The Covid Vaccine & Lyme Disease

Updated: 8/30/21

You should discuss the points raised in this article with your physician or other healthcare provider to make a decision about getting the vaccine. Marty Ross MD 

Covid-19 Vaccine & Lyme Disease

With the delta variant of Covid-19 running crazy, I am asked more frequently by my patients and others with Lyme disease or mold toxicity illness if I think they should get the Covid-19 vaccine.

My answer, for most people, is an emphatic YES!
There are some situations, based on a person's full medical history, that cause me not to recommend the vaccine. But having Lyme disease itself, does not disqualify a person from getting the vaccine. 

The Covid Vaccine Choice in Lyme Disease
All About Risks & Benefits

The potential benefit of the vaccine at preventing death, long covid syndrome, or major illness far exceeds any risk of harm from the vaccine. The risk of harm from Covid-19 - especially due to the delta variant - are real and very present.

There is not another option that will protect a person from death or serious illness from Covid-19 better than the vaccine. Supplements like zinc, vit D, or quercetin do not do this with such certainty. While they may help, they are not as effective as vaccines. Ivermectin, an anti-parasite medicine that may or may not work against Covid-19, is too much of a wild card at this time. 

Ivermectin Is Not the Best Answer

As for Ivermectin - the best I can say is maybe it will work to prevent or treat covid. I have read the science about Ivermectin. I do not trust it - in general it is very poor quality and largely created and organized by physicians acting more as Ivermectin cheerleaders rather than medical scientists. There are various types of bias in the majority of these studies. Worse yet, the Ivermectin supporters include a lot of unpublished and non-peer reviewed data making it so I cannot validate their findings. You can read more about the NIH review of science here. I agree with the NIH position indicating they cannot tell if Ivermectin works.

For the most part, the studies showing possible Ivermectin prevention benefits were done before the highly infectious delta variant. Even in these studies, a large number of people got infected when Ivermectin was used as a preventive.

Vaccine Choice - Which One?

I choose Pfizer or Moderna vaccines over Ivermectin because we have good science and real-world experience showing they work and that they are safe - plain and simple. To be clear, with Ivermectin - based on the poor science out there - who knows if it will work or how effective it is? 

I prefer the Pfizer and Moderna vaccines over the Johnson & Johnson vaccine because these have better effectiveness data and the Johnson & Johnson has rare blood clotting issues. I have no working experience with the AstraZeneca vaccine.

The Vaccine Appears Safe in Lyme Disease

After months of following my Lyme patients who chose to vaccinate, I can tell you the vaccine appears safe. People with Lyme tend to have the same vaccine side effects that people without Lyme do. This fact is supported by research conducted by lymedisease.org in its My Lyme Data project. You can read about the research here. In my experience I do not see Lyme relapses or ongoing declines in Lyme related to the vaccine. I do not see any new immune system illnesses triggered by the vaccine or immune compromise develop in people who have gotten vaccinated.

A few more points about vaccine safety. In the anti-vaxxer vortex there are many false arguments and statements that continue to circulate. I do not want to take this article to refute each of them. Instead take a look at the following two web pages that do a good job of refuting some of the bigger concerns.

• Feature Article: Long-term Side Effects of COVID-19 Vaccine? What We Know.
• Escaping COVID-19 Vaccine Hesitancy 

One false claim rebuked in these articles is that there are long term side effects that are going to develop in the vaccinated at some time in the future. There is a good argument against this claim: in all vaccines against infection, by two months of use all bad outcomes occur. In other words, by now, given how many people have recieved the vaccines in the Lyme world, we would know if it was dangerous to take the vaccine. And the real world experience since early this year is that these vaccines are safe. 

Manage Your Cytokines

Keep in mind, the covid vaccines - any of them - will trigger your immune system to make more cytokines. As many of you know, the symptoms of Lyme disease and mold toxicity illness are excess cytokine symptoms. In response to the vaccine, cytokines direct the immune system to get to work making antibodies and white blood cell Covid-19 killers. This is a good thing.

But these cytokine symptoms will cause fatigue, brain fog, achiness, temperatures, and even neuropathy. So, it will look like your Lyme or mold toxin illness worsened. But they have not. If you worsen with the vaccine - it is not a relapse - it is due to excess cytokines. Most recover from these side effects within a week. I have seen a very small number take up to a month. A very rare person takes longer.

