Tepezza and COVID vaccine, what should I know?
If you're taking Tepezza for Thyroid Eye Disease (TED) and considering COVID-19 vaccination, there is currently no specific guidance on optimal timing or vaccine preference. You should still get vaccinated against COVID-19 as soon as possible, but your healthcare provider needs to carefully weigh the individual risks and benefits in your case. This personalized approach is essential because recent evidence suggests an increased risk of developing TED following COVID-19 vaccination, particularly in people under 50 years old, though vaccination still provides important protection against severe COVID-19. Without clear official guidelines, your doctor will need to consider your specific factors including age, sex, other health conditions, and any predisposition to autoimmune diseases when making vaccination recommendations.
Can Thyroid Eye Disease (TED) reactivate following COVID-19 vaccination?
Yes, there is growing evidence that TED can both reactivate and develop de novo following COVID-19 vaccination. The risk of TED was significantly increased after COVID-19 vaccination, especially in people below 50 years of age, with clinical trials showing a 3.24-fold increased risk overall and a 4.70-fold increased risk in patients under 50.
Clinical Evidence:
A comprehensive self-controlled case series study of 98 consecutive patients with newly developed (n=92) or reactivated (n=6) TED between January 2021 and August 2022 found that among 81 vaccinated individuals, 25 (31%) developed TED within 1-28 days post-vaccination. The incidence rate ratio was significantly elevated, particularly in younger patients, with risk progressively decreasing over time following vaccination.
Earlier case reports documented specific instances, including a case series of 3 female patients who developed TED symptoms within 24 hours to 21 days after receiving Moderna or Pfizer vaccines. Two had previously inactive TED (stable for 5-15 years), while one had no prior thyroid dysfunction. Symptoms began 3 days following second vaccination in one documented case, with patients presenting with proptosis, periorbital edema, eyelid retraction, and diplopia.
Related questions
- What are Monoclonal Antibodies and how do they work?
- How does Tepezza work, what's the mechanism of action?
- Tepezza before and after, what should I expect?
Proposed Mechanisms:
Researchers suggest several potential pathways:
- spike protein interaction with angiotensin-converting enzyme II receptors
- molecular mimicry causing cross-reactivity with thyroid self-proteins
- immune reactions triggered by vaccine adjuvants.
Clinical Implications:
While the risk appears genuine, symptoms in reported cases generally improved over 4-8 months. Current evidence suggests that sex, smoking status, and radioiodine treatment history do not modify the association between vaccination and TED development.
Healthcare providers should monitor vaccinated individuals, especially those under 50 and with autoimmune predisposition, while noting that the overall benefits of COVID-19 vaccination likely outweigh these risks for most patients.
The higher risk in younger patients mirrors patterns seen with other COVID-19 vaccine adverse events like myocarditis. This likely reflects more active immune systems in young people, while elderly individuals show lower inflammatory responses but increased autoimmune susceptibility due to immune senescence.
What is the association between Thyroid Eye Disease (TED) and COVID-19 infection?
COVID-19 infection is also associated with thyroid dysfunction, including the development and reactivation of TED, likely due to high ACE-2 receptor expression in thyroid cells.
SARS-CoV-2 infection can trigger various autoimmune thyroid conditions, including TED and Graves' disease. The virus's spike protein binds to ACE-2 receptors, which are widely expressed in thyroid tissue, potentially causing direct tissue damage and triggering autoimmune responses.
References
- Park KS, Fung SE, Ting M, Ozzello DJ, Yoon JS, Liu CY, Korn BS, Kikkawa DO. Thyroid eye disease reactivation associated with COVID-19 vaccination. Taiwan J Ophthalmol. 2022 Feb 28;12(1):93-96. doi: 10.4103/tjo.tjo_61_21. PMID: 35399967; PMCID: PMC8988971.
- Ilaria Muller, Dario Consonni, Erica Crivicich, Francesco Di Marco, Nicola Currò, Mario Salvi, Increased Risk of Thyroid Eye Disease Following Covid-19 Vaccination, The Journal of Clinical Endocrinology & Metabolism, Volume 109, Issue 2, February 2024, Pages 516–526, https://doi.org/10.1210/clinem/dgad501
- Tepezza Prescribing Information. https://www.pi.amgen.com/-/media/Project/Amgen/Repository/pi-amgen-com/tepezza/tepezza_fpi_english.pdf
Read next
How long does it take Tepezza to work?
In studies with Tepezza (teprotumumab-trbw), some patients began to see less eye bulging and double vision by 6 weeks (after the first 2 treatments). By 24 weeks, 8 out of 10 (80%) of patients saw less eye bulging compared to 10 of 100 (10%) of patients taking a placebo. Continue reading
How long does Tepezza stay in your system?
Tepezza stays in your system approximately 100 days after the last dose. This is calculated by looking at the average half-life of Tepezza which is 20 days. The half-life is the time it takes for 50% of a medicine to be eliminated from the body. Research has shown that it takes 4 to 5 half-lives for a medicine to be fully cleared from the body which calculates out to 80 to 100 days or 11 to 14 weeks for Tepezza. Continue reading
Is Tepezza a chemotherapy drug?
No, Tepezza is not used for chemotherapy or to treat any form of cancer. Tepezza is used to treat Thyroid Eye Disease, an autoimmune disease. An autoimmune disease is a condition that causes your body's immune system to mistakenly attack healthy cells in your body instead of foreign substances. Continue reading
See also:
Related medical questions
- Is Tepezza used to treat Graves disease?
- How is Tepezza injected and administered?
- Can Tepezza treat eye bulging and double vision?
- Does Tepezza cause hearing loss?
- Can you have Covid without a fever?
- Which breathing techniques help with COVID-19?
- How effective is Lagevrio (molnupiravir) for COVID-19?
- Is Omicron worse than Delta?
- Can you become immune to COVID-19?
- Is obesity a major risk factor for Covid-19?
- COVID-19 vaccines and variants: What you should know
- Should I wear a face mask to protect myself from COVID-19?
- COVID-19: Why is social distancing so important?
- Why do more men die from coronavirus?
- Can ivermectin be used to treat COVID-19?
- Can you take Ibuprofen if you have COVID-19 (coronavirus)?
- What antibiotics kill Covid-19 (coronavirus)?
- COVID-19: What are the Stages and Causes of Death?
- What's the difference between Bacteria and Viruses?
- Does Zinc protect you from Covid-19 or boost your immune system?
- How do I Treat Nasal Congestion with COVID-19?
- Does Losartan block COVID-19 Coronavirus Receptors?
- An Update: Is hydroxychloroquine effective for COVID-19?
- Does Paxlovid make you less contagious?
- Where can I buy an at-home test kit for COVID-19?
- Can you take Paxlovid twice if COVID rebounds?
- Does Tamiflu (oseltamivir) work on COVID-19?
- Can vitamin C prevent or treat COVID-19 (coronavirus)?
- Does Mucinex help with Covid?
- Should I take Paxlovid after a Positive COVID-19 Test?
Drug information
Related support groups
- Tepezza (11 questions, 8 members)
- Teprotumumab (1 questions, 3 members)
- COVID-19 (103 questions, 91 members)
- Thyroid Eye Disease (8 questions, 3 members)