I did not want to get the Covid-19 vaccination.
And if left up to me, and if I lived by myself, under a rock, somewhere removed from people, I wouldn’t have done it.
I have Hashimoto’s Thyroiditis. Though most people rightly associate Hashimoto’s with the thyroid, the immune system is also culpable here. Hashimoto’s, after all, is an autoimmune disease, and like everyone living with autoimmunity, I’m managing an immune system that is already overstimulated, perhaps over vigilant for any invaders, such as a virus or pathogen, that might trigger an attack.
How would my immune system react to a Covid shot? Would it behave appropriately and undergo the necessary processing in order to remember the virus, should I be infected for real in the future? Or would it misbehave and engage in something known as “molecular mimicry,” whereby antibodies attack not just the virus but also “lookalike” parts of the human tissue?
Admittedly, I’m prone to catastrophizing, something that became starkly clear at the beginning of the pandemic when I had visions of being literally locked in my then-New York City apartment for days without being allowed to venture outside. That this never came to pass is something for which I am grateful. And yet, my fear that my immune system will become confused yet again, and instead of appropriately launching an attack against an invader mistakenly damage another gland or organ, is not unfounded. There are more than 100 autoimmune diseases, and, according to Maedica, a Journal of Clinical Medicine, “about 25 percent of patients with autoimmune diseases have a tendency to develop additional autoimmune disorders.”
Therefore, the idea of doing anything to further boost my immune system, such as receive a vaccination, is something that, personally, I’d prefer to avoid.
But I don’t live under a rock; I live with my husband and three children, all of whom are now, thankfully, attending in-person school and extracurricular activities. Any of them could unintentionally pass the virus onto me without knowing they are carriers, and, of course, I could pass it onto them.
Besides, I very much want to spend time in person with my friends and family. Because of Covid, I haven’t seen my dad in more than a year, and I look forward to once again traveling, attending live theatre productions, and going out to eat. I believe Covid is a real thing: friends have gotten sick, really sick, and though I have been spared thus far, I had pneumonia in the spring of 2019, and I remember how difficult it was to breathe. Respiratory illnesses are no joke.
Therefore, refusing the vaccine was never a real option for me. But I consider it the lesser of two evils: both Covid and the vaccine would stimulate my already over-stimulated immune system.
As I watched my dad, sister, brother, and friends, often on social media with their “I got vaccinated selfies,” I began to wonder when it would be my turn. Another friend and her family had gotten sick; more pernicious variants of Covid were on the rise. Meanwhile, my husband and I are hoping to take a canoe certification class that entails driving to Virginia this spring. We had planned to take the class last year, in celebration of my 50th birthday, and had even arranged months in advance for my sister to watch our kids, an amazing birthday present!
Alas, like so many other events, it was canceled, but we recently learned that the class would be offered this spring. How could we travel out of state without being properly vaccinated?
So I wrote to my internist at the beginning of March to ask if I would qualify for the Covid vaccination because of my Hashimoto’s diagnosis. He responded, “Unfortunately, Hashimoto’s does not qualify as a high-risk condition,” to which I replied that I actually found it comforting that Hashimoto’s did not count as a “high-risk condition!”
Meanwhile, the American Thyroid Association has advised, “People with thyroid conditions, including autoimmune thyroid disease and thyroid cancer, should receive the Covid vaccine if they are medically stable.” Similarly, the Society for Endocrinology has encouraged patients with endocrinology disorders to get vaccinated, stating, “We are not aware of any specific side effects of a COVID-19 vaccine that would be unique to people with endocrine conditions or diabetes mellitus, in the same way as there are no concerns about other vaccines.”
Still, hearing that one is not aware of any side effects or risk is not the same thing as no risk. That’s what I shared with my friend Laurie, with whom I had recently gone cross-country skiing, when she called me in mid-March to tell me that she had just gotten her shot. When I confided that I was still debating whether or not to — because of my Hashimoto’s — she told me that she’d discuss my concerns with her friend, Dr. Everett Schlam, an MD, who has been following the vaccine rollout closely.
Five minutes later she called me back. “Did you know that Hashimoto’s is one of the most common autoimmune diseases?” she asked when I picked up.
“Ah, yes, Laurie, I’m well aware,” I said, thinking of how so many of my female friends and colleagues have a “Hashi’s” diagnosis, and how Andrea Nakayama, the founder and CEO of the Functional Nutrition Alliance, had made this diagnosis a whole lot less scary to me when I had taken her “Girls Guide to Hashimoto’s,” back in 2015, which set me on an utterly new trajectory of health and wellness.
As it happened, earlier in March, Andrea, who certified me in 2018 as a Functional Nutrition and Lifestyle Practitioner, stated at our monthly group meeting that she herself was planning to get vaccinated, perhaps the strongest vote of confidence, in my circle, for the vaccine.
As I pondered this, Laurie said. “I just asked Everett, and he says you have nothing to worry about. Thousands of people with Hashimoto’s have gotten the vaccine and there have been no adverse effects.”
I considered that. Of course, my internist had told me the same thing, but for weeks, months, really, I had been sharing my concerns about a potential Covid vaccine with colleagues and fellow parents. Let’s face it: these vaccines might be effective, but can we really know if they are safe after just a few months?
On the other hand, there have also been studies that show that getting Covid-19 is itself a risk for autoimmune disorders. The symptoms of “long Covid,” which include fatigue, brain fog, and depression, sound eerily similar to the sometimes difficult-to-pin-down symptoms of autoimmunity.
