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Thursday, March 18, 2021

Vaccinate or Not

 Summary of webinar  on Current Vaccines and Newer Strains of Corona Virus 

Salient points.

1.All appoorved vaccines including Pfizer, Moderna, Covishield and Covaxin  have ~100% efficacy  in preventing Death due to Covid. In addition to this they also have 

 -Very High efficacy against Severe Covid Infections

 -High to moderate efficacy (60%-95%) against  symptomatic Covid infections but 

 -poor efficacy only  against asymptomatic covid infections

So people should not run after efficacy data while choosing a vaccine.  

 2. Because all vaccines prevent severe covid and death, vaccination of a large cohort of  population is important if we want to save the humanity from the ill effects of the  current  pandemic.

Every one should get vaccinated and encourage others to get vaccinated.


3. Nasal vaccines might be able to prevent even asymptomatic covid because it generates local IgA antibodies cutting chain of transmission and bringing an end to this pandemic.

4. Vaccination of 10000 pregnant ladies has been done in USA without any additional side effects seen   upto 3 months of follow up. Hence, pregnant ladies can also be safely vaccinated.

5. People with  allergy to food, drugs, latex, venom previous non covid vaccine can safely take covid vaccine. 

6.Only people with severe anaphylaxis to previous covid or non covid vaccines should avoid covid vaccine.

7. People who have had Covid in the past must opt for Covid Vaccination four to six weeks after recovery. 

Data is emerging that they might need just one shot of the vaccine as Robust Neutralising Antibody titres and Strong T cell responses have been found in them even after single shot of vaccination.

8. People who have received Plasma therapy should wait at least four weeks before taking a vaccine. During these four weeks, the preformed antibodies transfused in external plasma will  wane off and this will  avoid the  neutralization of virus (protein) produced by covid vaccine 

9. People with severe disease who are admitted should wait at least 4 to 10 weeks after recovery before taking any vaccine.

10. People with Diabetes should go for vaccination after taking food/breakfast. This would ideally apply to all as there is a wait time involved.

11. People who are on Corticosteroids should decrease dose to less than 7.5 mg per day, if possible for six weeks, when taking  the vaccine, because higher doses act as immunosuppressives and may decease immunity development.

12. Inhaled steroids need not be tapered when taking covid vaccine because systemic bioavailability of inhaled corticosteroid is low.

13. People with nasal allergy,  Bronchial Asthma, skin allergy can all be safely vaccinated.

14. People on immunosuppressive agents like methotrexate should stop the drug two weeks before and two weeks after the vaccine 

15. Rituximab given for Non- Hodgkin's Lymphoma, Rheumatoid arthritis should be avoided for at least 4 weeks {drug acts by attaching to B cells}.

16. Those being treated for Blood cancer and who have been given Bone Marrow Transplant should wait at least 3 months 

17. Those being given Monoclonal antibodies can be given vaccine safely as it is not live vaccine.

18. Those without bone marrow transplant/Cell therapy  should wait for vaccine till Absolute Neutrophils Count returns to normal.

19. Those who are planning to undergo surgery should to take vaccine at least 2 weeks in advance for protection. 

20. For patients with Autoimmune diseases like SLE, Sjogrens Syndrome, no disease specific data exists but theoretically Covishield and m RNA vaccination is unlikely to increase auto immunity. Vaccination should be encouraged though extra caution be taken.

21. Older people should be encouraged to take vaccine as risk of covid mortality is high among them.

22. People with Dementia, paralysis etc neurological disorders should take vaccine as their covid appropriate behaviour is likely to be compromised.

22. Stable CKD,  Cardiac failure,  Liver failure can take the vaccine but their immune response may be poor.

23. Immunocompromised people should preferably be given Covishield vaccine as it has a non replicating viral vector coding for spike protein.

24. People talking Aspirin and Clopidogrel need not stop these drugs before vaccination.

25. People on anticoagulants can be given vaccine safely.

For any clarifications please feel free to contact me personally


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