The National Advisory Committee on Immunization’s (NACI’s) issued recommendations on the currently approved COVID-19 vaccines. As CAPA members, in our letter to NACI, we have asked to reconsider and revise the wording on the recommendations relating to those who live with autoimmune disease and who are on immunosuppressant therapies. While we are aware that this recommendation is based on the GRADE system which accounts for the current evidence available, and that people with autoimmune diseases were excluded from both the Pfizer-BioNTech and Moderna vaccine trials, we are also aware that patient preferences are a key aspect of GRADE.