Frequently Asked Questions (FAQs)
What is JDRF’s position on the vaccines?
JDRF celebrates the authorization of the Pfizer-BioNTech, Moderna, and Janssen (J&J) COVID-19 vaccines by the U.S. Food and Drug Administration, which we hope will be the first three of many available in the weeks to come to address this deadly pandemic. We appreciate the many research scientists, clinical trial participants, industry partners, and government officials who are making this progress possible.
How do I get a vaccine?
The distribution of vaccines is being organized on a state-by-state basis following guidelines established by the Centers for Disease Control and Prevention (CDC). The initial number of doses will remain limited until additional doses are manufactured. Please refer to your state department of health to learn more. Also, reference ‘VaccineFinder’ a website that helps you find clinics, pharmacies, and other locations that offer COVID-19 vaccines in the United States. The website is operated by Boston Children’s Hospital and supported by the Centers for Disease Control and Prevention and the United States Digital Service.
How much does the vaccine cost?
All COVID-19 vaccines purchased by the Federal government are free to the patient regardless of health insurance coverage. All providers must vaccinate individuals regardless of their insurance status, type of coverage, and are prohibited from balance billing or otherwise charging recipients for the vaccine.
Are the vaccines safe for people with T1D?
All data show the vaccines are safe and effective for people with T1D and both vaccines were tested in people with diabetes. 9.4% of Moderna, 8.4% of Pfizer-BioNTech, and 0.5% of J&J trial participants had diabetes. There were no adverse effects reported in these populations. We do not have any information on the number of people with T1D in these trials, nor about T1D-specific adverse events reported yet in scientific literature, but there is no evidence at the moment to indicate that these vaccines are unsafe for people with T1D.
When people with T1D have a sickness, e.g. fever, flu, etc., it’s important to follow the guidelines that your practitioner provides. It is possible that a vaccination, like the COVID-19 vaccine or otherwise, can lead to illnesses with similar symptoms. If you become ill following a COVID-19 vaccination, please consult your doctor and follow sickness-related guidelines.
Do I Need a Booster Shot?
On September 24, the Centers for Disease Control (CDC) recommended booster shots for certain people who received the Pfizer-BioNTech COVID-19 vaccine at least 6 months after receiving the second dose, which includes people with T1D. Specifically:
- All individuals 65 years and older and those 50-64 at risk for severe complications from COVID-19, which includes people with T1D, should receive a booster shot of the Pfizer-BioNTech COVID-19 vaccine.
- Individuals 18-49 at risk for severe complications from COVID-19, including people with T1D, may receive a booster based on an individual assessment of benefit and risk.
There has been no recommendation from the CDC or the Food and Drug Administration (FDA) for individuals who received the Moderna or Johnson & Johnson vaccines to receive booster shots.
I received the Janssen (J&J) vaccine – should I be concerned about negative outcomes?
On April 13, the FDA and CDC recommended a pause in the use of the J&J vaccine so they could review cases of rare and severe blood clots accompanied by low platelets, also known as thrombosis-thrombocytopenia syndrome (TTS), that presented in 6 people after receiving the vaccine. On April 23, the FDA and CDC – following a thorough safety review – have determined that the recommended pause should be lifted and use of the vaccine should resume. In short, the FDA has determined that the available data show that the vaccine’s known and potential benefits outweigh its known and potential risks in individuals 18 years of age and older.
Vaccine recipients or caregivers should review the Fact Sheet for Recipients and Caregivers, which has been revised to include information about the risk of this syndrome, which has occurred in a very small number of people who have received the J&J vaccine. Also, the CDC and FDA state that people who have received the J&J vaccine and develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their healthcare provider.
What about children with T1D?
The Pfizer-BioNTech vaccine is authorized for use in people 12 years of age and older, and the Moderna and Janssen (J&J) vaccines in people 18 years and older. We will continue to monitor progress and enhance our efforts as there is more evidence and as vaccines are authorized for use in broader populations, such as younger individuals.
Does it matter which vaccine I get?
It does not matter which one you get. Brand availability varies from market to market, and JDRF does not recommend getting one over another. The most important thing is getting vaccinated as soon as possible.
Who do I talk to about getting a vaccine?
Each state is responsible for distributing the vaccine through the networks of hospitals, doctors, and pharmacies within their jurisdiction. We encourage you to visit your state’s department of health website and get in touch with your doctor to learn more about your state’s process.
Did JDRF provide input for national vaccine distribution prioritization?
