Jag följer. Har lång covid och oss avråder de med anledning av avsaknad av studier i kombination med att det verkar finnas en autoimmun komponent.
Jag delar en text som jag fått till mig genom en kurs av en amerikansk kvinna som levt med svår ME i 8 år, men nu har lindrigare besvär. Där finns referenser på slutet för den som vill läsa mer.
”By Charles W. Lapp, MD
Note: Dr. Lapp is the founder and Medical Director of the Hunter-Hopkins Center in Charlotte, North Carolina, a medical practice specializing in ME/CFS and FM.
Vaccines Against COVID-19 & ME/CFS
Two vaccines for COVID-19 are now available to the American public, one from Moderna and the other from Pfizer, and a third vaccine, from Johnson and Johnson, is expected to be approved soon.
Both Moderna and Pfizer vaccines utilize a new type of immunization using mRNA to deposit recombinant antigen into the bloodstream. Because a live or attenuated virus is not involved, it is thought that such vaccines would not trigger flares or relapses in people with ME/CFS (PWCs), who may develop relapses from ‘live virus’ vaccines like influenza, MMR, and Hepatitis B.
Both the Moderna and Pfizer vaccines require two doses, and may cause local pain and swelling, fever, headache and flu-like symptoms for a day or two. Two immunizations are required – at least 3-4 weeks apart – for full immunity in over 90% of cases, but the second dose generally causes more adverse effects than the first.
The Johnson & Johnson vaccine is a single dose that utilizes an attenuated adenovirus to convey antigen into the system and is therefore more likely to trigger flares and relapses in PWCs. It has been up to 85% effective in reducing COVID-19 infection, and 100% effective in preventing hospitalization and death due to SARS-CoV-2.
It is not clear if people with ME/CFS (PWCs) are at higher risk for contracting COVID-19. Clearly their immune systems are low functioning due to reduced antibody production, increased cytokine activity, autoantibodies, reduced NK function, etc.
Others would say that PWCs are not immunodeficient, and they are less susceptible to viral infection than the general public. Our recommendation is to take either the Moderna or Pfizer vaccine when it is available to you.
Some providers have suggested taking Tylenol, NSAIDs, or steroids before a vaccination to reduce the side effects. However, recent evidence suggest that these may reduce the effectiveness of the vaccine or affect antibody production. It is okay, however, to take Tylenol, Advil, Aleve, aspirin or similar analgesics for any side effects that occur after the immunization.
Key Points
Persons with ME/CFS/FM should tolerate the Moderna and Pfizer vaccines, perhaps not J&J
Avoid Tylenol, NSAIDs, and steroids prior to the vaccination.
Prevention (masking, handwashing, social distancing and immunization) is key to preventing Long Covid
10-50% of people who contract COVID-19 will develop a prolonged ME/CFS-like illness
COVID-19 infection should be documented with nasal swab or blood tests
Long Haulers should seek specialists with an understanding of ME/CFS
Long Haulers may wish to boost immunity with a single dose of vaccine
References
1. Komaroff AL and Bateman L, 18 Jan 2021, “Will COVID-19 lead to myalgic encephalomyelitis / chronic fatigue syndrome?’ Frontiers in Medicine, 7: article 606824
2. Topol E, Verghese A, Fauci A, 2020, “We’re all in this together and we’re gonna get through it,” Medscape. Available online at
https://www.medscape.com/viewarticle/933619#vp_2
3. Jason LA and Mirin AA, 2021, “Updating NAM ME/CFS prevalence and economic impact figures to account for population growth and inflation,” Fatigue: Biomedicine, Health & Behavior, doi: 10.1080/21641846.2021.1878716
4. Komaroff AL, 2019, “Advances in understanding the pathophysiology of chronic fatigue syndrome,” JAMA 322: 499-500.
5. Association of State and Territorial Health Officials, 13 Jan 2021, “Pfizer and Moderna vaccine comparisons.” Available online at
https://www.astho.org/COVID-19/Pfizer-Moderna-Vaccine-Comparison/
6. Zimlich R, Miller A, 4 Feb 2021, “An overview of the Johnson & Johnson COVID-19 vaccine,” available online at
https://www.verywellhealth.com/johnson-and-johnson-covid-19-vaccine-5093160
7. Krammer F, Srivistava K, et al’, 1 Feb 2021, “Robust spike antibody response and increased reactogenicity in seropositive individuals after a single doe of SARS-CoV-2 mRNA vaccine,” MedRxiv, doi:
https://doi.org/10.1101/2021.01.29.21250653. Preprint available online at
https://www.medrxiv.org/content/10.1101/2021.01.29.21250653v1.full.pdf ”