When Anne Mills, a physician in Virginia with rheumatoid arthritis, went public with her inoculation experience last year, she hoped to reassure her friends in the autoimmune community that the shots are safe and effective. “We’re still looking at very high response rates and very robust protection against severe disease,” she told me. Now that her entire family is vaccinated, Mills feels better able to mentally compartmentalize her condition, and she is working and traveling again while maintaining some precautions. But she worries that many immunocompromised people have gotten the message that vaccination isn’t worth it.

Michael Putman, a rheumatologist at the Medical College of Wisconsin who cares for many patients receiving immunosuppressive medications for autoimmune diseases, confirms that it’s a battle to get his patients inoculated. “The idea that the vaccines don’t work for immunocompromised people has definitely contributed to hesitancy,” he told me. Many autoimmune sufferers worry that the shots might lead to a flare-up of their disease symptoms. Some of Putman’s patients have decided not to take that risk after reading news stories suggesting that the injections wouldn’t help them much anyway. Ironically, patients with rheumatologic conditions, like Putman’s, are generally among the most protected within the immunocompromised cohort, as measured both by antibody production and clinical outcomes.