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

 

 

56 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.

    • Hi, I just got my booster at walgreens today. Just check off 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

        • Haha! Love it!

        • Back before I had type 1 diabetes, and I had to learn an immunology class an easy pneumonic to differentiate type 1 from type 2, I thought the “1” looked like an insulin syringe, where exogenous insulin is required for survival, and type “2” looked like a bent insulin syringe, since insulin is either optional or it’s bent from all the insulin **resistance**.

    • Hey Cathy, I was 32 when dx with Type 1. SO misleading as Type 1 and Type 2 are not the same disease. My brother, father and son all have Type 1 as well and it was called Juvenile diabetes decades ago but that is a misnomer and they really should reclassify each condition. I wish exercise and diet would get rid of my diabetes!!!

  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.

  17. Thank you for the info. As a T1D and an RN in the emergency department I appreciate the support in getting a booster.

  18. I’m a type 1 diabetic. It has been approximately 7 months since my second dose of Moderna. I made an appointment with Giant grocery/pharmacy and was denied for a 3rd shot, once I arrived, because I did not meet their immune deficiency requirements. I just want the 3rd shot so I have less to worry about. 🙁

    • Moderna boosters aren’t currently available. This is from the CDC website under frequently asked questions:
      https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html

      The Advisory Committee on Immunization Practices (ACIP) and CDC’s recommendations are bound by what the U.S. Food and Drug Administration’s (FDA) authorizationexternal icon allows. At this time, the Pfizer-BioNTech booster authorization only applies to people whose primary series was Pfizer-BioNTech vaccine. People in the recommended groups who got the Moderna or J&J/Janssen vaccine may need a booster shot. More data on the effectiveness and safety of Moderna and J&J/Janssen booster shots are expected soon. With those data in hand, CDC will keep the public informed with a timely plan for Moderna and J&J/Janssen booster shots.

  19. Ah, sorry. I was talking about a 3rd dose of Moderna, not a booster. Those with compromised immune systems are allowed to get a 3rd dose, but I was denied because for some reason diabetes was not listed as one of the immune issues that grant you the ability for a 3rd dose of Moderna. This website helps explain it. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/booster-shots-and-third-doses-for-covid19-vaccines-what-you-need-to-know

    • You should be able to get it now. Tell them you are immunocompromised and if one pharmacy turns you down, try another pharmacy. Shop around.

  20. I am 75 an at risk patient with diabetes. Why was I truned down the booster. I had my 2 shots in March.

    • Try going to another pharmacy and just tell them you are immunocompromised, but also because of your age, you should be able to get the booster regardless.

  21. It was announced today that Maderna Boosters are now available to the immunocompromised. I called my Dr’s office to schedule a shot and was turned down. I am a Type One Diabetic with A1C of 8.2 and lost my thyroid to Cancer in 2009. I don’t understand. Tim Neeley

    • Hi Timmy,
      If you haven’t already, I would check again. You should be able to go now without issues. And if you get turned down from one location, shop around and try other pharmacies.

  22. Hello! Thank you for all of your interesting articles! Now that Moderna is offering a lower dose for the booster, do you still think people with Type 1 diabetes should get the full dose third shot, or the lower dose booster? I am guessing you will say the full dose third shot, but I just wanted to check because your article came out before they started recommending the booster as a lower dose.
    Thank you!

  23. I just received my 2nd Pfizer. No problems. I am T2, and a stroke survivor with thyroid disease as well. Was told I qualified for the booster but wasn’t told when

  24. How much A1C that qualify for the booster shot?

    • If you want to get the booster shot and you are asked about your medical situation, tell them you are immunocompromised.

  25. I took my booster shot today I have type 2 diabetes the pharmacist only gave me half of the booster vaccine I would like to know is that accurate

    • Yes it’s accurate, and people who get the full dose are the ones who have extraordinary risk, such as working with covid patients, or they’re getting chemotherapy. Congrats on being very protected.

  26. Our son is T1D and 17.5 y.o. So far, no one will give him the 3rd dose. His Pediatric Endo said, “if we can get it, get it” We will be travelling for the holidays and wanted him boosted. We, the parents, are boosted because he has t1D and would be the caregivers if he had a breakthrough. However, we have been denied 3x now because he’s not 18yo even when I check off “immunocompromised”. Getting frustrated because they let us make the appt and then when we arrive, we get turned down. What a time sucker, but willing to continue to shop around. Just keep shopping? Or is this a dead end for now?

    • It is not a dead end. You should keep trying different pharmacies – even ones that are the same company (a different Walgreens location, for instance) because every pharmacist is different. I’m confident you’ll find a healthcare institution that will give the shot to your son.

      • Thank you!!! We finally found a local pharmacy willing to give him his 3rd dose. Apparently, I kept checking off “booster” so they wouldn’t give it to him. They said to check off “immunocompromised” and they allowed it. Who knew? What is the difference between 3rd dose and booster? Either way, he was “boosted” yesterday!!! We can exhale now. Thank you again!!!!

Leave a Reply