When the U.S. Food and Drug Administration (FDA) approved the Pfizer/BioNTech and Moderna COVID-19 vaccines in December 2020, people living with autoimmune conditions like rheumatoid arthritis (RA) had many questions about safety and effectiveness. Today, with years of research and millions of doses of the vaccine administered, health experts can provide clearer guidance about how the vaccine affects people with RA.

If you’re wondering how the COVID-19 vaccine may affect your RA or interact with your medication regimen, we have answers. Here’s what experts and recent research say about the safety, timing, and effectiveness of COVID-19 vaccination in rheumatoid arthritis.

Should People With RA Get the COVID-19 Vaccine?

The answer is yes. Health experts strongly recommend that people with RA receive the COVID-19 vaccine, unless they have a known allergy to one of the vaccine ingredients. According to the American College of Rheumatology (ACR) and the Centers for Disease Control and Prevention (CDC), the benefits of the vaccine far outweigh the risks for people who are immunocompromised. Health experts agree that people with rheumatoid arthritis are at greater risk of being infected with COVID-19 and having severe complications, including hospitalization.

“The vaccine helps prevent getting the infection, but more importantly, it really does a great job in terms of preventing very bad consequences from COVID infections,” says Dr. Siddarth Tambar, a rheumatologist at Chicago Arthritis and Regenerative Medicine, where he has specialized in rheumatology and regenerative medicine since 2008.

Dr. Tambar emphasized the importance of getting vaccinated if you’re living with rheumatoid arthritis: “There is still a higher risk for severe COVID-19 disease in our autoimmune patients who are on medications, so there is still a definite need for people to get vaccinated. You should speak with your physician if you have an autoimmune condition, but with very few exceptions, I would say the vast majority of our patients should be getting vaccinated.”

“The vaccine helps prevent getting the infection, but more importantly, it really does a great job in terms of preventing very bad consequences from COVID infections.”

— Dr. Siddharth Tambar

Per expert opinion, there are no known reasons why people with rheumatoid arthritis shouldn’t receive the COVID-19 vaccine.

What about if you’ve already had COVID-19? One myRAteam member and COVID-19 survivor wrote, “I already had coronavirus, and I do not want it again, so I will take the vaccine.”

The CDC recommends staying up to date on your COVID-19 boosters, even if you’ve already had COVID-19. If you’ve recently recovered from COVID-19 infection, you can consider waiting up to three months to get your next shot, but delaying it isn’t necessary.

Is the COVID-19 Vaccine Safe for People With RA?

Yes, studies have shown that the COVID-19 vaccines are safe for people with rheumatoid arthritis. Most side effects are short-lived and mild, such as flu-like symptom, fatigue, and headache, as well as soreness at the injection site. Some people may experience a temporary worsening of their symptoms, but severe side effects are rare.

“I have felt a lot more reassured as data has come out with the vaccines that are available in the United States, when it comes to safety and efficacy, how the vaccines are actually made, and how they work,” Dr. Tambar shared. “So while I understand people’s concerns, it’s a low-risk intervention with very high potential for positive results and benefits.”

If you’ve had allergic reactions to other vaccines in the past, talk with your doctor. Even people with a history of reactions to flu vaccines can usually still receive the COVID-19 vaccine safely, though they may be monitored for a longer period after the shot. However, if you’ve had a severe allergic reaction to the COVID-19 vaccine in the past, you shouldn’t get that same type of COVID-19 vaccine in the future.

Is There a Link Between Rheumatoid Arthritis and the COVID-19 Vaccine?

If you’ve wondered whether COVID-19 vaccines can trigger RA or RA flares, you’re not alone. Current research shows that disease flares after vaccination are uncommon in people with preexisting RA and usually mild if they do occur. Some people report an uptick in their RA symptoms after the COVID-19 vaccine.

However, a 2022 review published in Arthritis & Rheumatology found that rates of flares following vaccines were low and didn’t lead to long-term issues for most people with inflammatory arthritis. Overall, there doesn’t seem to be a relationship between the COVID-19 vaccine and rheumatoid arthritis.

Do RA Medications Change How Well the Vaccine Works?

“Theoretically, some medications for RA may reduce the effectiveness of the vaccination,” said Dr. Tambar. In general, vaccines are slightly less effective in people who are on immunosuppressive medications for their RA.