I could have spent months going down this rabbit hole, but time was not on my side. Just when I thought the numbers were decreasing, there was a spike in cases in my area. Some schools in our district went remote again for a couple of days; my daughters’ respective softball practices and tennis lessons that had just started were abruptly stopped. A family of four nearby all came down with cases that ranged in severity.
A week later, on Monday, March 22, New York Governor Andrew Cuomo announced that 50-year-olds and up would be eligible for the vaccine starting the very next day.
I surprised myself by jumping into action and scouring the Internet for available test sites, only to receive the reply, “No appointments available.”
When I shared this with my friend Kate, one of the volunteers helping to secure vaccine appointments for New Yorkers, she was able to see that spots had opened at the hospital located three miles from my house. I signed up for an appointment for 2:16 pm the next day — easy peasy! I was going to get my shot!
I arrived at 2, but as soon as I got into the hospital, I realized that I probably had not left enough time. My teenage son was scheduled to meet with a new pediatrician for his annual physical later that day, and I had signed up for the slot thinking that everything would run on time.
It did not. The line was long; there were forms to complete, and I was told I would need to wait for 15 minutes post-vaccination so that I could be monitored for any immediate after-effects. Ultimately, I had to get out of line. I did not want to be late for my son’s appointment.
Before I left, I asked if I could return later in the day.
“We close at 3,” the line coordinator said with an apologetic look, even though I was the one who should have considered beforehand that there would be a wait. “How about you come back first thing tomorrow,” she offered.
So, on Thursday, after dropping off my son at school, I promptly drove to the hospital. I was told to wait outside, as I was one hour early. I also happened to be the first person in line. I listened to Mark Bittman’s excellent Animal, Vegetable, Junk on my iPhone while I jogged in place. Exercise, after all, is good for the immune system.
At 8:30, I texted Kate, “More than 20 people in line. . . glad I got here early!”
She wrote back, “En boca al Lupo!”
She had already texted me the day before to keep my day light — which I was already planning to do — as well as to get the shot on the side of my body that I don’t sleep on, which hadn’t occurred to me.
By 8:55, when the staff finally opened the door, more than 30 people had gathered. To my dismay, almost all of them were invited to go ahead of me, since they were there for their second dose. I later learned that syringes had been prepped first for those getting their second shot.
It was not a pleasant scene to witness. Much as I had tried to stand six feet in front of the second person in line, there was a stampede to the door when the receptionist started calling people up in small groups. People hovered around me, jockeying for space in an already narrow area. One woman kicked me with her cane, most likely unintentionally in her exuberance to get her second dose.
When I suggested that people “wait to be called,” since the hospital staff had asked for three people to come forward, not ten, another woman told me I should “go stand in the back of the line where I was supposed to be,” even though I was standing exactly where I had been told to stand, before everyone else arrived.
At that point, I turned to the man who had been patiently waiting behind me, and said, deadpan, “they say we’re all in this together,” which made us laugh.
Finally, we first-timers were admitted inside the hospital. But when I explained that I didn’t have an appointment, the receptionist nearly turned me away. She wanted to know exactly to whom I had spoken to the day before, but alas, in my hurry to collect my son, I had neglected to get the person’s name. I was tempted to tell her if they didn’t give me the jab now, I might not come back. Fortunately, the woman taking people’s temperatures remembered me, and I was allowed to proceed.
The shot itself was a non-event. It wasn’t painful, barely a pinch.
Of course, I knew that I could have symptoms starting later. Several friends have reported fevers and chills after the second dose of Moderna, the vaccine that I got. If that happens, I plan to let the fever run its course. I’m not going to try to stop it with ibuprofen or acetaminophen, as I understand that fever is the body’s way of protecting itself. Besides, NSAIDs (nonsteroidal anti-inflammatory drugs) have been shown to cause a “leaky gut,” which could potentially trigger a downstream autoimmune disease, perhaps not immediately but years later.
Supporting or modulating, not boosting, my immune system with nourishing meals, a few key supplements, sound sleep, and gentle exercise is perhaps the most powerful thing I can do right now — it’s how, in large part, I’ve been able to successfully manage my Hashimoto’s. It sounds so easy, but we all know it takes work, every single day. This is how we can build what Dr. Elisa Song, MD, a holistic pediatrician, calls, “immune resilience,” which is necessary for all of us, whether or not we choose to be vaccinated. Indeed, had I not been feeling so well, so resilient, I may very well have decided to postpone getting vaccinated, in exchange, for continuing to shelter in place in a semi-quarantined state.
I’m grateful that we have several vaccinations that appear to be working well; given where we were a year ago, it feels nothing short of miraculous. But I’d be lying if I said that I don’t have concerns about the long-term effects of these vaccinations.
I appreciate how the Center for Disease Control and Prevention is continuing to collect information regarding any side effects the vaccines may cause. Every day for one week after receiving the vaccine, I logged onto my “v-safe check-in” in order to respond to a series of short, multiple-choice questions, sent by the CDC via text to my iPhone. I understand they will continue to monitor me, once a week, for the next several weeks as well. Save for some very minor soreness at the injection site that lasted for the first 36 hours, I’ve had nothing notable to report thus far.
In addition to asking these generic questions about post-vac side effects, it is my hope that the CDC will examine the long-term effects of the Covid vaccinations in individuals with autoimmune disease, including Hashimoto’s. The “v-safe check-in,” for example, did not even ask if I have an autoimmune disease.
With better information in the future, I will feel even more confident that my small act toward the achievement of herd immunity — and my family’s well-being — was in fact the right choice for my individual health as well.