Coronavirus vaccination: who cannot be vaccinated?

Coronavirus vaccination: who cannot be vaccinated?

Politicians, many health experts and the Standing Vaccination Commission (STIKO) of the Robert Koch Institute continue to appeal to the population to be vaccinated against the coronavirus. Even though many people in Germany have already been vaccinated against the coronavirus, some people are still unsure about who cannot be vaccinated against coronavirus. What about allergies, previous illnesses or pregnancy, for example? You can find out more about this here.

Vaccination for pre-existing conditions

Both the BioNTech/Pfizer and Moderna efficacy studies included people with pre-existing conditions such as diabetes mellitus and COPD. No severe side effects occurred in these groups of people during the studies.

In people with an inflammatory rheumatic disease who are taking immunosuppressants, the formation of antibodies may be reduced by the vaccination. However, vaccination is still recommended. Whether and if so, which medications could affect the immunisation should be clarified by a doctor.

To be safe, vaccination with the AstraZeneca vaccine should not be given in the presence of thrombosis with thrombocytopenia syndrome (TTS) or capillary leak syndrome.

Even if the vaccination can be carried out without any problems in most cases, the following applies: If you have a previous illness, it is still advisable to seek medical advice before the vaccination.

Vaccination after surviving coronavirus infection?

After the infection has been overcome, there is at least a specific protective effect against a new infection. In this respect, persons for whom a disease has been detected are usually vaccinated at the earliest three months after the infection has been overcome. This also applies to people who fell ill after the first vaccination.

Suppose you are still determining whether an infection with the coronavirus may have gone unnoticed or undetected. In that case, you do not have to worry: So far, there is no evidence that vaccination could pose any risks in such a case. Therefore, Carrying out a test to detect antibodies before immunisation is unnecessary. For this reason, after consultation with a doctor, vaccination can be carried out as early as four weeks after recovery from a coronavirus infection. The three-month waiting period is, therefore, not binding.

Vaccination during pregnancy and lactation

The mRNA in the BioNTech/Pfizer and Moderna vaccines is rapidly broken down in the body. Therefore, experts do not assume that vaccination of pregnant or breastfeeding women could have negative consequences. Study data from the USA also show that no adverse effects from the vaccination are to be expected in pregnant women.

Nevertheless, pregnant or breastfeeding women were initially excluded from the vaccination. The STIKO initially only recommended vaccination for affected women who belong to a risk group or are exposed to a higher risk of infection due to their living conditions. In September 2021, however, the STIKO issued a general recommendation for pregnant women from the second trimester of pregnancy and breastfeeding women. A two-dose vaccination with an mRNA vaccine was recommended.

This recommendation was adjusted again in November 2021. Since heart muscle and pericarditis were somewhat more common in women and men under 30 who had been vaccinated with the Moderna vaccine, the STIKO recommendation was changed about this age group and (despite the lack of data) to pregnant women. The STIKO now only recommends vaccination with the vaccine from BioNTech/Pfizer for pregnant women. This also applies to second and booster vaccinations.

Vaccination for allergies

Since severe allergic reactions to coronavirus vaccines became known in the USA and Great Britain, many people with allergies have expressed concern: Is it even possible to get vaccinated against the coronavirus if you have an existing allergy?

Experts give the all-clear: Corona vaccination, like any other vaccination, can lead to a severe allergic reaction. However, this occurs extremely rarely.

Since symptoms appeared in most of those affected within the first 15 minutes after vaccination, an appropriate observation period is provided after the injection, during which the vaccinated person is under medical supervision. An observation period of 30 minutes is offered to persons with a known medical history of severe allergic reactions. This is determined in a patient questionnaire before the vaccination.

Vaccination should not be given if there is a known allergy to any ingredient in the vaccine. The primary suspected allergy triggers are:

  • Polyethylene glycol ( PEG ) in the BioNTech/Pfizer vaccine.
  • PEG and thrombamine/trometamol in the Moderna vaccine.
  • Polysorbate in the AstraZeneca and Johnson & Johnson vaccines.

According to the current state of knowledge, however, a corresponding allergy only affects very few people. Current recommendations from the Paul Ehrlich Institute for allergy sufferers can be found here.

Vaccination of children and adolescents

The vaccine from BioNTech/Pfizer was approved for children aged 12 and over in the European Union on May 31, 2021. In July 2021, the Moderna vaccine was approved for children aged 12 and over. The BioNTech/Pfizer vaccine has been approved for children aged five since November 2021, and the Moderna vaccine for children aged six since March 2022.

Which STIKO recommendations now apply to children and young people? In mid-August 2021, the Standing Vaccination Commission issued a general recommendation for vaccination for children aged 12 and over. In December 2021, the recommendation for children from five to eleven years followed – but initially limited to children with previous illnesses or contact with people from a risk group. In May 2022, STIKO adjusted its recommendation again. According to this,  all children under five should be vaccinated. However, only one vaccine dose, preferably from BioNTech/Pfizer, should be used in healthy five to eleven-year-olds without contact with risk groups.

The vaccination should continue to be carried out after medical information about the benefits and risks. Parents of children and young people who belong to a risk group are also recommended to be vaccinated to reduce their child’s infection risk.

 

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