As soon as in a number of regions of Russia they introduced compulsory vaccination against coronavirus for certain categories of people, the network actively started talking about medical withdrawals. What chronic diseases guarantee a permanent medical treatment, and which – only temporary? Who shouldn’t be vaccinated against covid in principle, and who just needs to change the vaccine?
“Sputnik V”: who is not allowed?
If you look at the updated instructions for the vector Russian vaccine, the contraindications for vaccination against coronavirus in adults are as follows:
1. Age under 18 years: no information on efficacy and safety is available yet. At the same time, it is known that on the basis of two Moscow hospitals, a clinical trial of a vaccine for children 12–17 years old has started. 100 people were selected as volunteers with the consent of their parents. The study will last a year, vaccination will be carried out at a lower dosage than for adults. If the experiment is successful, the vaccine will be allowed for this age category.
2. Breastfeeding. On May 28, the Minister of Health of Russia Mikhail Murashko said that changes will appear in the instructions for vaccination against COVID-19 “Sputnik” for pregnant women. As the therapist Alexei Vodovozov notes, according to international data, expectant mothers tolerate the vaccination well, and the child is born with antibodies. In many countries, pregnant women have been vaccinated for several months – in the USA, Israel, Great Britain, Belgium.
Earlier, the deputy director for scientific work of the Central Research Institute of Epidemiology of Rospotrebnadzor, Alexander Gorelov, on the air of the radio station “Moscow Says” stressed that it is allowed to vaccinate expectant mothers only in the third trimester – by this time all the baby’s organs have already been formed.
In addition, according to the recommendations of the Ministry of Health, vaccination against covid is necessary for those pregnant women who are at risk and suffer from excess weight, lung diseases, diabetes mellitus, diseases of the cardiovascular system, kidneys and liver.
3. Hypersensitivity to any component of the vaccine. Component I consists of recombinant adenoviral particles of the 26th serotype, which contain the gene for the S-protein of the SARS-CoV-2 virus. It also contains tris (hydroxymethyl) aminomethane, sodium chloride, sucrose, magnesium chloride hexahydrate, EDTA disodium salt dihydrate, polysorbate, ethanol and water.
Component II contains similar substances, only adenoviral particles of the 5th serotype are used as an active agent.
4. Severe allergies in history. Here we are talking about any severe allergic reactions that have happened throughout life. If the result was anaphylaxis, edema, decreased pressure or respiratory arrest, it is absolutely impossible to vaccinate.
The Stopkoronavirus.rf website also notes that allergies that are not caused by vaccines or medications are not grounds for refusal.
That is, if a person is allergic to honey, bee venom, plant sap, dust or animal hair, vaccination against covid will not harm.
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Temporary contraindications for “Sputnik”
Infections and other diseases, including chronic ones, during an exacerbation… In this case, the medical withdrawal will be temporary, and the vaccination can be done 14-30 days after recovery or stable remission. As for colds, SARS and infections of the gastrointestinal tract, you can get vaccinated as soon as the temperature returns to normal.
Russian contraindications coincide with world practice – for example, the Advisory Committee on Immunization Practices in the United States agrees that acute illnesses of moderate severity or proceeding are difficult are a reason to postpone vaccination. However, patients are vaccinated as soon as their condition improves.
When to use Sputnik with caution
Another item in the Sputnik instructions, which allows you to get a medical lead from a doctor. Manufacturers advise patients with chronic diseases of the liver and kidneys, the endocrine system, and diabetes mellitus in the stage of decompensation to take a more careful approach to vaccination.
With diseases of the hematopoietic system in a severe form, it is also not worth vaccinating against covid. Among the diseases are also listed: epilepsy, diseases of the central nervous system, acute coronary syndrome, severe cerebrovascular accident, pericarditis, endocarditis and myocarditis. The decision to vaccinate against COVID-19 should be made after a visit to the attending physician.
People with autoimmune diseases also have certain risks during vaccination, since stimulation of the immune system can provoke a relapse. Cancer patients are also asked to approach vaccination with caution, although there are no obvious contraindications for this category. So, in early April, the chief freelance oncologist of the Ministry of Health of the Russian Federation, Andrei Kaprin, said that patients with oncology should be vaccinated, but only after consulting a doctor.
The director of the St. Petersburg Clinical Scientific and Practical Oncology Center, Professor Vladimir Moiseenko, also confirms that the vaccination should be done whenever possible, since the risks of a severe course of infection increase: the majority of cancer patients are elderly and senile people. Oncologists recommend vaccination before or after chemotherapy, radiation, targeted or other therapy or surgery, so that the vaccine does not conflict with treatment, which is often aimed at suppressing the immune system.
At the same time, the head of the Gamaleya center, Alexander Gunzburg, noted that the Sputnik V trials on cancer patients would start on March 13 and would take 6-7 months. That is, it will be possible to find out about the exact efficacy and safety of the vaccine for this category of people by October.
For what diseases can adults not be vaccinated against coronavirus if EpiVacCorona is used? Contraindications for the peptide vaccine are similar to those indicated in the instructions for “Sputnik V”, but there are others.