At one time, I advised my patients to stop their anti-cytokine supplements like glutathione, quercetin and curcumin before the vaccine and to stay off of them for two weeks after the vaccine. I was concerned that blocking cytokines could decrease the effectiveness of the vaccines. I have changed my opinion. I now recommend that people stay on anti-cytokine supplements while they get the vaccine.

For vaccine related cytokine flares I suggest:

• Liposomal Curcumin 500 mg 2 pills three times a day. In my practice the product I use is Meriva 500 SF by Thorne.
• Liposomal Glutathione 400 to 500 mg two times a day. The product I use in my practice is Tri-Fortify Orange or Tri-Fortify Watermelon by Researched Nutritionals

Read more about cytokines in Control Cytokines: A Guide to Fix Lyme Symptoms & The Immune System.

Mask Up - Be A Good Neighbor!

Ughh - I hate it too!

But I am back wearing my mask once again. Given how contagious the variant is (see below) I am once again masking to prevent a breakthrough infection for vaccinated me. I also care about my neighbors - so I mask up because I am a good citizen who does not want to spread a silent covid infection from me to my neighbors or patients.

Masking does help. Here is a review of the research in support of this.

Extra. Extra. Read All About It!

The delta virus is VERY scary - you should not fool with it. Given this, vaccines are the best way to go. See excerpts below from Dr. J Stacey Klutts MD in his Tamp Bay Times op-ed showing

• why and how the delta variant is spreading so rapidly and
• covid vaccines are very effective even with breakthrough infections.

Dr. Klutts makes these points far better than I can.

1. Like Gorilla Glue. The delta variant (lineage B.1.617.2) has a particular collection of mutations in the spike protein (that knob-like projection you see in renderings of the virus) that make it extremely effective in attaching to human cells and gaining entry. If the original COVID strains were covered in syrup, this variant is covered in ultrafast-drying Gorilla Super Glue (industrial strength).

2. 1,000 times higher. There are two recent publications which demonstrate that the viral loads in the back of the throats of infected patients are 1,000 times higher with the delta than with previous variants. I can tell you from data in my own labs, that is absolutely true. We are seeing viral signals we never saw last year using the exact same assays.

3. Much more infectious. This much higher load plus the ultra “stickiness” of the delta strains for adhering to human cells makes it remarkably more infectious than previous strains. You may have heard of R0 (Pronounced R naught) which is, in a nutshell, the number of people to which an infected person would be expected to transmit the virus. Early versions of the virus had a 2 to 2.5 R0 value. So one infected person would infect two or so people on average. Delta has an R0 of about eight! In the infectious disease world, that’s almost unheard of. Chickenpox and measles are about all we have ever seen that spread that efficiently from human to human. This changes the story line completely from earlier in the pandemic and makes this surge, in many ways, like a completely different pandemic event.

4. Five days. There is another recent publication out of Singapore with data that confirms something we suspected. I will explain more about the “why” on this below when I talk about vaccines, but the gist is this: The viral loads in the throats of vaccinated persons who become infected with delta rises at identical rates as in unvaccinated persons, but only for the first few days. After five days or so, the viral loads in the vaccinated person start to quickly drop whereas those in the unvaccinated person persist. This key set of observations is important for several reasons relating to

5. Young people. This pandemic, Round 2, is primarily being observed in younger patients than in Round 1. Our children’s hospitals are even already filling up or full. Because of the delta viral dynamics, it is much more capable of causing severe disease in a larger swath of the population. You spew enough of any human pathogen on someone without immunity, and it’s not going to end well. This sets up very poorly for the beginning of the school year — which has already started in Florida — and it scares me. Check that. It is actually terrifying. I sure hope we have vaccines for the 5- to 11-year-olds soon.

6. Vaccines work! Speaking of vaccines. Are they working? Yes! They are absolutely doing their expected job. We know a lot about vaccines for upper respiratory viruses, as we have been giving the population one every year for decades (influenza). To explain all of this, I need to provide some biological context. When you get a vaccine as a “shot,” the “antigen” in the vaccine leads to formation of an antibody response. You probably knew that. What’s important, though, is that it primarily leads to a specific Immunoglobulin G (IgG) response. That’s the antibody type that circulates around in really high numbers in the blood, is located some in tissues and is more easily detectable by blood tests, etc.

