CFS/ME and COVID Vaccines

A reader ask me to do a post on the COVID vaccines and people with Chronic Fatigue Syndrome / Myalgic Encephalomyelitis. The risk of death is a significant factor in making a personal decision. This is different than most vaccinations; we need to look afresh at this decision and not run off pro forma decisions for things like measles or extremely low risk-of-infection diseases (polio)

  • Measles risk of death 2 in 10,000 or 0.02%
  • For flu: [cdc]
    • 18-49: 0.02%
    • 50-64: 0.05%
    • 65+: 0.85%

There are possible side-effects, which appear to be transitory for typical people.

 A review of unblinded reactogenicity data from the final analysis which consisted of a randomized subset of at least 8,000 participants 18 years and older in the phase 2/3 study demonstrates that the vaccine was well tolerated, with most solicited adverse events resolving shortly after vaccination. The only Grade 3 (severe) solicited adverse events greater than or equal to 2% in frequency after the first or second dose was fatigue at 3.8% and headache at 2.0% following dose 2. Consistent with earlier shared results, older adults tended to report fewer and milder solicited adverse events following vaccination


I did a prior post on POTS as a consequence of vaccination. Fortunately, that is moot since most people with ME/CFS already have POTS! It is important to note that positive benefit can happen with some vaccines: Effects of  vaccine on pain and fatigue in patients with fibromyalgia/chronic fatigue syndrome.[1998] that “Fifty percent [of ME/CFS] were rehabilitated successfully and resumed half-time or full-time work.”

There is concern on aluminum in vaccines and ME/CFS as documented in this 2016 post. With subsequest studies

More Recent Studies

Which Vaccine has Aluminum?

For people in the US, we have a list of all vaccines and their ingredients here. You will see Human Papillomavirus (HPV) (Gardasil 9) cite above, contains amorphous aluminum hydroxyphosphate sulfate.

Bottom Line

The key issue is whether there is aluminum in the vaccine. If there is, it may worsen existing symptoms (especially neurological issues). The bad news is that appears that the current COVID-19 vaccines some contains aluminum (alum) and others do not.

So the traditional and documented issue with vaccines (the aluminum in it) does not apply to two of the Covid vaccines. This implies that for FM, CFS/ME, there is not a supportable evidence-based reason to decline it.

For all ages, the risk of death is significantly higher than for the flu: [see cdc numbers above]

  • 18-49: 0.02% vs 0.1 to 0.4% i.e. 20x greater risk
  • 50-64: 0.05% vs 0.5 to 3.6% i.e. 72x greater risk
  • 65+: 0.85% vs 6.3% to 20%, i.e. 24x greater risk
Covid cfr by age

The side effect risks are low and appear to be transient. “Long Covid” – the name given to a CFS-like syndrome after a COVID infection is likely to make any existing ME/CFS or FM much worst. This is estimated that 10% of people are prone. The probable model is that long covid has resulted in a stable gut bacteria dysfunction (for a similar documented-over-several-years similar scenario see this post)

One study of people hospitalized with COVID-19 in Italy found that 87.4% reported experiencing at least one symptom, often fatigue or shortness of breath, 2 months after discharge. Among people with milder infections, however, the prevalence of long COVID has been unclear. Data from the COVID Symptom Study app suggest that 1 in 10 people with the illness experience symptoms for 3 weeks or more

COVID-19 Symptoms: Longitudinal Evolution and Persistence in Outpatient Setting [2020]

Get the vaccine — there is no evidence-based reason not to (especially if there is no aluminum in it). Not taking the vaccine means significant risk of death and likely more severe CFS/ME or FM.

Post Script – I had COVID… Should I get the vaccine?

Answer is a simple yes. Protection with the vaccine is expected to last longer… Think of it as a booster shot!

University of Washington study: Immune memory in mild COVID-19 cases lasts 3 months [Jan 7, 2021]