“It’s all good news,” says Robert Quigley, MD, DPhil, a Philadelphia-based immunologist who specializes in infectious diseases and is the senior vice president and global medical director of International SOS. There’s no reason why people with hepatitis C shouldn’t get the vaccine, he says. Here, we answer a handful of the questions you may have about the COVID-19 vaccines if you or a loved one has this liver infection.
1. When Will I Be Able to Get the Vaccine if I Have Hepatitis C?
It depends on where you live. It’s up to each state to decide how to distribute the vaccine and which types of underlying health conditions receive priority. In general, having hepatitis C does not put you at increased risk of severe COVID-19, and therefore likely does not give you priority, says Anurag Maheshwari, MD, a physician who is board certified in transplant hepatology, gastroenterology, and internal medicine and works with the Institute for Digestive Health and Liver Disease in Baltimore. “Their risk of complications both from COVID and the COVID vaccine are pretty much the same as the general population, like the average Joe,” he says. On the other hand, the Centers for Disease Control and Prevention (CDC) says if hepatitis C is not well controlled, the risk of complications from COVID infection may increase. Visit your local health department’s website or ask your doctor if you’re eligible to receive the vaccine now — and if not, when. RELATED: Your Everyday Guide to Living Well With Hepatitis C
2. Does Having Another Health Condition With Hepatitis C Affect My Place in Line?
In most states, people ages 16 to 64 with underlying health conditions that increase the risk of serious complications from COVID-19 are in phase 1c of the vaccine rollout recommendations. Whether you’re included in phase 1c will depend on your state’s definition of “underlying health condition.” For instance, you may have cirrhosis as a result of hepatitis C — 15 to 30 percent of hepatitis C patients do, according to the World Health Organization. If that’s the case, you likely are included in phase 1c. “People who have cirrhosis are more at risk of developing COVID-19 side effects and complications than people who do not have cirrhosis,” Dr. Maheshwari says, adding that because they are at a higher risk of severe COVID-19 illness, the recommendation to receive the vaccination is even stronger. Again, you’ll want to consult your state’s guidelines to determine if and when you’re eligible. RELATED: Can Diet and Lifestyle Choices Affect COVID-19 Vaccine Efficacy?
4. Are COVID-19 Vaccines Free for People With Hepatitis C?
Yes. The COVID-19 vaccines are free to everyone living in the United States, regardless of your immigration status and whether you have health insurance, according to the CDC.
5. Why Is It Important to Get the Vaccine if You Have Hepatitis C?
Most people with hepatitis C are not at increased risk of developing severe COVID-19, but the vaccine is still recommended. “They need to take all the precautions the rest of us are taking to mitigate against COVID,” Dr. Quigley says. That includes mask wearing, social distancing, washing hands frequently, and getting vaccinated once eligible. According to the CDC, becoming vaccinated can keep you from getting seriously ill from COVID-19 and protect those around you. That protection is especially important if you have a liver disease, such as cirrhosis, as well as hepatitis C, Maheshwari says. RELATED: COVID-19 Vaccines and Treatments: Where They Stand Now
6. Are the Vaccines Safe and Effective for People With Hepatitis C?
Yes. “There’s no literature out there that indicates that having hepatitis C, whether you’re undergoing treatment or not, has any impact on your immune response to the vaccine or your immune response in general,” Quigley says.
7. What Side Effects of the Vaccine Should People With Hepatitis C Pay Attention To?
Having hepatitis C does not increase your risk of unique side effects, Maheshwari says. But you may experience the same ones that otherwise healthy people have reported — pain at the injection site, fatigue, headache, or a fever, according to the Toronto Centre for Liver Disease. If you have cirrhosis, you may be dealing with these side effects longer. “In the general population, side effects tend to dissipate within 24 to 36 hours,” Maheshwari says. “In patients with cirrhosis, we’ve seen these side effects linger on for three to five days or so.” That shouldn’t deter you from getting the vaccine though, Maheshwari says. “People need to be warned that you are going to experience some side effects to the vaccine no matter which vaccine you take, and you just need to be prepared for it,” he says. “I would describe it as short-term pain for long-term gain.” RELATED: 6 Things People With Heart Conditions Must Know About the COVID-19 Vaccines
8. What Questions Should People With Hepatitis C Ask Their Healthcare Teams About the COVID-19 Vaccines?
Discuss your vaccination plans with your doctor beforehand, especially if you have experienced anaphylaxis following other vaccinations or are on an immunosuppressant. The Toronto Centre for Liver Disease says taking an immunosuppressant may affect the effectiveness of the vaccine, though that’s up for debate. “That’s actually the million-dollar question,” Maheshwari says. “A fair number of our patients are on a medication that suppresses their immune system. We don’t have any data on the percentage of patients who are likely to respond. It’s something we’re still learning.” Maheshwari says people with hepatitis C who have had a liver transplant or have an associated condition that affects the immune system, such as rheumatoid arthritis or Crohn’s, may be on tacrolimus or Humira (adalimumab). In the meantime, it’s still a good idea to get the vaccine, but ask your doctor for the go-ahead to be sure. “Hepatitis C in general would not be something that would prevent patients from responding appropriately to the vaccine,” Maheshwari says. Finally, Maheshwari says to ask your doctor when you should receive the vaccine if you’ve already been infected with COVID-19. “The recommendations are different based on your underlying health or illness,” he says. Because each individual’s health profile is different, your doctor will be able to give the best advice.
