My friends at ConsumerLab.com have updated their excellent article answering the question: Who Should or Should Not Get Vaccinated with the COVID vaccine?
According to recommendations made by the Advisory Committee on Immunization Practices (ACIP) of the CDC, people with some, but not all, underlying medical conditions may still receive the mRNA COVID-19 vaccines (CDC, Interim Clinical Considerations 2020).
Below is a list of underlying medical conditions and the current recommendations regarding the safety of the mRNA COVID-19 vaccines in people with these conditions:
- Current or past COVID-19 infection: Those with active infection can be vaccinated after they’ve recovered from acute illness and are able to discontinue isolation. This applies to those with the active infection before the first dose and to those who develop SARS-CoV-2 infection between the first and second dose.
However, for those who received monoclonal antibodies or convalescent plasma as a treatment for COVID-19, vaccination should be deferred for at least 90 days after passive antibody therapy as a precaution.
- Exposure to COVID-19: People who have been exposed to COVID can be vaccinated, but most should defer vaccination until their quarantine period has ended to prevent exposing healthcare personnel to COVID.
The exception to this is those living in long-term care facilities, correctional and detention facilities, homeless shelters, and other congregate settings where potential exposure is likely to occur over long periods of time.
These individuals can be vaccinated when it’s available, regardless of possible exposure, provided COVID-19 is not strongly suspected.
In people in congregate settings who are strongly suspected of being infected after exposure, vaccination can be delayed pending test results.
- Immunocompromised or taking immunosuppressants: The safety and effectiveness of the vaccine in people who are immunocompromised are still unknown.
People who are immunocompromised might have a reduced immune response to the vaccination, so if they choose to be vaccinated, they should continue to social distance and wear masks even after being vaccinated.
- Cancer: The CDC does not provide information regarding COVID-19 vaccines for people with cancer.
However, the American Society of Clinical Oncology and Association for Clinical Oncology (ASCO) indicate that, although the safety and effectiveness of the vaccine specifically in people with cancer are still unknown, cancer patients, those undergoing cancer treatment, and cancer survivors may be offered the COVID-19 vaccine if they have no other contraindications and they have been counseled by their healthcare professional on the risks.
Those currently undergoing cancer treatment should consult with their oncologist before getting vaccinated to reduce the risk of possible interactions.
Both ASCO and the American Association for Cancer Research (AARC) are advocating for cancer patients to receive priority status for the vaccine given their increased risk for severe infection.
- Autoimmune conditions: Although there is no data to confirm the efficacy and safety of these vaccines in people with these conditions, these people were eligible to be included in the clinical trials.There was no difference in the occurrence of autoimmune-related symptoms or symptoms of inflammatory disorders for people who received the COVID-19 vaccine vs. those who received a placebo.
- Mast cell activation syndrome (MCAS): The CDC’s recommendations do not explicitly address the use of the COVID-19 vaccine in those with MCAS, a condition associated with some autoimmune conditions.
The American College of Allergy, Asthma, and Immunology states that there is limited data related to the safety of the COVID-19 vaccine in people with MCAS, so people with this condition should consult with their doctor to weigh the risks and benefit.
Physician advisors from The Mast Cell Disease Society Medical Advisory Board recommend that patients with mast cell disease who choose to be vaccinated carry an Epi-Pen with them to the vaccination site and remain at the site for 30 minutes after being vaccinated.
- Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): The CDC’s recommendations do not explicitly advise on the use of COVID-19 vaccines in people with this condition, but the vaccine is not contraindicated in people with this condition. People with this condition should talk with their doctor to weigh the risks and benefits.
- History of Guillain-Barre syndrome (GBS): No cases of Guillain-Barre syndrome have been reported for people vaccinated with either COVID-19 vaccine.
- History of Bell’s palsy: Despite several reported cases of Bell’s palsy in people who received the mRNA COVID-19 vaccine, it is unclear if there is a causal association. Until more is known, people with a history of Bell’s palsy may still be vaccinated.
- Pregnant or lactating: The risk of mRNA vaccines during pregnancy (both for the mother and the fetus) or breastfeeding is unknown, although the mRNA vaccines are not considered to pose a significant risk to a breastfeeding infant.
- Pregnant or breastfeeding women who are among those recommended to get vaccinated, such as healthcare professionals, can choose to be vaccinated after weighing the risks and benefits with their healthcare professional.
© Copyright WLL, INC. 2021. This blog provides a wide variety of general health information only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment from your regular physician. If you are concerned about your health, take what you learn from this blog and meet with your personal doctor to discuss your concerns.