Frequently Asked Questions (FAQs)
What is JDRF’s position on the new vaccines?
JDRF celebrates the authorization of the Pfizer-BioNTech and Moderna COVID-19 vaccines by the U.S. Food and Drug Administration, which we hope will be the first two 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.
COVID-19 has taken a significant toll on the diabetes community. A new study shows that adults who get COVID and have diabetes, whether type 1 or type 2, have three to four times higher risk of severe illness and hospitalization. Based on this evidence, JDRF calls upon healthcare decision makers to make people with type 1 or type 2 diabetes, as well as their caregivers, a high priority for receiving COVID-19 vaccines.
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.
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. 8.4% of Moderna trial participants had diabetes and 9.4% of Pfizer/Biontech 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.
What about children with T1D?
The Pfizer vaccine is authorized for use in people 16 years of age and older, and the Moderna vaccine in people 18 years and older. Both vaccines are now being tested in clinical trials enrolling people age 12 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. Your local state health authorities will determine which vaccine you receive, and JDRF does not recommend getting one over another. The most important thing is getting vaccinated as soon as possible.
Who will set priorities for vaccine distribution?
The CDC is establishing national guidelines for prioritizing vaccine distribution; however, states will make decisions on how and in what order the vaccine will be distributed. The decision-making process will vary in each state, with some public health officials and health systems seeking community input. Review your respective state department of health website, or this resource from Kaiser Family Foundation which provides the sources for each state’s prioritization criteria.
Do people with T1D have priority in getting a vaccine?
Currently, healthcare personnel and residents and staff of long-term care facilities are being offered the first doses of the COVID-19 vaccine. JDRF supports this initial prioritization as critical to slowing the spread of this virus.
The Advisory Committee on Immunization Practices, an expert panel that advises the CDC, recommended that adults aged 75 and older and frontline essential workers* be designated as the second priority group to be vaccinated against COVID-19—called Phase 1b.
The Committee also voted to recommend that the third stage, called Phase 1c, should focus on adults 65 to 74, people 16 to 64 years old with high-risk medical conditions, and essential workers not included in the second phase of vaccination. Based on the evidence the Committee has reviewed to date, it finds that adults with T1D might be at risk for severe illness. But, the evidence cited does not include a more recent publication which shows that adults with T1D are at an increased risk for severe illness. Because of this, JDRF is advocating for the T1D community to be prioritized.
Importantly, state and local health authorities will make the final decisions on how to roll out vaccination in their locales and some have already decided to include people with T1D in a prioritized category.
What is the rationale for people with T1D being prioritized?
JDRF has been closely monitoring the data on how COVID-19 affects people with T1D. The most recent data show that adults with diabetes—type 1 and type 2—are more likely to have serious complications from COVID-19. There are other risk factors, which include glycemic and vascular health, ethnicity, and socio-economic status.
The bottom line is people with T1D need higher priority access to the vaccines as they become available, and JDRF is working hard to make that happen. JDRF also strongly encourages decision makers to recognize the disparate impact COVID-19 has had on people of color in the United States and to prioritize health equity in its vaccine distribution plans.
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 has 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. The CDC finds, based on the evidence it has considered, that adults with T1D may be at an increased risk of serious illness. Because this consideration does not include the most recent data, JDRF is continuing to engage with CDC and advocate that people with T1D or T2D be a high priority for receiving COVID-19 vaccines.
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.
How can I advocate for people with T1D to receive the vaccine earlier?
There are several steps you can consider taking to advocate for vaccine access for people with T1D, whether for individuals seeking the vaccine or on behalf of the community. Options will vary by locality, depending on health systems and policy decision-making processes. You may wish to reference the following steps as you consider advocating for yourself and the T1D community for COVID-19 vaccine prioritization:
- Identify where T1D is prioritized in your state, and which key vaccine influencers are relevant in your area. Reference your state department of health (see list), or this resource from Kaiser Family Foundation which may also be a helpful starting point. For you and your family, these influencers could be your doctor, your hospital, or your local health agency. For the T1D community, you may wish to contact your respective state department of health and your governor.
- Develop your message and feel free to utilize information from this page. Reference our prevalence of T1D by state spreadsheet and a sample template (right- click to download), for your consideration.
- Consider ways to make your voice heard, such as engaging on social media tagging key influencers, speaking at public meetings, submitting comment letters, a letter to the editor of your local newspaper, or a letter directly to your governor and state department of health.
What message can I deliver to decision makers in my local community about vaccine prioritization for the T1D community?
- We applaud the healthcare workers, research scientists and so many others who have helped our community during this pandemic and are now bringing us life-saving vaccines.
- We strongly support the initial prioritization of healthcare personnel and residents and staff of long-term care facilities, and also urge decision makers to prioritize health equity in their vaccine distribution plans, given the disparate impact COVID-19 has had on people of color in the United States.
- We want to draw attention to the latest research, which shows COVID-19 has taken a significant toll on the diabetes community.
- A study published in December 2020 shows that adults who get COVID-19 and have diabetes, whether type 1 or type 2, have three to four times higher risk of severe illness and hospitalization, compared to people without diabetes.
- This new study is consistent with earlier data, and unequivocally demonstrates that adults with diabetes are at a significantly heightened risk of severe illness and mortality due to COVID-19.
- Based on this evidence, state vaccine distribution plans should make people with T1D or T2D – as well as their caregivers – a high priority for receiving COVID-19 vaccines.
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.
* 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/.