Vaccines for COVID-19 – your questions answered

Why is it important for me to have the vaccine?

Last updated: 15 January 2021

There are some types of arthritis which are caused by the body’s immune system, which usually protects us from infection. When the immune system is affected by arthritis or drugs to treat the condition, the risk from COVID-19 is increased.

People who catch COVID-19 can become very unwell. Many people will need hospital treatment even if they don’t have a health condition.

Vaccines are a good way for people with rheumatology conditions to stay safe. Vaccines teach the immune system to recognise infections, stopping people becoming unwell.

You can find out more about vaccines on our Vaccinations webpage.

Making a decision about the COVID-19 vaccine

To help you make a decision about having the COVID-19 vaccination, we have worked with other organisations to develop a decision support tool.

Decision support tool for the COVID-19 vaccine (PDF, 289 KB)

This is designed to support conversations about the vaccine between you and your healthcare professional. You can use this to prepare for appointments, during appointments, or both.

What vaccines are available?

There are many vaccines in development for COVID-19, but we don’t know exactly when each of these will be available. So far, three COVID-19 vaccines have been approved for use in the UK – the Pfizer/BioNTech vaccine, the Oxford AstraZeneca vaccine and the Moderna vaccine.

The Pfizer/BioNTech vaccine became available in early December 2020, and the Oxford AstraZeneca vaccine became available from January 2021.

The Moderna vaccine isn’t expected to be available in the UK until spring 2021.

This page covers the two vaccines which are currently available in the UK – Pfizer/BioNTech and Oxford AstraZeneca.

What types of vaccines are being developed?

There are many different types of vaccinations for COVID-19 in development around the world, which act in slightly different ways to cause the immune system to respond.

The Pfizer/BioNTech vaccine uses bits of genetic code to cause an immune response, and is known as an mRNA vaccine. The Oxford AstraZeneca vaccine uses a real virus that has been inactivated to cause an immune response. These are safe ways to show the body what COVID-19 looks like, so that the immune system is better prepared to fight a COVID-19 infection.

Could my medication or condition mean I can’t have the COVID-19 vaccine?

People with some types of arthritis take medicines to suppress the immune system. In general people on these treatments need to avoid live vaccines. You can find out more about live vaccines and how they can affect people taking drugs to suppress the immune system on our vaccinations webpage.

All of the COVID-19 vaccines available in the UK are safe for people with arthritis and people taking drugs that suppress the immune system, even if your condition is active.

The Pfizer/BioNTech vaccine is not a live vaccine, and people who take medicines to suppress the immune system can have this vaccine. People on drugs that suppress the immune system are on the priority list for vaccination that has been produced by the Joint Committee on Vaccination and Immunisation (JCVI).

Although the Oxford AstraZeneca vaccine is made of a real virus, it has been inactivated so it can’t cause a serious infection, even in someone whose immune system has been suppressed. This means that it’s safe for people who are on medicines to suppress the immune system.

Is one vaccine more suitable than another for people who are on drugs that suppress the immune system?

There is no good evidence that one vaccine is more suitable than another for people who are on drugs that suppress the immune system. It may take many months of further research to determine this.

If you’re offered the vaccine and delay taking it, then you leave yourself at risk from COVID-19.

When will people with arthritis receive the vaccine?

The Joint Committee on Vaccination and Immunisation has produced advice on the COVID-19 vaccine and priority groups. It says that unpaid carers (friends or family who help care for someone), frontline health and social care workers and those at increased risk of COVID-19 will be in the first priority groups for vaccination.

The JCVI advice applies to all four nations of the UK.

The NHS will contact you when it’s your turn to have the vaccine. If you’re not sure that the NHS has the right information about your COVID-19 risk level, then you should get in touch with your GP.

Once you have received your letter you can book your vaccination appointment online, or for those who cannot access online booking service, helpline services are available. Read more about guidance in your area and how the vaccine will be rolled out in England, Scotland, Northern Ireland and Wales

You can find out more about who is at an increased risk of coronavirus on our dedicated page: Arthritis and COVID-19 - what are the risks?

We know that many people who are clinically vulnerable or clinically extremely vulnerable are concerned about leaving home to have the vaccine. There are things you can do to reduce your risk of COVID-19 outside the home, such as wearing a mask, washing your hands regularly, and keeping a distance from other people as much as possible.

If you are offered the vaccine and delay taking it, you leave yourself at risk of COVID-19.



Will the drugs I take for arthritis mean the vaccine doesn’t work as well for me?

