Vaccination does not exclude strict social distancing guidelines and mask wearing until “herd immunity” levels of vaccination have been reached (70% of the population)! Most importantly, vaccination is not 100% (in fact the two initial vaccines trials were 95% effective in preventing or reducing the severity of infection). Although they came to the market very quickly, we will know more about the quality of the antibody tests over the next few months. It is not yet known how long the immunity will last, but there are blood tests that look at antibody levels available. Please note: that if you take the vaccine you should take the whole recommended dose, and the current vaccines, Pfizer and Moderna, should be administered twice. In this special circumstance, premedication with a steroid, the same way we premedicate people who need a CT scan with iodine contrast dye, could be provided by your physician. If you do take the vaccine, plan to stay in the medical setting for at least 30 minutes, consider several hours, to be in a safe place if you do have a reaction. So you may want to wait (taking all of the COVID-19 precautions very seriously). I suspect we will know fairly quickly, with millions of doses already administered. If you have been diagnosed with mast cell activation syndrome, it would make sense that your risk of an immediate reaction to any vaccine should be higher, though the data on the risk to people with mast cell activation syndrome or prior vaccine allergic reactions is not yet known with the COVID-19 vaccines. There are natural supplements that act to block or clear histamine and stabilize mast cells such as alpha lipoic acid, ascorbic acid, B6, diamine oxidase enzymes (DAO), luteolin, N-acetylcysteine (NAC), Omega-3's, riboflavin, SAMe, quercetin, and natural sources of theophylline like green and black teas. Maitland's excellent lecture from out recent CME Workshop: Managing the Syndrome Soup: POTS, EDS, MCAS & ME/CFS, if you want to know more: There are many mast cell stabilizers watch Dr. (Benadryl is one of the strongest, Zyrtec is another good choice). So, take an antihistamine before and for several days after the vaccine – the strongest one you can tolerate. If it happens immediately, that is anaphylaxis, but if it happens slowly and low grade over days the mediators mast cells release can drive a classic ME/CFS relapse. The big mediator of post vaccination relapse and immediate reactions is mast cell activation. Before the vaccine, make sure you are taking enough antioxidants, particularly NAC or glutathione and CoQ10. You can mitigate the risk in a number of ways - just the way you do when you feel a relapse coming on. So while there certainly is a risk of an ME relapse with these hyper reactive vaccines (the first wave to be released), you have to weigh the possibility of an ME relapse against the risk of death from COVID-19. It kills people with over activated and damaged immune systems preferentially – and that is what ME/CFS is all about.
I have been asked this question dozens of times over the past week. Veterans with concerns related to Gulf War illness have a lot in common with ME/CFS patients, so my advice to them is the same.
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