What that shot does not do is produce an Immunoglobulin A (IgA) antibody response to the virus at the surface of the throat mucosa. That’s the antibody type that could prevent the virus from ever binding in the first place. As such, in a vaccinated person, the virus can still attach like it’s about to break into the house, but it doesn’t realize that there is an armed homeowner on the other side of the door. When that virus is detected, the IgG beats it up and clears it before the person gets very ill (or ill at all). (Sidebar: Anyone ever had their kid — or themselves — get the “Flumist” vaccine as their annual flu booster? The idea there is to introduce the antigens at the surface of the throat mucosa leading to that IgA response that will prevent infection from happening at all. Sounds good and still has a place, but it isn’t quite as effective overall as the shot.)

7. Preventing disease and death. The COVID-19 vaccines are designed to prevent disease/death through that IgG response (though it does also reduce infections somewhat). How good are the vaccines at doing all of this with delta? The Centers for Disease Control and Prevention has just released data addressing that very question. Punchline: They’re remarkably good! The vaccine shows an 8-fold reduction in the development of any symptomatic disease secondary to delta. For hospitalization, it is a 25-fold reduction. That’s 25 times! Remarkable. For death, it is also 25 times! This is a very effective pharmaceutical class when looking at overall efficacy toward the intended/expected purpose. When looking at the very tiny side effect profile, I’d personally consider it one of the best overall pharmaceuticals on the market in any class of drugs.

8. So, you’re vaccinated? First of all, a sincere, heart-felt thank you! But you may now ask, so why do I again need to wear a mask? We talked about disease, hospitalizations and death above, but what about infections themselves? The vaccines are now estimated to provide a 3-times reduction in infection. For reasons that I tried to make clear above, it isn’t surprising that the vaccine is less effective at preventing infection vs. preventing disease. We are indeed seeing detectable virus, at high levels, in asymptomatic, vaccinated persons when we test them prior to procedures, etc. We have a few that are mildly symptomatic, too.

While we now understand that the virus fades from the back of the throat pretty quickly in a vaccinated person, we also know that an infected, vaccinated person can transmit this very infectious virus to others for at least a couple of days. So, as before, you are being asked to wear a mask to primarily protect others.

We need you again to interrupt the transmission cycle of the virus, as you don’t know when you might be infectious. The vaccine alone cannot interrupt this cycle when there is a lot of virus in the community within unprotected persons.

9. What’s next? I live and practice in Iowa, and I see the tsunami wave on the horizon. It’s typical for respiratory viruses to begin in the southern United States (where it is hot and everyone clusters indoors in the air conditioning to escape the heat) and then creep north to affect those areas when it gets colder (and people go inside because it’s getting colder). If you live in the north and are not vaccinated, it is not too late, but it’s getting damn close. It’s also time to start wearing masks in public again (ugh...I hate it, too).

Those of you in the south, particularly in Florida, know that the tsunami is already on your shores. If you weren’t already off the beach, you might be in trouble. However, if you are there and haven’t yet been affected, run like hell to metaphorical higher ground — get vaccinated, wear a mask.

I beg of you, watch that wave and don’t ignore it. I have zero political agenda (I hate politics). I’m just a nerdy scientist and physician who loves you all, and I certainly don’t want to see a mass of my friends grieving — or dead — because I didn’t yell loud enough to get you and your families off that beach. So, run! (to your pharmacy ... driving is allowed). You don’t want any part of this thing without vaccine on board.

Dr. J. Stacey Klutts is a clinical associate professor of pathology and clinical microbiology at the University of Iowa and is the chief of the Pathology and Laboratory Service for the Central Iowa VA Health Care System. He is the past president of the Academy of Clinical Laboratory Physicians and Scientists (ACLPS) and chairs the National VA Clinical Microbiology Council in addition to his national roles referenced above. This is adapted from a Facebook post with permission of the author.

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The person with Lyme should discuss the points raised in the article with their own physician to make a decision about getting the vaccine.