What you need to know before taking the COVID-19 jab

Note to readers: The information below relates to the Pfizer vaccine only, advice and precautions may differ for other vaccines.

The initial wave of doses of the long-awaited COVID-19 vaccine are being administered across Malta, but the small print shows that it might not be for everyone. 

The vaccine developed by Pfizer is the only COVID-19 vaccine currently available on the island and is comprised of two doses given intramuscularly, 21 days apart.

The Health Authorities have said that since there are no clinical safety data regarding pregnant women, children under 16, and women who are breastfeeding, the vaccine is not thus far recommended for these groups. The Malta Association of Public Health Medicine (MAPHM) spoke to MaltaToday about the Pfizer vaccine and what readers need to know before taking the jab.

COVID-19 and allergies

One of the most common concerns cited is whether persons suffering from allergies can safely take the vaccine. MAPHM said that most allergies would not affect whether one can take the vaccine. However, the association said the only group that should “definitely” not take the vaccine are those who have had a severe allergic reaction to any ingredient or component of the vaccine in the past.

“One of the ingredients of the vaccine known to cause a very rare allergy is polyethene glycol (PEG), which is commonly found in medicines, household goods and cosmetics. Known allergy to polyethene glycol is extremely rare, but those who suffer from this allergy should not receive this vaccine,” the association warned.

MAPHM said that persons who have had a severe allergic reaction to any other vaccine or any other medicine or therapy given by injection, be it intramuscular (into the muscle), intravenous (into a vein), or subcutaneous (below the skin) should speak to a doctor before taking the vaccine. “Your doctor will carry out a risk assessment to determine the type of allergic reaction you had, as well as the certainty of information regarding your allergy and guide you further,” the association said.

The association explained that the vaccine is egg-free and so may be used by those with an egg allergy. There are also no animal products or preservatives in the vaccine, which is administered from a vial with a synthetic rubber stopper that does not contain latex and which is therefore safe for those with latex allergies.

Having a mild allergic reaction to a vaccine or injectable therapy, such as itchy or stinging red bumps on the skin alone without signs or symptoms of severe allergic reaction, does not mean one should not receive the vaccine.

MAPHM also said that persons who suffer from allergic reactions, including severe allergic reactions, unrelated to vaccines or injectable therapies, such as allergies to food, pets, venom, environmental allergies, or latex allergies, as well as allergies to oral medications such as tablets, capsules and syrups can take the vaccine.

It explained that persons who receive the vaccine are monitored for around 15 minutes after being vaccinated, as a precaution against a rare serious allergic reaction. “Vaccination centres are equipped to give the necessary treatment in case of these rare events,” assured the association.

Other conditions to be wary of

MAPHM highlighted the fact that individuals with certain medical conditions should seek advice from their doctors before receiving the vaccine as additional precautions may be needed.

These include bleeding disorders, patients with a low platelet count and patients stabilised on anticoagulants (blood-thinning medications). Persons in this category are mostly not excluded from receiving the vaccine but should discuss with their doctor to see if further precautions are needed to minimise their risk of bleeding/bruising after the injection.

MAPHM said these might include checking whether the relevant blood tests results are in range, adjusting medication dose timing, or rescheduling the vaccination close to the date certain therapies are given, according to the individual case.

“When attending for vaccination, these individuals should advise those vaccinating them that they have a bleeding disorder/take anticoagulants, so a fine needle is used to give the vaccine. They should also apply firm pressure to the injection site for several minutes after receiving the vaccine to minimise the risk of bruising,” the association said.

MAPHM added that individuals who are immunocompromised, including persons with HIV and persons taking medications that suppress the immune system, are encouraged to take the vaccine unless other exclusions or precautions apply.

“Their response to the vaccine may be weaker due to their weakened immune system. We do not yet have evidence of the best timing for receiving the vaccination when taking immunosuppressive therapy. These individuals are advised to discuss with their specialist who will guide them on the ideal timing to receive the vaccine,” said the association.

Advice for those who cannot take the vaccine

MAPHM said the public needed to understand that both those who receive the vaccine, and those who do not receive the vaccine need to remain cautious and continue following the public health measures that are currently in place for some time yet; social distancing, avoiding gatherings, wearing masks, washing hands and so on.

“So far, we know that the vaccine is highly effective at preventing symptomatic cases of COVID-19. While we hope this is the case, we do not yet have data to indicate whether the vaccine prevents asymptomatic COVID-19,” the association said, adding that it may well be that vaccinated people can still contract asymptomatic COVID-19 and pass it on to others. This is why continuing to adhere to public health measures is so important.

“One has to understand that the vaccine does not give you a guarantee of protection (as is normal for all vaccines): in the case of the vaccine, after seven days from the 2nd dose, it is 95% effective at preventing symptomatic COVID-19. While a vaccine will help protect individuals and those around them, a large proportion of the population must be immunised and protected before transmission is significantly reduced,” the association said.

MAPHM said that vaccinating the whole population will take several months, and encouraged all those who can receive the vaccine to do so, to protect those who can’t receive it themselves.

“The higher the proportion of people in our population who are vaccinated the better, since fewer people will suffer from severe COVID-19 and more resources will be available to treat the vulnerable should they still get infected and require hospitalisation,” the association said.

MAPHM said that if the number of people who take up vaccination is sufficiently high and herd immunity is achieved, then the many who will have received the vaccine will be protecting the small minority who could not take it for medical reasons.