Should People with Diabetes Get the COVID-19 Booster Shot?

COVID-19 Booster: General Info & Guidelines

The COVID-19 booster shot is recommended for certain conditions (described below) eight months after the second Moderna or Pfizer injection. It is the same dose as the first two injections, and you cannot switch from Moderna to Pfizer or vice versa. The CDC says that breakthrough COVID-19 cases in fully vaccinated individuals start to rise after eight months, hence the recommended timetable. There are no guidelines yet for the Johnson and Johnson COVID-19 booster dose.

The general guidelines on who should receive the COVID-19 booster vaccination are individuals who are immunocompromised (e.g. anyone taking immunosuppressants for a kidney transplant or anyone receiving chemotherapy). There’s a long list of medical conditions that lead to a compromised immune system. Anyone over 70 years old is also considered high risk for a poor outcome from COVID-19, with or without comorbid conditions such as heart and kidney disease.

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease, and it’s high on the list of conditions that cause someone to be immunocompromised. Susceptibility is even worse for people with poor glucose control. Although the exact level of poor control (indicated by an elevated A1c) is not known, above 8% is generally considered poor glucose control.

Type 2 Diabetes

Type 2 diabetes is not an autoimmune condition, but the literature is very clear that poor glucose control in people with type 2 is associated with an immunocompromised state. Both type 1 and type 2 diabetes are associated with a higher rate of COVID infections and poorer outcomes.

Taking all these facts into consideration, we believe anyone with any type of diabetes should be eligible for the COVID-19 booster vaccination. Jeremy and I are both type 1s and recommend the booster to our brethren.

Potential Side Effects

Potential side effects of the booster shots are similar to the first two injections of either the Moderna or Pfizer vaccines. Common sides effects include injection site pain and swelling, fatigue, headache, and chills that may last up to a few days. It is impossible to predict if you will experience any side effects, or how hard they will hit if you do have them. Be prepared with Tylenol and flexible work hours if possible. Rest and drink plenty of low caloric fluids.

The Seasonal Flu Shot

The viruses targeted by the flu vaccine are very different from COVID-19, and the flu vaccine can be taken within a short period of time before or after the COVID-19 booster injection. Whichever vaccine you receive first, it is probably a good idea to wait a few days until any symptoms (symptoms are the same for both vaccines) have dissipated. The CDC recommends getting the seasonal flu shot before the end of October, but anyone will still benefit until the end of January 2022.

Recap

Anyone with type 1 or type 2 diabetes is eligible for the Pfizer and Moderna booster shot eight months after your second injection. If your glucose control is poor, you should have a greater sense of urgency to get the booster. You can expect side effects to be similar to the initial doses. You should also get your flu shot as early as possible, but wait several days between your booster shot and the flu injection.

How and Where to Get the COVID-19 Booster

You can speak to your healthcare provider about getting a booster injection, but you can also call your local pharmacy or any healthcare institution administering COVID-19 vaccinations and make an appointment.  If asked why you are requesting a booster shot, the answer is simply, “I am immunocompromised.” If you get any pushback, be insistent, and let us know so we can call and straighten them out!

Steve and Jeremy

32 Comments
  1. I have type 2. I had to cancel a trip out of state Alaska air wouldn’t refund my money even though where I was going the virus is rampant. Michigan and Wisconsin. The home in Wisconsin is in quarantine. Any help?

    • Each airline has its own cancellation policy and you’ll need to work with them, perhaps they’ll at least give you a credit for another flight at another time.

  2. Thank you so much. I haven’t been wondering about this and what to do.

  3. I was told by Walgreens that my TD1 diagnosis did not qualify me for the booster

    • Go to Google, and type in “Is type 1 diabetes an immunocompromised condition?” There are lots of articles. Print them up, bring them in and say your doctor said you are immunocompromised.

  4. Thanks! So helpful.

  5. T1d for 54 years. Was in hospital post farming accident. Had respiratory arrest when given med with PEG, TWICE. AFRAID TO DO VACCINE. SO STAY HOME ALOT. ANY OTHER ADVICE.

    • I am ignorant on what PEG is, but I’d ask your physician if there’s any relation to what you’re referring to and the COVID vaccine.

  6. Could someone work on renaming of Type 1 (Juvenile) and Type 2 Diabetes. It’s all so confusing to people!
    People said I was too old to get “Juvenile” Diabetes. They also said that they had heard I could get rid of Diabetes by doing exercise and dieting! I had a doctor tell me in the ER when I had a bad low that if I was his patient he would take me off insulin!
    Most people don’t realize Type 1 is an autoimmune disease.
    I have had Type 1 since I was 38 years old. I am now 74!
    Cathy

    • Cathy, I’m afraid we’ll always have to be diabetes educators ourselves. Before I became Type 1 diabetic, I didn’t know the difference, either. Now, having to educate a doctor – that is something new!

      Be blest,

      Leila

    • Really great to hear from you and your stories. Send some name suggestions and I’ll work on it!

      • Hi Dr Edelman! What do you think about these name suggestions:

        T1D = This Sucks (TS)
        T2D = This Sucks Too (TS2)

        Thought you and a few others might like them but we share a very small portion of a Venn diagram.

        : )

        Mark R

  7. Thanks for comments!
    What about they who has been vaccinated whit the chinese vaccine?
    Are there some guidelines for that?
    🙂
    Ana

  8. What booster should I get if I received Johnson and Johnson CoVid vaccine at UCLA ?

  9. Good morning! I went to my RiteAid on Clairemont Dr on 9/17 and was told DM1 is not on the list of immuned compromised patients?

    • Go to Google, and type in “Is type 1 diabetes an immunocompromised condition?” There are lots of articles. Print them up, bring them in and say your doctor said you are immunocompromised.

  10. Thank you, this articles was very helpful.

  11. This is exactly the succinct advice I was looking for! Thank you!

  12. Thank you for this. Clear and informative. I’ve spent a long time trying to determine whether or not as a well controlled T1 I am still at higher risk. Now I know. I would very much appreciate an update for J and J when you know. I love finding reliable resources!

  13. Pharmacist I consulted checked online with a pharmacy site, and said that I could receive both quadrivalent flu shot and COVID-19 booster at the same time.

    Told her I also take Cosentyx (2 pens/month) so I timed the above injections to be 15 days after the last Cosentyx use. Apart from some soreness at the injection sites, no problems.

  14. Can you address pigmentary glaucoma? I run 5 times per week (4 miles each) and ride my bike at least one time per week (50 miles). I was just diagnosed with this and it is associated with activity. My eye doctor told me not to quit exercising. What are your thoughts? Am I making it progress more quickly by continuing to exercise? I don’t know how well I will be able to manage my diabetes type 1 without exercise. I have had type 1 since the age of 32 and I am 61 years old.

    Thank you.
    Bernadette Henrichs (henrichsb@wustl.edu)

  15. Why is there no mention of an antibody test before getting a booster shot?…

    Please respond

  16. I am a 75 y.o. female. My doctor says I am pre-diabetic. I am on Metformin as part of treatment for stroke prevention. Can I qualify for a COVID 19 booster? I had the Pfizer vaccine in March.

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