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COVID-19 and asthma: Our expert answers your questions

Dr.  Arjun Mohan addresses the impact of COVID-19 on people with asthma and whether the vaccine is right for you. 

Woman using an inhaler Photo: Getty Images

Updated January 14, 2022, to include the importance of booster shots.

Asthma is a common, chronic (long-term) lung condition that affects the airways. The airways are tubes that carry air in and out of your lungs. If you have asthma, your airways can become inflamed and narrowed at times, making it hard to breathe. These episodes can be sudden and severe and are often referred to as exacerbations, flare-ups or attacks.

COVID-19 is a respiratory disease, just like asthma. Both cause shortness of breath and other breathing difficulties. Here Dr. Arjun Mohan, director of our new asthma program, answer questions regarding COVID-19 and asthma.

Arjun Mohan, M.D.How dangerous is COVID-19 for people with asthma? Am I at greater risk of severe symptoms, complications or even death, if I get COVID-19?

As of now, we do not have direct hard evidence to show that asthma predisposes people to more severe COVID-19 illness. It is important to remember that our understanding of COVID-19 is constantly evolving and historically, viral illnesses, similar to COVID- 19, are known triggers for asthma flare ups in certain individuals.

The CDC (Centers for Disease Control and Prevention) lists asthma as an underlying medical condition that puts adults at high risk for severe illness from COVID-19, while conceding that the evidence is still “mixed.” While we await more robust science to understand the relationship between COVID-19 and asthma, patients with asthma must remain vigilant. This is especially true if you have moderate to severe asthma and or under-controlled asthma.

Is it harder to treat people with asthma if they get COVID-19?

Potentially. As with COVID-19, the severity of asthma (and associated flare ups) range from mild to severe. The combination of severe COVID-19 illness with a severe asthma flare up, for example, can be challenging to treat and often results in hospitalizations — even the need for ICU-level care.

Fortunately, as of now, there is no evidence to support that patients with asthma are at higher risk of contracting the coronavirus, nor is there is evidence to support that COVID-19 increases the risk of hospitalization, severity or mortality due to asthma.

Is it safe for people with asthma to come to VCU Health for a routine appointment or treatment? What precautions are you taking to keep patients safe?

Yes, it’s very safe. We have increased our cleaning and disinfecting measures to make sure our hospitals and clinics are a safe environment for your care. We screen people entering our facilities for symptoms of COVID-19, and we have fewer people in our waiting rooms. Please visit our COVID-19 news center for more information on the measures we’re taking to keep patients, staff and visitors safe.

As someone with asthma, is there anything special I need to do before I come in for my appointment?

We ask that you follow standard COVID-19 safety procedures. When you enter the building, be sure to wear your mask, stop for your temperature check, look for the signage in the elevator as to how many people can enter, and wash your hands when you enter the doctor’s office.

If you are having new or worsening respiratory symptoms before your appointment, please contact our clinic staff to ensure it is safe for you to come in. We are still offering phone and virtual appointments, and that maybe the best way to serve you in certain situations. Needless to say, if you can safely attribute your respiratory symptoms to your asthma, it is ok for you to come in.

Is the COVID-19 vaccine safe and effective for asthma patients?

Yes. The COVID-19 vaccines are safe and effective for people with asthma. The Centers for Disease Control and Prevention approved all three vaccines -- Pfizer, Moderna and Johnson & Johnson (J&J). To be approved, the vaccines must go through a careful trial process with several phases to address safety and effectiveness. The COVID-19 vaccine trials did just that, and they included thousands of participants.

The COVID-19 vaccines were produced so rapidly not because they were rushed by cutting corners but because scientists have significant prior experience working with other coronaviruses such as SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome). Research on a COVID-19 vaccine did not start from scratch.

In addition, the U.S. government made vaccine development a priority once the COVID-19 coronavirus took off in the U.S.

But isn’t there a chance I could get COVID-19 from the vaccine? Is it worth the risk?