The American College of Rheumatology has come out with guidelines recommending some adjustments on the timing of certain medications. Holding off from some of these medications temporarily after getting vaccinated can allow you to avoid limiting the effectiveness of the vaccination.

The recommendations are:

• If you’re on methotrexate, hold your methotrexate for one week after getting each vaccination dose.
• For the JAK inhibitors, such as upadacitinib (Rinvoq) and tofacitinib (Xeljanz), hold for one week after each vaccination dose.
• For rituximab (Rituxan), it’s recommended to get the first vaccination dose four weeks before an infusion, then hold for two to four weeks after the second vaccination dose.
• For cyclophosphamide, try to schedule the infusions one week after each vaccination dose.
• For abatacept (Orencia) injections, hold for one week before and one week after the first vaccination dose only.

For all the other medications, there are no recommendations to change the dosage schedule.

According to Dr. Tambar, people with RA should touch base with their rheumatologist to make sure that they can delay their treatment appropriately. “It gets a little bit complicated when you talk about people who have active disease,” he said. “But in coordination with your rheumatologist, try to schedule these medications if possible.”

What about people taking high-dose corticosteroids for an active RA flare? “Is it possible that steroids such as prednisone could blunt the effectiveness of vaccination?” Dr. Tambar asked. “Possibly — but you should still be vaccinated. At this point, I would not delay vaccination, and I definitely would not stop steroids. If you have a very active autoimmune issue that requires staying on medication, I would 100 percent continue medication and get vaccinated as well.”

Health experts agree that COVID-19 vaccines are considered more effective when given to people who aren’t in an active flare.

Which COVID Vaccine Is Best for Rheumatoid Arthritis?

As of 2025, there are three brands of the COVID-19 vaccine offered in the U.S.: Pfizer, Moderna, and Novavax. They target the virus in different ways. All three of those vaccines are considered safe and effective for people who are immunocompromised.

Pfizer and Moderna vaccines are mRNA vaccines. This type of vaccine gives your cells instructions for how to make a protein found on the surface of the virus. After being vaccinated, the body’s cells begin making these protein pieces, allowing your immune system to create antibodies. If you get exposed to COVID-19, your body will be prepared to fight the virus when it sees those same proteins on the surface.

Instead of providing the instructions for the protein, the Novavax vaccine directly supplies the protein, skipping that first step.

Some people worry that the vaccine contains live coronavirus. Dr. Tambar assures us that that’s not true. “You’re not being exposed to the full virus. You’re just being exposed to a very tiny bit of mRNA, which is a small bit of genetic code that your body then uses to create a key protein in COVID-19, and your body reacts to that protein,” he explained. “It helps your body develop a reaction to COVID.”

What Is the Current Recommended Vaccine Schedule?

For the average person, COVID-19 vaccines are now being offered as an annual vaccine during the fall and winter season, similarly to the flu vaccine. However, if you’re living with RA or another immunocompromising condition, your doctor may recommend getting boosters more often. Ask your doctor when you should get your next dose.

What Are myRAteam Members Saying About the COVID-19 Vaccine?

Many members of myRAteam have shared their COVID vaccine experiences:

• “I feel like a weight has been lifted and there is light at the end of the tunnel.”
• “I’m a nurse and have seen too many deaths — I believe I made a great decision.”
• “I had COVID and don’t want it again. I’ll take my chances with the vaccine.”

What Should You Ask Your Doctor About the COVID-19 Vaccine?

If you have questions about whether to get the COVID-19 booster or any other vaccines in the setting of your rheumatoid arthritis, talk to your doctor. “Don’t get too fearful with rumors and the unknown,” said Dr. Tambar. “Speak with your physicians, who have an understanding of your medical condition.”

Before getting your next COVID-19 vaccine, some questions to ask your doctor include:

• Should I pause or adjust any of my medications before getting the vaccine?
• How should I time my booster doses?
• What should I do if I experience a flare after vaccination?
• Is it better to wait until my current flare calms down?

Shared decision-making between you and your doctor is the best way to safely and effectively protect yourself from COVID-19. Overall, the vaccine is a low-risk and high-reward way to protect you from serious illness, especially if you’re immunocompromised.

Join the Conversation

On myRAteam, people share their experiences with rheumatoid arthritis, get advice, and find support from others who understand.

Are you living with RA and curious about the COVID-19 vaccine? Share your experience in the comments below.