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Treston supports federal guidelines that all people 12 and older — except those with previous vaccine allergy reactions — be vaccinated. She points to federal guidance that says people with
HIV “should receive COVID-19 vaccines, regardless of their CD4 or viral load, because the potential benefits outweigh the potential risks.” 4. LUPUS Lupus is an autoimmune disease, meaning
that the body's immune system attacks its own organs and tissue. It affects 1.5 million people in the United States, mostly women of child-bearing age. It is characterized by mild or no
symptoms interrupted by “flares” or flare-ups, periods when symptoms worsen. Lupus can also lead to serious problems such as kidney failure, blood clotting and heart attacks. The lupus
immune system is less capable of fighting infections, says Ashira D. Blazer, M.D., a rheumatologist at NYU Langone Health in New York City. And when a lupus patient has an active flare, the
immune system is less effective in combatting such infections, she said. The medical center recommends that lupus patients get the COVID-19 vaccines, and those who have are not getting more
flares than those who have not. But those experiencing moderate to severe flares should confer with their rheumatologists about the vaccines’ risks and benefits, she said. "Some
medications that are required to treat more serious lupus features may decrease the vaccine's efficacy,” Blazer adds. 5. MULTIPLE SCLEROSIS Like lupus, Multiple Sclerosis (MS) is an
autoimmune disease. A patient's immune system attacks the protective coating on nerve fibers, which can be damaged or even destroyed. Symptoms include muscle spasms, loss of balance and
the inability to walk. Nearly 1 million people in the United States age 18 and over have MS. Some treatments can rein in the immune system's ability to fight infection, says Julie
Fiol, associate vice president of health care access for the National MS Society. For instance, people taking certain medications “will have a reduced and possibly indetectable antibody
response to the COVID-19 vaccines,” Fiol says. But even then, other parts of the immune system may kick in and offer protection. Clinical trials have been launched to probe how those with
multiple sclerosis respond to the vaccine. "These studies are critical for people with MS,” Fiol says, “So they can understand their level of protection and feel comfortable returning
to their ‘normal’ as many others already are.” _Deborah Schoch is a contributing writer who covers health and science. A longtime journalist, she has most recently done work for AARP, _The
New York Times_ and KNBC-TV Los Angeles._