Some people who are taking drugs that suppress the immune system may be given advice to continue avoiding exposure to COVID-19 after they have had the vaccination. This is because their medications could mean their immune system doesn't respond as strongly to the vaccine as people who don't take these drugs.

Everyone in the UK will need to follow government advice on reducing the spread of COVID-19, even after they have had the vaccine. People who are clinically extremely vulnerable will need to follow the local advice for this group, even if they have been vaccinated against COVID-19.

This does not mean you should stop your treatment, because this can result in a flare of your condition which puts you at greater risk from COVID-19.

If you’re offered the vaccine and delay taking it, then you leave yourself at risk from COVID-19.

Should I delay my rituximab treatment so I can have the vaccine?

Rituximab treatment in particular may reduce the effectiveness of vaccines. This is because it blocks the body from making antibodies.

If you’ve already had rituximab then it’s safe to have the vaccine when you’re offered it.

If you’re offered the vaccine close to an infusion of rituximab, ask your clinical team if you can delay the infusion by a few weeks, if it’s safe to do so.

If you’re about to start rituximab and haven’t yet been offered the vaccine, your healthcare team might suggest you try another drug instead.

If you’re offered the vaccine and delay taking it, then you leave yourself at risk from COVID-19.

Can I have the vaccine if I am taking steroids?

It’s fine for you to have the vaccine while you’re taking steroids. There’s no reason to delay the vaccine if you’re taking steroids, or have recently had a steroid injection or finished a course of steroid treatment.

Taking steroids as tablets, liquids, injections or drips might mean that your immune system doesn’t respond as well to the vaccine as someone who isn’t taking these drugs. This means that you may be advised to follow advice on shielding and social distancing guidance after you have had it. Steroid creams or eye drops should not affect your immune system or response to the vaccine. 

Your healthcare team might want to discuss delaying a dose of steroids or a steroid injection with you, especially if there is a high risk of getting COVID-19. It’s important that you don’t stop taking your steroid medication without speaking to a healthcare professional, as this can leave you at risk of having a flare-up, which can increase your risk of COVID-19.

Do children need to have the vaccine?

Trials for the vaccine in children have only just begun, so it’s generally not recommended for children under 16. It’s also known that children and young people are at a very low risk of COVID-19 generally.

It’s possible these recommendations may change once more adults have had the vaccination.

Can I have the vaccine if I am pregnant?

The COVID-19 vaccine can be given to pregnant women in cases where the benefits outweigh the risks – for example, if the risk of being exposed to COVID-19 is high or if the woman is at an increased risk of serious complications of COVID-19. The benefits and risks can be discussed with a healthcare professional before having the vaccine.

Women who are trying to get pregnant don’t need to avoid pregnancy after having the vaccination.

Your doctor or midwife will be able to give you more advice. These vaccines haven’t been tested during pregnancy and breastfeeding, but there is nothing to suggest that they are harmful during pregnancy or breastfeeding.

Can I have the vaccine if I am waiting for surgery?

Guidelines recommend people do not have major surgery and vaccines within one week of each other. This is because both surgery and the vaccine can cause a fever.

How is the vaccine given?

Vaccines are usually given as an injection into the upper arm.

The Pfizer/BioNTech vaccine is given in two doses, between 3 and 12 weeks apart. The Oxford AstraZenenca vaccine is given in two doses, between 4 and 12 weeks apart.

Are there any side effects?

The person giving you the vaccine will be able to let you know about any side effects that you can expect, and these may differ depending on which of the vaccines you have. It’s common to have some pain at the injection site following a vaccination.

If you have any adverse reactions to the vaccine, it’s important to tell a healthcare professional so they can report it to the Yellow Card Scheme. Anyone is free to use the scheme to report adverse reactions , but it’s still important to tell a healthcare professional if this happens to you.

How long will the vaccine take to work?

Both of the available vaccines are thought to offer short-term protection after the first dose. The second dose is important for long-term protection from COVID-19.

The Oxford AstraZeneca vaccine prevented COVID-19 in about 7 in every 10 people, with no severe cases from 14 days after the first injection. The Pfizer/BioNTech vaccine prevented COVID-19 in more than 9 in every 10 patients (95%) and starts to work around 10 days after the first dose.

Do you still need the vaccine if you have had COVID-19?

It’s possible for people who have already had COVID-19 to have the vaccine for it. It’s not known yet how long the antibodies made by your body in response to COVID-19 last, so a vaccine could offer more protection or boost any antibodies your body has already made.

We're here for you

If you’re looking for support, especially during these uncertain times, we’re here for you. Read our dedicated coronavirus information with signposting to the latest official government advice and guidance.