FAQ: What Comorbidities Are Covered in Phase 2 COVID Vaccine Plan?

4 min read
FAQ: What Comorbidities Are Covered in Phase 2 COVID Vaccine Plan?

India is all set to begin the second phase of vaccinations against coronavirus from 1 March. People above 60 years of age and those with comorbidities above 45 years of age are eligible to get the jabs.

Who exactly is eligible to get the Covaxin and Covishield jabs? What comorbidities are prioritised? FIT breaks it down.

Who Can Get the Vaccine?

First things first: here’s who is eligible.

Those with severe co-morbidities need to procure a medical certificate certified by a general physician to qualify. The protocol to qualify will include doctors scoring the patient as per a set criterion, and often new tests to verify may be needed. These medical certificates need to be uploaded on the Co-WIN IT platform.

The government has not yet clarified which comorbidities will be included in the above 45 category. AIIMS Director Randeep Guleria said,

“There are specific categories based on those who are at higher risk of dying because of Covid-19. People with heart disease, diabetes, those who have underlying cancer, people with disability which predisposes to severe pneumonia, or those who are on immunosuppressant steroids, and post-transplantation patients will come under this category.”
Randeep Guleria, AIIMS Director

The aim is to give the vaccine to those who are most at risk of dying.

As per a Times of India report the following co-morbidities to receive the vaccine on priority are:

  • diabetes
  • heart disorders
  • respiratory diseases
  • kidney diseases
  • any type of cancer
  • people with disabilities - although which ones aren't mentioned,
  • neurological disorders like Parkinson's or those that can result in higher chances of severe pneumonia
  • people who are on immunosuppressant drugs will also be eligible, although which ones were not mentioned. It seems like the criteria will look at the severity of the disease and its impact on increasing mortality from infection or lowering the immune system so a person with severe diabetes for more than 10 years will get priority over someone younger with diabetes who has the problem under semi-control.

Can Those With Certain Health Conditions Be Administered the Vaccine?

  • People who had COVID-19 in the past
  • People with chronic diseases and comorbidities - cardiac, neurological, pulmonary, metabolic, and malignancies - in fact, these are people who are at risk of the infection and need the vaccine
  • Immunocompromised people or people with HIV or immune suppression due to any condition.

Will the vaccine be effective in those with comorbidities? Well, the Union Health Ministry issued a fact sheet that states the response to the COVID-19 vaccine “may be less in these individuals.”

However, further information on this is awaited.

Can People on Blood Thinners Get the Vaccine?

There is much confusion about this, but Indian Council of Medical Research (ICMR) Director-General Balram Bhargav clarified on 28 January that both Covaxin and Covishield are safe for people on blood thinners.

“Relative contraindications regarding blood thinners have been mentioned in the factsheets of both the vaccines and both the companies have written to the DCGI regarding revision of this. The revision will happen every soon. Blood thinners are of two categories — antiplatelets and anticoagulants. For those on antiplatelets like aspirin, the vaccine causes no problem but for those on anti-coagulants, 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.”
Balram Bhargav, ICMR D-G

Prof.  K. Srinath Reddy, a cardiologist and epidemiologist, is President, Public Health Foundation of India (PHFI). Writing for FIT, he said, ‘blood thinner’ is a lay person’s term and should not have been used in the product information sheet, without specifying what kinds of drugs constitute contraindications to vaccination. It is a misleading term because the drugs usually grouped under this term do not dilute the blood like severe anaemia does.”

“Persons with any of the above medical conditions, for which anti-platelet or anti-coagulant drugs are prescribed, are at a high risk of severe disease or even death if they are infected with the Covid-19 virus. They are among the people who will most need the protection of the vaccine. Why then are they listed as persons who should not receive the vaccine? Do these instructions apply to both anti-platelet drugs and anti-coagulants.”
Prof.  K. Srinath Reddy

“There is no rationale for flat denial of the vaccine to those who need it most because of their medical conditions. Unless suitable clarifications are issued by the authorities, vaccinators may turn away persons who are on these drugs. It will be a disservice if many millions who are on aspirin because of cardiovascular risk are denied a potentially life-saving vaccine. Can these instructions now flow through the fine needle of rational guidelines rather than the blunt rejection of all persons who are on ‘blood thinners’?”, he said.

So far, the centre has not issued any clarification but from a health perspective, those on blood-thinners should not have a problem if they get the vaccine.

Who Is Not Eligible to Be Administered the COVID-19 Vaccine?

  • Those below 18 years of age are not allowed to receive the COVID-19 vaccine
  • Pregnant and lactating mothers
  • Those with allergic reactions to vaccines, pharmaceutical products, notable food allergies
  • Anyone who has had an adverse reaction to a COVID-19 vaccine earlier

Who Are Those People Who Are Temporarily Not Eligible to Get the Vaccine?

  • Persons showing active symptoms of SARS-CoV-2 infection.
  • COVID-19 patients who have been given anti-SARS-Cov-2 monoclonal antibodies or convalescent plasma.
  • Acutely unwell and hospitalised patients (with or without intensive care) due to any illness.
  • The vaccine should be given with “caution” to persons with a history of any bleeding or coagulation disorder – platelet disorder, clotting factor deficiency, or coagulopathy.

What Are the Common Adverse Events With Covishield Vaccine?

For Covishield, the fact sheet says some mild adverse events can happen following immunisation:

  • Injection site tenderness; injection site pain; headache; fatigue; myalgia (muscle pain); discomfort; pyrexia (an abnormal elevation of body temperature); chills; and nausea.
  • In such cases, a paracetamol can be given, the advisory adds.
  • It also says “very rare events of demyelinating disorders” have been reported following vaccination with Covishield, “without the causal relationship establishment.”

What Are the Common Adverse Events With Covaxin Vaccine?

According to the Centre’s fact sheet, these are the common adverse events after administering Covaxin.

  • Injection site pain
  • Fatigue
  • Fever
  • Headache
  • Body ache
  • Nausea
  • Abdominal pain
  • Dizziness
  • Sweating
  • Cold
  • Cough

Bharat Biotech has claimed that no serious adverse event has been reported in Phase 1 and 2.

What Should I Do if I Experience Any of These Symptoms?

  • You should contact your physician immediately.
  • For any queries about the vaccination, one can contact 1075 – the 24x7 COVID-19 hotline.

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