Information for Special Populations and the COVID-19 vaccine

COVID-19 can cause severe medical complications and lead to death in some people and vaccination can help protect you and others around you from COVID-19.  In certain circumstances, people may be advised by their doctor to receive a specific type of COVID-19 vaccine or to delay vaccination due to immunosuppressing medical treatment or surgery to a future date when immunization is more likely to have an effective immune response. Pregnant and lactating people are encouraged to speak with a healthcare provider about COVID-19 vaccine should they have questions.

Can people with allergies get the COVID-19 vaccine? Yes, in most cases with 2 exceptions:

  1. People with a severe allergic reaction (anaphylaxis) to any component of either an mRNA vaccine or the Johnson & Johnson COVID-19 vaccine should NOT receive that vaccine. Many people will be safely able to receive an alternate vaccine. An allergic reaction is considered severe when it is classified by a healthcare provider as an anaphylactic reaction or a person needs to be treated with epinephrine or EpiPen© or if the person must go to the hospital.

If You Are Allergic to Polyethylene Glycol (PEG) or Polysorbate

  • PEG and polysorbate are closely related to each other. PEG is an ingredient in the mRNA vaccines (Pfizer and Moderna), and polysorbate is an ingredient in the Johnson & Johnson (J&J)/Janssen vaccine. If you are allergic to PEG, you should not get an mRNA COVID-19 vaccine. Ask your doctor if you can get the J&J/Janssen vaccine.
  • If you are allergic to polysorbate, you should not get the J&J/Janssen COVID-19 vaccine. Ask your doctor if you can get an mRNA COVID-19 vaccine.

2.  People with a severe allergic reaction (anaphylaxis) to any vaccine or injectable (intramuscular or intravenous) medication should consult with their health provider to assess risk prior to receiving the COVID-19 vaccine.

More information about allergies and the COVID-19 vaccines can be found on the Centers for Disease Control and Prevention website. The medical exemption request forms must be accessed on the Yale Vaccine Portal, then uploaded once completed prior to being submitted to the university’s COVID-19 Vaccine Medical Exemption Review Committee. Learn more about the exemption request process here. 

Everyone else with severe allergic reactions to foods, oral medications, latex, pets, insects, and environmental triggers can  get vaccinated against COVID-19.

People with severe allergies require a 30-minute observation period after vaccination, while all others must be observed for 15 minutes. Vaccine clinics have safety protocols in place to respond to any adverse reactions.

If I am pregnant or breastfeeding? 

The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM), the two leading organizations representing specialists in obstetric care, recommend that all pregnant individuals be vaccinated against COVID-19. The organizations’ recommendations in support of vaccination during pregnancy reflect evidence demonstrating the safe use of the COVID-19 vaccines during pregnancy from tens of thousands of reporting individuals over the last several months, as well as the current low vaccination rates and concerning increase in cases.

COVID-19 vaccines have been studied in animals both before and during pregnancy and found no safety concerns. Pregnant individuals were included in clinical trials and thousands more have been vaccinated since the vaccines became available. Early data from safety monitoring systems did not identify any safety concerns for pregnant people who were vaccinated or for their babies. The CDC is continuing to collect data on vaccinated pregnant people through the v-safe COVID-19 Pregnancy Registry.

There are no data on the safety of COVID-19 vaccines in breastfeeding people or on the effects of mRNA vaccines on the breastfed infant or on milk production/excretion at this time. However, mRNA vaccines are not thought to be a risk to the breastfeeding infant. There is evidence of  robust secretion of protective antibodies in the breastmilk of people vaccinated with mRNA COVID-19 vaccines suggesting a potential protective effect for the breastfed infant.

If you are pregnant or breastfeeding you may wish to discuss the benefits and risks of the vaccine balanced with the risks of COVID-19 infection with your healthcare provider. While a conversation with your healthcare provider may be helpful, it is not required prior to vaccination.

We encourage pregnant and breastfeeding people to discuss COVID-19 vaccination with their health care provider prior to requesting medical exemption. The medical exemption request forms must be accessed on the Yale Vaccine Portal, then uploaded once completed prior to being submitted to the university’s COVID-19 Vaccine Medical Exemption Review Committee. Medical exemption for pregnancy, planning pregnancy or breastfeeding will be granted on a temporary basis and is subject to reassessment. Learn more about the exemption request process here.

Is the vaccine as effective in people with suppressed immune systems? Specific efficacy and safety data are not yet available for people with immunosuppression (weakened immune system) due to medications or chronic illness. People who are immunocompromised are recommended to be vaccinated in most cases as they are at higher risk for severe complications from COVD-19 infection. Those who are vaccinated should be counseled on the potential for reduced immune responses and the need to continue to follow all current guidance to protect themselves against COVID-19. If you are immunocompromised you and your doctor can decide together by weighing the benefits and risks. If you and your health care provider feel that it is appropriate to pursue a request for medical exemption, you must access and submit the form on the Yale Vaccine Portal once completed. Medical exemptions may be granted on a temporary basis and are subject to reassessment. Learn more about the exemption request process here.

Should people with autoimmune diseases receive COVID-19 vaccine?

People with autoimmune conditions are at higher risk for severe illness from COVID-19 infection and vaccination is recommended in most cases.  If you have an autoimmune disease, consult with your healthcare provider to discuss the risks and benefits of vaccination. If you and your health care provider feel that it is appropriate to pursue a request for medical exemption, you must access and submit the form on the Yale Vaccine Portal. Medical exemptions may be granted on a temporary basis and are subject to reassessment.

Can children get the COVID-19 vaccine?  The Pfizer mRNA vaccine is currently authorized for people 12 years and older. The Moderna mRNA vaccine and J&J vaccine are currently authorized for people 18 years and older. Learn more about COVID-19 vaccination for children here. 

Should I get the COVID-19 vaccine even if I’ve already had COVID-19?

Yes. The extent to which antibodies that develop in response to COVID-19 infection are protective is still under study. If these antibodies are protective, it’s not known what antibody levels are needed to protect against reinfection. Therefore, even those who previously had COVID-19 can and should receive the COVID-19 vaccine.

I was recently diagnosed with COVID-19 can I receive the vaccine? 

Yes, for Dose #1 you can be vaccinated four weeks after onset of symptoms or a positive test (whichever is earlier). For Dose #2 you may be vaccinated after you have completed your isolation period. Isolation is for 10 days or 10 days plus 24 hours with no fever and an improvement in symptoms.

Updated August 18, 2021.