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By Jennifer Crystal In my “I Have Lyme Disease. Should I Get the COVID-19 Vaccine?” post, I addressed the question many Lyme patients have been asking. These patients are understandably concerned, wondering if the vaccine might spur their already highly activated immune systems into a Lyme flare-up. Unfortunately, there’s no set answer to this question, as Drs. Daniel Cameron and Casey Kelley recently noted in the GLA webinar “COVID-19 Vaccines and Lyme Patients: What You Need to Know”. As with Lyme disease itself, each case is different. The way a person’s immune system responds to a COVID-19 vaccine depends on a variety of factors; for patients with tick-borne illness, it depends what phase of disease they’re in, what state their immune system is in, and what other underlying health conditions might be at play. There are risks and benefits to consider for each individual patient. “Instead of telling patients what to do, we need to weigh risks and benefits with them, and decide with them,” Dr. Cameron said. In my own case, my doctors and I decided that the benefits of the vaccine outweigh the risks, so I got my first dose of the Pfizer-BioNTech vaccine last Monday. This post will address the question many of you have asked: how did it go? Spoiler alert: relatively well, all things considered! But before I go into details about my experience, it’s important that I establish where I am as a patient. I have had Lyme disease and babesiosis since 2005, though the infections were undiagnosed for eight years prior. I also had ehrlichiosis (now cleared up), and have had chronic active Epstein-Barr virus since 2003. My Lyme disease and babesiosis have been in remission for over a decade, with occasional flare-ups, particularly of babesiosis. I still take low-dose maintenance medications, follow certain dietary and lifestyle needs, and do adjunct therapies to keep my infections at bay. In addition to being a tick-borne illness patient, I am also a COVID-19 long-hauler. I got COVID-19 in March 2020 and was symptomatic (fever, coughing, shortness of breath, loss of taste and smell) over a period of four months. I received a positive COVID-19 antibody test in June 2020. Though I am otherwise recovered and back to my usual life, I still struggle with residual pulmonary symptoms including shortness of breath, chest soreness, and occasional bounding heartbeat. An important question that was raised in the webinar, and that many patients have asked me is, “Why get the vaccine if you already had COVID-19 and have immunity?” The answer is that from what we know so far, COVID-19 antibodies only last three to six months. Dr. Kelley noted that if a person got the COVID-19 vaccine right after having the illness—say, two weeks later—there might be an increased risk of a cytokine reaction. For those of us who recovered from COVID-19 a while ago, that risk, and our antibodies, are likely decreased or gone. With that setup, I decided to get a COVID-19 vaccine. The injection itself was fine. I felt a small prick and, like most people, had soreness in that arm that felt stronger than the soreness I’ve experienced with a tetanus shot. It hurt to touch, move, or lie on that arm for a couple days, but over the course of the last week, that pain has dissipated. I also experienced swelling and redness at the injection site, which has also now gone away. I got my shot at 5:00 p.m. on a Monday. Within a few hours, I began to experience slight nausea and achiness. This feeling continued through the next morning. By about 10:00 a.m. on Tuesday, I felt like I had a mild flu: chills, achiness, headache, and fatigue. I did not run a fever. While these symptoms did prevent me from working for the rest of that day, they did not completely fell me the way Lyme or COVID-19 symptoms did (nor did they feel similar to either of those illnesses). Ibuprofen helped with the headache and body aches (I took ibuprofen because I am allergic to acetaminophen). By Wednesday, the chills were gone and the headache and achiness had dulled. I felt a little weary and woozy, but was able to work that day and teach a remote class that night. I felt the same way on Thursday morning, with a very slight headache. At 6:00 p.m., right at the 72-hour mark, I suddenly felt completely better. I have been fine since, and have returned to regular activity. In the GLA webinar, Dr. Kelley talked about ways to “try to reduce negative response and increase positive response” to a vaccine. In addition to eating well (it’s an especially good time for anti-inflammatory diet), getting enough rest, moving in whatever way is possible for you (Dr. Kelley acknowledged that for some Lyme patients, taking a shower might be the most exercise they can do in a day), and managing stress and anxiety, Dr. Kelley also recommended supplements such as glutathione, zinc, probiotics, fish oil, and vitamins A, C, and D. I did increase some of my immune supplements for a few days before and after the vaccine. Only your doctor can decide which supplements, and what dosing, would be best for you (for an explanation of why it doesn’t help for me to give out my own ever-changing protocol, please read this post. Anecdotally, I have heard that the second dose of a COVID-19 can be worse than the first. I know several people who were in bed for a couple of days after their second dose. Do I worry that I might be bedridden longer than a couple days, or that the second dose might cause more of an immune reaction or a Lyme flare-up? A little, but I worry much more about getting COVID-19 again. As Dr. Cameron said, “Yes, the vaccine can touch your immune response, but so can COVID-19 itself.” After four months of COVID-19 and a year of residual symptoms, I’ll take what will hopefully be only a few days of feeling sick, and what will hopefully be long-term protection. I will write with an update after my second dose! For more blogs, click here
jennifer crystal_2 Opinions expressed by contributors are their own. Jennifer Crystal is a writer and educator in Boston. Her memoir about her medical journey is forthcoming. Contact her at  lymewarriorjennifercrystal@gmail.com .
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