JDRF provided a letter about COVID-19 risks to the T1D community to the CDC, both to CDC staff directly and through formal comments to the Advisory Committee on Immunization Practices, including data published in December. A copy of each letter can be found here and here. JDRF also held several meetings with CDC staff to share the latest data regarding the elevated risk of COVID-19 to the T1D community.
In the Fall, we also provided input to the National Academies of Science, Engineering, and Medicine, which were seeking input on a proposed framework for vaccine distribution. The CDC is now using this framework.
JDRF, along with other diabetes organizations, sent a letter to the CDC about the urgent need to prioritize people with T1D.
JDRF has also been sharing this important data with the news media including being featured in STAT News, a health and medicine focused news website, and contributing to the piece featured in The Hill, a media source for policy and political coverage.
On March 29, the CDC announced that it has updated their COVID-19 prioritization guidance to include T1D as a high risk condition, thus paving the way for states who follow CDC guidance to include those with T1D in their priority groups.
What Do We Know about T1D and COVID?
- Based on current scientific literature, there is no evidence that people with T1D are at higher risk for contracting T1D.
- Although children with T1D can catch the virus, they usually have mild symptoms. However, the virus could make it harder to manage blood glucose levels and therefore create a risk for diabetic ketoacidosis.
- Two new studies show that adults with T1D are at an increased risk of severe COVID-19 illness. Details on each of these studies are below. These add to an October 2020 UK population-based registry publication showing that people with type 1 diabetes have more than 3-fold level of increased risk of mortality when hospitalized due to COVID-19.
- A December 2020 U.S.-based study shows that adults who get COVID-19 and have diabetes, whether T1D or T2D, have three to four times higher risk of severe illness and hospitalization.
- Specifically, the study found “after adjustment for age, race, and other risk factors, the odds of a COVID-19–related hospitalization and greater illness severity for patients with type 1 diabetes are three- to four-fold higher than patients without diabetes. This increased risk is approximately the same for patients with type 2 diabetes.”
- Per this study, “hypertension, race, recent diabetic ketoacidosis, health insurance status, and less diabetes technology use were significantly associated with illness severity.”
- Those at greatest risk are people with consistently elevated blood-sugar levels and those with a second comorbidity (such as obesity or heart, kidney, or lung disease).
- This study “COVID-19 Severity Is Tripled in the Diabetes Community: A Prospective Analysis of the Pandemic’s Impact in Type 1 and Type 2 Diabetes,” by Justin M. Gregory et.al. was published in December 2020 in the peer-reviewed journal Diabetes Care. It was conducted by a clinical research team at the Vanderbilt University School of Medicine and the University of California San Diego Medical Department. The study analyzed data from nearly 6,500 patients with COVID-19 in a regional health network, comparing factors and outcomes in patients with T1D, T2D, or no diabetes.
- A December 2020 study published out of Scotland shows that the risk of serious outcomes among adults with T1D and T2D were significantly higher than compared to a baseline of the general population.
- Specifically, the study found that the risk of severe COVID-19 for adults with diabetes compared to the general population when adjusted for age and sex was 2-4 times higher for T1D and 1-4 times higher for T2D.
- The report indicates that greater elevation in T1D “is probably accounted for by longer duration of diabetes because in the older age bands, cumulative incidence was higher in type 1 than type 2 diabetes…”.
- The study found that the “risk of fatal or critical care unit-treated COVID-19 in diabetes rose steeply with age and was higher in males…”.
- The authors state, “The risk of fatal or critical care unit-treated COVID-19, and therefore the need for special protective measures, varies widely among those with diabetes but can be predicted reasonably well using previous clinical history.”
- This study, “Risk of and risk factors for COVID-19 disease in people with diabetes: a cohort study of the total population of Scotland” by Stuart J McGurnaghan et al. was published in December 2020 in the peer-reviewed journal Lancet Diabetes and Endocrinology. It was a cohort study conducted by Health Protection Scotland in conjunction with several universities using the total population of Scotland.
- Given the higher risks of severe illness and hospitalization from COVID-19 found in these studies, JDRF calls for people T1D and T2D to have prioritized access to the COVID-19 vaccine.
What do we know about COVID variants, the intersections of T1D, and vaccine efficacy?
Currently, there isn’t published research that has studied the SARS-CoV-2 variant and its impact on T1D. The current vaccines approved by the FDA and their efficacy against this new variant in T1D or other populations are still being studied, but we are committed to providing you with updates as soon as we learn more.
* The committee defined frontline essential workers as first responders, teachers and other education workers, food and agriculture workers, correctional facility staff, postal workers, public transit workers, and people who work in manufacturing and in grocery stores.
For more information about Coronavirus, visit https://www.jdrf.org/coronavirus/.