Ankylosing Spondylitis and COVID Vaccine: What to Know 
Rheumatic ConditionsAnkylosing Spondylitis

Ankylosing Spondylitis and the COVID Vaccine: What to Know

Ankylosing Spondylitis and the COVID Vaccine: What to Know
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Updated on November 4, 2025
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If you or your loved one is living with ankylosing spondylitis (AS), you may have questions about the effectiveness and safety of the COVID vaccine that go beyond those posed by the general public.

We spoke to experts and examined the research to answer the most important questions about the COVID-19 vaccines for people living with AS.

Why Is It Important to Get the Vaccine if You Have Ankylosing Spondylitis?

COVID-19 can be a debilitating and deadly virus, especially for those with preexisting conditions or diagnoses. When COVID-19 first began circulating, questions arose about whether people with rheumatic diseases like AS might be hit especially hard.

The good news is that this doesn’t seem to be the case.

“Compared with other rheumatic diseases, patients with AS may not be at high risk of severe COVID-19 among hospitalized patients,” says Abhijeet Danve, MBBS, MD, an associate professor of medicine specializing in rheumatology at the Yale School of Medicine and the director of the Yale spondyloarthritis program in New Haven, Connecticut.

According to Dr. Danve, this may be because people who have ankylosing spondylitis are not prescribed the high-dose steroids — a risk factor for poorer outcomes — unlike some people with other rheumatic conditions such as rheumatoid arthritis or lupus.

Are Vaccines Safe for People With Ankylosing Spondylitis?

Every vaccine has its risks, but experts say that the benefits of the vaccines often outweigh the risks associated with them.

"It's hard to give a one-size-fits-all answer about whether the COVID-19 vaccine is safe and effective for people with rheumatologic diseases like ankylosing spondylitis,” says Tyler B. Evans, MD, MPH, an infectious disease specialist and the CEO of Wellness Equity Alliance in Santa Cruz, California. “Because everyone's health situation is different — including their medical history and the medications they’re on — it’s important to talk to your rheumatologist or primary care doctor for advice that fits your specific needs.”

Dr. Evans adds that “people with conditions like ankylosing spondylitis often have weaker immune systems, especially if they’re taking medications that further suppress the immune system. This puts them at a higher risk for infections like COVID-19.”

Evans and other experts recommend that people get vaccinated, including booster shots, before they begin any medications that might suppress the immune system.

How Effective Are Vaccines for People With Ankylosing Spondylitis?

The COVID-19 vaccinations are effective in preventing infections of coronavirus. A study published in 2022 of those with an immune-mediated inflammatory disease, such as ankylosing spondylitis, found that the vaccines were effective in preventing infection in 79 percent of those surveyed.

The same study revealed that the effectiveness of preventing severe COVID-19 outcomes, including hospitalization and death, was between 92 and 97 percent.

Do I Need to Change My Ankylosing Spondylitis Medications Before Getting the Vaccine?

While the most recent recommendations from the American College of Rheumatology (ACR) don’t require that AS medications be completely stopped, the ACR does recommend that certain adjustments be made in the timing of medications in conjunction with the COVID-19 vaccination.

  • Abatacept (IV): Vaccination should occur one week before the next IV administration.
  • Abatacept (SQ): Administration should be paused for 1 to 2 weeks after COVID-19 vaccination.
  • JAK inhibitors: Administration should be paused for 1 to 2 weeks after COVID-19 vaccination.
  • Cyclophosphamide IV: Administration should occur approximately 1 week after vaccination, if feasible.
  • Rituximab: Discuss timing of vaccine administration with rheumatology professional prior to vaccination
  • Anti-inflammatory medications, including NSAIDs: If AS is stable, hold dosage for 24 hours prior to vaccination. Following vaccination, no restrictions are applied.

For IL-17 and TNF inhibitors, the ACR could not reach a consensus on interruptions to the medications prior to or following COVID vaccinations.

When Can I Get a Vaccine if I Have Ankylosing Spondylitis?

If you have questions or concerns about your eligibility to receive the vaccination or subsequent boosters, you should consult your rheumatologist. A shared decision between patients and their doctor is always recommended, Danve says.

Where Can I Get a Vaccine if I Have Ankylosing Spondylitis?

Vaccines are offered in a variety of places, including your medical professional’s office and local pharmacies. To find a vaccine location near you, you can visit Vaccine.gov, reach out to your medical professional’s office, or visit your state’s public health department for further information.

You can also find information about vaccination sites and coverage information by visiting the website for the U.S. Centers for Disease Control and Prevention (CDC).

Are COVID-19 Vaccines Free for People With Ankylosing Spondylitis?

In some instances, you will not have to pay for a vaccination. In other cases, the professional administering the vaccine may charge a fee, but it’s possible that it will be reimbursed by your public or private health insurance.

If you are uninsured, free vaccines may be available from your local health department.

What Side Effects of the Vaccine Should People With Ankylosing Spondylitis Expect?

In general, COVID-19 vaccines have minimal and short-lived side effects. Most common are pain and swelling in the arm where the injection occurred; some people also experience fever, chills, joint pain, and headaches.

Most of these side effects can indicate that the immune system is robust but any lingering or concerning side effects can be talked about with your doctor.

For people with AS, there is a theoretical risk of a flare or disease worsening after COVID-19 vaccination, but the ACR task force says that the benefits of being protected far outweigh this possibility.

The Takeaway

  • The COVID-19 vaccination is an effective way to protect yourself from illness.
  • Adjusting medications prior to or after vaccination can ensure that the vaccine is effective.
  • It’s important to discuss any concerns about vaccination timing with your rheumatologist so that a care plan can be established.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Sparks JA et al. Effectiveness of COVID-19 Vaccination in Immune-Mediated Inflammatory Diseases. The Lancet Rheumatology. April 2022.
  2. COVID-19 Vaccine Clinical Guidance Summary for Patients with Rheumatic and Musculoskeletal Diseases. American College of Rheumatology. August 12, 2022.
  3. Coronavirus Disease 2019 (COVID-19) Vaccine Safety. Centers for Disease Control and Prevention. January 31, 2025.
  4. Having Symptoms After Getting a COVID Vaccine May Indicate robust Immune Response. University of Minnesota. June 2024.
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Sian Yik Lim, MD

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Castle Connolly Top Doctor
Sian Yik Lim, MD, is a board-certified rheumatologist at Hawaii Pacific Health. He is a clinical certified densitometrist, certified by the International Society of Clinical Densitometry. He completed his rheumatology fellowship at Massachusetts General Hospital and was also a research fellow at Harvard Medical School. His research interests include osteoporosis, gout, and septic arthritis. Dr. Lim has published in JAMA, Current Opinions in Rheumatology, Osteoporosis International, Bone, Rheumatology, and Seminars in Arthritis and Rheumatism.

Lim has authored several book chapters, including one titled “What is Osteoporosis” in the book Facing Osteoporosis: A Guide for Patients and their Families. He was also an editor for Pharmacological Interventions for Osteoporosis, a textbook involving collaboration from a team of bone experts from Malaysia, Australia, and the United States.
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Meryl Davids Landau

Meryl Davids Landau

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Meryl Davids Landau is an award-winning health and science writer and a women's fiction author. Her latest novel is Warrior Won, in which a woman facing serious life challenges must learn to use all of her mindfulness and meditation skills. Meryl's articles have appeared in numerous publications, including National Geographic, the Washington Post, The New York Times, Prevention, Oprah Magazine, Consumer Reports, AARP, and of course many pieces for Everyday Health.
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