ancestry or those who identify as Black. People with SCD should discuss any questions or concerns about the vaccine with their doctor.
The risk of vaccine side effects in people with SCD appears lower than that of severe illness due to COVID-19. Common side effects may include pain, redness, swelling, fatigue, muscle pain, headaches, fever, chills, nausea, and allergic reactions (rare).
Several medical and public health organizations, including the ASH and the CDC, encourage people with SCD to get vaccinated to reduce their risk of severe illness. The COVID-19 vaccine has been shown to safely and effectively reduce the risk of severe complications from the disease.
People with SCD should seek medical attention if they experience worsening symptoms or rare adverse events, such as severe allergic reactions, after receiving the COVID-19 vaccine. A 2022 study found that people with SCD did not show a notably higher risk of side effects or hospitalization following COVID-19 vaccination.
It's important to note that the overlap between acute chest syndrome and COVID-19 can amplify the harm they can do to someone with SCD, as both conditions affect the lungs. People with SCD are more likely to develop a range of complications, including acute chest syndrome, anemia, bone tissue death, blood clots, fever, infection, kidney problems, leg ulcers, hand-foot syndrome, liver problems, organ damage, pain, pulmonary hypertension, sleep disorders, stroke, vision loss, and pneumonia.
In summary, the ASH and CDC strongly recommend COVID-19 vaccination with updated, multi-dose mRNA vaccine schedules for persons with SCD to reduce severe COVID-19 risks, with dosing intervals and series tailored to immunocompromised status and age. Ongoing safety monitoring and co-administration with other vaccines is supported.
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