COVID vaccine recommendations for patients with comorbidities

The Advisory Committee on Immunization Practices (ACIP) in the USA recommended COVID-19 vaccination for patients with underlying medical conditions. It has been described that, despite limited data, COVID-19 vaccination can be performed in immunocompromised individuals, considering the high risk of progression to severe conditions. The Joint Committee on Vaccination and Immunisation (JCVI) in the UK also recommended COVID-19 vaccination for those with comorbidities, including immunocompromised individuals. The Daily Mirror Health Capsule therefore spoke to several medical experts to inquire about recommendations when vaccinating patients with various health conditions.

Heart patients

“Heart patients are advised to take the COVID-19 vaccine and there are no contraindications,” opined Consultant Cardiologist, Dr. Chandrike Ponnamperuma. “But if they have had a heart attack, bypass or stenting, they are advised to delay vaccination for at least two weeks. On the other hand if they are on warfarin they are advised to do an INR test. If their INR is less than 3 they can get the vaccine. The syringe should have a 25-27 gauge needle.” He further said that if a heart patient gets infected with COVID-19 there may be complications such as blood clots. “Therefore the infection has to be managed accordingly.”

Diabetes

Certain comorbidities have been identified as increasing the risk of severe COVID-19 and death. One of them is diabetes. When contacted, Consultant Endocrinologist Dr. Prasad Katulanda said that getting the vaccine is a priority for diabetic patients and that there have been no complaints about complications so far.

Rheumatic diseases

Patients with rheumatic diseases such as arthritis are also advised to get the vaccine. “Sometimes there may be a muscle pain in the area that has even vaccinated but there aren’t any documented cases of inflammation after the vaccine was given,” opined Consultant Rheumatologist Dr. Himantha Athukorala. “But joint pain is one of the symptoms of post-COVID syndrome. A week after patient’s recover from COVID they may get a severe arthritis-like condition. A decade ago when patients recovered from a viral infection called Chikungunya, they complained of joint swelling. Other than joint pain there’s no contraindication of the vaccine for arthritis. Even with arthritis we advice patients to get the vaccine.”

Cancer

The US Centers for Disease Control and Prevention (CDC) recommends that anyone 12 years of age and older be offered the vaccines, and this includes people with cancer. When contacted, Consultant Oncologist Dr.Wasantha Rathnayake said that no complications have been reported from cancer patients who received the COVID-19 vaccine. “But we delay vaccination for one or two weeks if the patient is on acute chemotherapy. Otherwise we recommend the vaccine for almost all patients because it’s a lifesaver.”

HIV

People with Human Immunodeficiency Virus (HIV) and weakened immune systems due to other illnesses or medications maybe at increased risk for severe COVID-19. In his comments, Consultant Venereologist Dr. Iresh Jayaweera said that since the COVID vaccine is not a live vaccine it can be given to anyone. “Right now we have arranged the lists of patients who are willing to be vaccinated. If they get infected with COVID they have a high risk than others. Therefore it’s safe to get vaccinated.”