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Tepezza and COVID vaccine, what should I know?

Medically reviewed by Carmen Pope, BPharm. Last updated on June 29, 2022.

Official answer


People with Thyroid Eye Disease (TED) prescribed Tepezza should be vaccinated against COVID-19 as soon as possible but there are no guidelines regarding preference for one COVID-19 vaccination over another or for the timing of vaccine administration. There is no evidence that people with TED are at more risk of severe COVID-19 or if Tepezza increases the risk of infection with the SARS-CoV-2 virus.

When is the best time to get a COVID-19 vaccination if you are on Tepezza?

There is no guidance regarding the best time to get a COVID-19 vaccination if you are on Tepezza; however, the product information states that Tepezza should not be infused at the same time as other medicines. Because Tepezza is given as a series of 8 injections every 3 weeks, and there is a risk of infusion reactions occurring with Tepezza, it may be best to allow at least 24 to 48hours between an infusion of Tepezza and a COVID-19 vaccine since, if a reaction or a side effect was to occur, it may be challenging to work out which injection was to blame. There is no reason to stop Tepezza until you complete the course of the COVID-19 vaccinations.

Can Thyroid Eye Disease (TED) reactivate following COVID-19 vaccination?

There have been reports of patients with thyroid eye disease experiencing reactivation of the condition following COVID-19 vaccination. One case series details 3 female patients who received either the Moderna or Pfizer COVID-19 vaccine and presented with symptoms of TED within 24 h to 21 days of receiving their first or second dose. None of the patients had been previously infected with COVID-19. Two patients had a history of inactive TED with stable thyroid function tests; one with stable disease for 15 years and the other for 5 years. The third patient had no previous history of thyroid dysfunction or TED and presented with low levels of thyroid-stimulating hormone. All three cases presented with proptosis and in two of three cases, periorbital edema, eyelid retraction, and diplopia were present. None were current smokers. Symptoms in all cases were improving at 4 to 8 months.

What is the association between Thyroid Eye Disease (TED) and COVID-19 infection?

COVID-19 has been reported to cause thyroid dysfunction both during and after infection with the COVID-19 virus (SARS-CoV-2). This is thought to be because ACE-2 is highly expressed in thyroid cells. COVID-19–related autoimmune thyroid conditions include thyroid eye disease (TED) and Graves disease and multiple other thyroid dysfunctions.

Has the supply of Tepezza been affected by COVID-19?

There was a short-term disruption to the supply of Tepezza during 2020 due to Government-Mandated (Operation Warp Speed) COVID-19 Vaccine Production that dramatically restricted the capacity available for the production of Tepezza at its drug product contract manufacturer, Catalent, in favor of manufacturing COVID-19 vaccines. This resulted in the cancellation of previously guaranteed and contracted Tepezza drug product manufacturing slots which were required to maintain Tepezza supply. Supply was resumed by April 2021 but an estimated 2,000 patients who were taking Tepezza during the third quarter of 2020 may have had to forgo the drug for more than 4 months. There has been no disruption since.

  • Horizon Therapeutics plc Announces Short-Term TEPEZZA® (teprotumumab-trbw) Supply Disruption Due to Government-Mandated (Operation Warp Speed) COVID-19 Vaccine Production Dec 17, 2020.
  • Eye disease drug to resupply after COVID-related disruption.
  • 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.

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