You can’t get COVID-19 from any of the vaccines. None of the vaccines contain the live coronavirus nor do they contain a weakened or dead version of the coronavirus. The vaccines have no coronavirus to pass on to you. It’s definitely worth getting vaccinated.

Is there a risk of a dangerous interaction with my meds? Should I stop taking my meds or using my inhaler before my vaccination?

There are no known dangerous interactions between your asthma medications and the vaccines. It is imperative for you to continue your asthma medications before and after taking the vaccination. The last thing we want is for your asthma to get under-controlled or for you to have an attack.

What if I’ve already had COVID-19? Do I still need to get the vaccine?

We recommend you get the primary vaccination series as well as the booster. Reinfection is possible. If you've had symptoms of COVID-19 but were never diagnosed, don't assume you had the disease and are immune. Get the vaccine.

A few additional tips. If you have recently recovered from COVID-19, then delay getting the vaccine till you have fully recovered and are done with self-isolation.

Also, if you received antibody treatment for your COVID-19, then you should wait 90 days from that time to get the vaccine, as the antibodies may interfere with the immune response required for the vaccine to work. But the bottom line remains the same — get the vaccine!

How do I get the vaccine?

You can register for the COVID-19 vaccine through the Virginia Department of Health (VDH) or vaccine finderThe websites provide a list of sites where you can get vaccinated. 

If you are a patient at VCU Health, please visit our COVID-19 vaccine page for information on how you can get vaccinated here. 

Are the side effects of the vaccine any different for someone with asthma? Is there anything specific to asthma patients that I should look out for?

Having asthma does not increase the likelihood of side effects. As in the general population, side effects from the vaccine are usually mild. They include injection site pain or redness, fatigue, headaches, muscle pains, chills, nausea, fevers or joint pains. The side effects are short term and if needed, can be managed with over-the-counter medications such as Tylenol.

I hear some people have an allergic reaction. As someone with asthma, will I have an increased risk of an allergic reaction?

Having asthma does not increase your risk of an allergic reaction to the vaccine. The only true vaccine contraindication is if you have a known allergy to one of the ingredients in the vaccine.

If you have a history of an allergic reaction to any other vaccine or injectable therapy or history of anaphylaxis (severe allergic reaction with hives, low blood pressure, difficulty breathing, etc.) then inform the staff member at the time of vaccination. We will then monitor you longer for an allergic reaction after the vaccination and hence, further increase your safety.

Can children with asthma get the vaccine?

For the latest information on whether your child can get the vaccine, please visit Children's Hospital of Richmond at VCU

Is there anything else you’d like to add?

While there are direct concerns relating to COVID-19 and asthma, it is also important to remember the indirect effects of this virus on our health care system.

For example, there has been additional strain on clinics, hospitals, urgent care centers, emergency rooms and ICUs — all areas where patients with asthma often go for help. Hence, it is important to monitor your asthma and have your asthma under control.

Seek out help as needed and ensure that you not only have a good understanding on how to use your asthma medications but that you also have sufficient supplies and refills.

Similarly, continue to protect yourself against COVID-19. This would include getting the vaccine and the booster, as well as using hand sanitizers, avoiding large gatherings or social events, and limiting travel as best as possible. Wearing a mask will help protect you as well as others near you. 

Finally, if you do use nebulizers, remember that this may increase the risk of spreading the virus to others in the form of aerosolizing droplets. Speak to your provider if it is safer for you to use inhalers instead. If that is not an option, avoid having anyone enter the room where the nebulizer was used for a few hours after.

We’re here to help

The Adult Pulmonary Asthma Program operates out of:

  • VCU Medical Center Ambulatory Care Center 4, 417 N. 11th Street, Richmond, Va., (804) 828-2161
  • VCU Health Stony Point Clinic, 9000 Stony Point Pkwy, Richmond, Va., Phone:804-237-6644).

If you feel you need to be evaluated for your asthma, please call the above numbers per your preferred location.

For more information

For a variety of news and information on COVID-19 and how VCU Health is keeping patients safe, please visit our COVID-19 News Center

This story was originally published May 4, 2021.

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