What is the Health Ministry advisory on children, pregnant women and those on blood thinners?
The story so far: On January 14, two days before India began the massive inoculation drive for COVID-19, the Health Ministry released a note on precautions and contradictions for the vaccines cleared so far, Covishield and Covaxin. Both India-made vaccines had emergency use approval and one of the points the circular clarified is that shots are to be given only to those 18 years and above.
What are the other specifications?
The Health Ministry note said there should ideally be a gap of at least 14 days between a COVID-19 vaccine shot and other vaccines. It said it was not permitted to interchange the COVID-19 vaccines: under the two-dose regime the second dose should be of the same vaccine which was administered the first time around. Further, the vaccines should be administered with caution in persons with a history of any bleeding or coagulation disorder (clotting factor deficiency, coagulopathy or platelet disorder).
While the existing fact sheets of both companies indicate that people on blood thinners should “inform their health-care provider” (Covishield) or that “it is not advisable to take the vaccine in this condïtion” (Covaxin), the Indian Council of Medical Research (ICMR) Director-General Balram Bhargava on Thursday at a Health Ministry press conference said the vaccine is safe for people on blood thinners. He said both the manufactures of the vaccines had approached the Drugs Controller General of India (DCGI) for revision of this contraindication on their fact sheets.
Dr. Bhargava said, “Blood thinners are of two categories — antiplatelets and anticoagulants. For those on antiplatelets like aspirin the vaccine causes no problem but with those on anti-coagulants in these patients the tendency to bleed is much higher. This is also a relative contraindication and the anticoagulant can be stopped a day or two before administering the vaccine.”
The Health Ministry has advised special precaution for vaccine use in persons with a history of any bleeding coagulation disorder and added that other vaccine-specific contraindications may apply as new information becomes available.
Also read | Vaccine dilemma — to take or not to take Covaxin
Should pregnant women take it?
The Health Ministry advisory says pregnant and lactating women should not be given either vaccine for now. Pregnant and lactating women have not been part of any COVID-19 vaccine trial so far, it said.
People who have an allergic reaction to the first dose of the vaccine, immediate or delayed, should not take the second dose. For those who develop an allergy or other symptoms, the second dose can be taken in four to eight weeks after recovery. This includes persons with active symptoms with SARS-CoV-2 infection and others acutely unwell. Also SARS-CoV-2 patients who have been given the anti-SARS-CoV-2 monoclonal antibodies or convalescent plasma have been advised a deferral.
What about people who are ill?
For acutely ill or hospitalised patients due to any illness, vaccination can be deferred for four to eight weeks after recovery. Covaxin in its fact sheet specifies that beneficiaries should inform vaccination providers before getting the vaccine if they are on regular medication for any illness. Covishield notes that people who are allergic to any of the ingredients specified in the vaccine should not take it. It says if a beneficiary has a serious adverse reaction to the first dose he should stop the process.