1. Age up to 18 years. Director of the State Research Center “Vector” Rinat Maksyutov recently announced that it is planned to return to the question of studying the drug among children in the near future – after the last phases of clinical trials on adults are completed. This will happen by the beginning of autumn, Tatyana Nepomnyashchikh, Deputy Director General of Vector, mentioned earlier.
2. The period of breastfeeding and pregnancy. Clinical trials have not been conducted for this category.
3. Primary immunodeficiency. This is not about HIV, acquired immunodeficiency syndrome. The effectiveness of vaccination against coronavirus for people with a positive HIV status will depend on the success of antiretroviral therapy, ex-chief physician of the Botkin Hospital Alexei Yakovlev is sure. If the level of CD4 + cells is high, there will be an immune response.
4. Cancer of blood and other neoplasms. It is known that volunteers with cancer can participate in Phase III clinical trials “EpiVacCorona” and “KoviVaca”. This is stated in the official response of the Ministry of Health of the Russian Federation to the request of the Deputy Chairman of the Federation Council Committee on Social Policy Tatyana Kusayko. But so far there is no safety data for this category.
5. Strong sensitivity to the components of the preparation. EpiVacCorona consists of three peptide antigens of the S-protein SARS-CoV-2, aluminum hydroxide, potassium dihydrogen phosphate, potassium chloride, sodium hydrogen phosphate dodecahydrate, sodium chloride and water for injection.
6. Severe allergies.
Temporary contraindications “EpiVacCorona”
Infectious and non-infectious diseases in acute form, exacerbation of chronic ailments. The vaccine is given 30 days after recovery or remission. In the case of mild ARVI and acute gastrointestinal infections – after normalization of body temperature.
It is also known that if after the first dose of any vaccine against coronavirus, a patient catches a cold or contracted a respiratory illness, he needs to complete the vaccination cycle 14-21 days after the symptoms disappear. The deputy director for scientific work of the Central Research Institute of Epidemiology of Rospotrebnadzor, Corresponding Member of the Russian Academy of Sciences Alexander Gorelov spoke about this.
When to use EpiVacCorona with caution
This section refers to people with “chronic” liver and kidneys, expressed in endocrine system disorders, as well as patients with complex diseases of the hematopoietic system. This also includes epilepsy, strokes and other diseases of the central nervous system. People who have experienced myocardial infarction, myocarditis, endocarditis and pericarditis, coronary heart disease should be more attentive.
Primary and secondary immunodeficiency is a reason to consult with your doctor. Autoimmune diseases also pose a risk. In all cases, the doctor can issue an appropriate certificate. One way or another, all of the above diagnoses mean that before vaccination, a person will be sent to a specialized doctor so that he assesses the stability of the patient’s condition – and gives medical advice or consent.
Who should not be vaccinated against coronavirus with Chumakov’s KoviVac? Among the contraindications:
1) Severe reaction after vaccination (temperature above 40 ° C, edema) or complication (collapse, shock within two days after the injection of the component; convulsions with or without fever) to any previous vaccination in the past.
2) Severe allergies in the past (anaphylactic shock, Quincke’s edema).
3) Pregnancy and breastfeeding.
4) Age under 18.
Temporary contraindications from “KoviVac”
1) Acute febrile conditions, diseases in the acute phase. Vaccination in such cases is done about a month after the person is cured. With mild ARVI and intestinal infections, it is possible to vaccinate against covid as soon as the temperature settles at 36.6 ° C.
2) Exacerbation of chronic infections. The vaccine is given during remission, and the attending physician agrees.
When to use KoviVac with caution
A dangerous combination with vaccination can represent chronic kidney disease, which turns out to be a violation of the neuroendocrine system for the patient. For those who have problems with blood clotting and a tendency to thrombosis of dangerous types, it is also better to postpone the vaccination. Diseases of the central nervous system, diseases of the heart, bronchi and lungs, gastrointestinal tract and the immune system are also a reason to consult a doctor once again.
In addition, the KoviVac vaccine has not yet been approved for people over 60 years of age.
Important: it is also known that component II of any of the three vaccines will not be administered if anaphylactic shock or other serious allergic reactions have occurred after the first. However, the doctor may decide on a full course of vaccination three months after an allergy caused by another vaccine. This was stated by Natalya Pshenichnaya, deputy director for clinical and analytical work of the Central Research Institute of Epidemiology of Rospotrebnadzor.
In addition, if a person has had time to get sick with covid, vaccination measures are not required – only after 6 months in a pandemic or after a sharp drop in antibody titers in the blood, as stated in the recommendations of the Ministry of Health.
If the person who comes for the vaccination has had contact with people with covid in the past two weeks, or showed symptoms, they will first be referred for testing. Such a rule is contained in clause 6.2 of the Methodological Recommendations.
If a person comes in with a temperature above 37 ° C, they will not be vaccinated. And if he falls ill with covid in the period between two doses, the second will not be administered, – such a recommendation was given by Alexander Gorelov, Deputy Director for Research of the Central Research Institute of Epidemiology of Rospotrebnadzor, Corresponding Member of the Russian Academy of Sciences. Revaccination of such a patient will be done only after 6 months.
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