I have recently received numerous inquiries on this subject. Patients who suffer or have suffered from venous thrombosis, peripheral arterial disease, have undergone bypass surgery or an aneurysm. Should they get the vaccine? Which one of them? Can I suffer from thrombi? Is one vaccine better than another for me? Can I get infected with the coronavirus from the vaccine? Should I ask my doctor for a report to get one vaccine or another? I will try to clarify these doubts.
Question: Should I get vaccinated? Remember that I suffer from ... (thrombosis, varicose veins, aneurysm, arrhythmia, stroke, atheromas in the arteries, a pulmonary thromboembolism that gave me a long time ago, etc., add any pathology you may have) and that I take ... (Adiro, Sintrom, Warfarin o Aldocumar, Plavix o Clopidogrel, Xarelto, Pradaxa, Lixiana, Eliquis, etc, add any drug you take)
Answer: YES.
Question: But… also that of AstraZeneca (Vaxzevria)?
Answer: Yes, too.
These questions are very logical, since we receive a lot of information from the media, social networks and friends. In the end, we are left with the vaccine-thrombosis association. The reality is that the AstraZeneca vaccine has been associated with a minimal number of cases of thrombosis in rare locations associated with thrombocytopenia (decreased number of platelets in the blood). These thromboses have been characterized by appearing in rare locations: at the level of the cerebral venous sinuses, at the level of the splenic or mesenteric veins and at the arterial level, especially in women under 60 years of age. With 18 deaths in Europe from more than 25 million vaccines administered, the risk is considered "very rare".
The mechanism of production of these thromboses with thrombocytopenia appears to be immunological, so that NOTHING has to do with the patient's coagulation status and cardiovascular risk, according to the current state of knowledge. That is, whatever pathology you have (except those contraindicated for vaccination that I describe below), you must be vaccinated. If you are in the risk group (women under 60 years old), don't worry. Today in Spain you will be given another vaccine. And if it has already been administered to you and 14 days have passed… congratulations! you have passed the period during which this very rare complication manifests itself.
Question: Should I ask my doctor for a report so that I can get another vaccine or directly so I don't get vaccinated?
Answer: NO. For all of the above, the risk of suffering side effects is identical whether or not you have cardiovascular disease, whatever it may be. Thrombi have not been related to any cardiovascular disease but to an autoimmune mechanism.
Question: But then, if I have an autoimmune disease or I have a weak immune system… am I more prone to thrombi? Should I get the vaccine? Will it give me a severe reaction? Can I have a Guillain-Barré? And a facial paralysis?
Answer: If you have an autoimmune disorder, you should get the vaccine. The risk of COVID is much greater than that of having a complication from the vaccine. Believe me, it does not compensate you to run the risk of suffering the complications derived from a coronavirus infection. If you have weak immunity, the vaccine may have little effect on you, because your immune system does not make enough antibodies to fight the coronavirus. You should do an antibody test once you have been vaccinated and after the antibody creation period (about 3 weeks after the final dose). The risk of suffering from any neurological disease is the same as if you do not get the vaccine, unless you get infected with coronavirus by not getting it, that you are at risk of long-term COVID
Question: Can the vaccine give me COVID? I have seen that it has already happened in some nursing homes ... And I have friends who have had a fever, headache and severe joint pain after the vaccine.
Answer: NO. None of the commercialized vaccines carry a live coronavirus inside. There are three types of vaccines:
The mRNA vaccines (Pfizer, Moderna) carry a piece of coronavirus (mRNA) that acts as an instruction manual so that our cells can copy a harmless protein from the virus. Once they create it, our body detects it and creates defenses against it.
Protein subunit vaccines (Novavax) already include the virus protein (not the virus), so our cells recognize it and create defenses.
Vector vaccines (AstraZeneca, Janssen, Sputnik V) contain a harmless virus (NOT the coronavirus) that does not replicate and that carries coronavirus material in its envelope (coronavirus material, not coronavirus); When it enters our cells, it instructs them to produce an exclusive protein of the coronavirus, which causes the defenses against it to be activated.
In the end, everything consists of having within our body a coronavirus protein (synthesized by whoever synthesizes it) so that it is recognized as foreign by our defense system and creates antibodies and defensive cells against it, for which it takes between 2 and 3 weeks, which is the time necessary to be protected after the administration of the vaccine. NO vaccine modifies our DNA.
There are other vaccines not yet marketed (Sinopharm, SinoVac) that include an inactivated coronavirus through a chemical process that makes the coronavirus unable to replicate but that maintains the proteins that are recognized as foreign by the defenses of our body, which allows the generation of antibodies .
Headaches (headaches), fever, general malaise, joint pain ... are as a consequence of the immune reaction generated by the vaccine and indicate that your body has received this substance as a foreign one. That's a good thing, since by recognizing it as strange, it will produce antibodies, which is what it is all about. If you have been vaccinated but you have not had any of those side effects, it does NOT mean that you are not going to immunize, far from it. Each organism reacts differently, but the effectiveness of vaccines is proven.
Question: If I am going to travel, they ask me for a PCR. If I get vaccinated ... will I test positive?
Answer: NO, since the PCR detects coronavirus (alive or dead) and what we generate with the vaccine is a protein of the virus and the defenses against it. If we get antibodies, it may be positive if we have not indicated that we have been vaccinated (a specific antibody test would have to be done).
Question: I have already passed the COVID. Should I get vaccinated?
Answer: Yes, if more than 6 months have passed since the infection. If less time has passed, you can also get vaccinated, although the risk of reinfection in the first 6 months after COVID is considered very low. It is NOT necessary to do an antibody test before getting vaccinated.
Question: Is there anyone who should not get vaccinated? Are there any CONTRAINDICATIONS?
Answer: Yes, those people who are allergic to any of the ingredients in the vaccine (beware of polyethylene glycol) or who have previously suffered a hypersensitivity reaction to the first dose. Also those who suffer a SERIOUS acute illness at the time of vaccination or are under 16 years of age (18 in the case of Vaxzevria). Pregnant women who are not in high-risk groups in which they suffer a high exposure to the coronavirus should not be vaccinated until the end of the pregnancy, simply because they have not been tested in pregnant women. But if you have been vaccinated and are pregnant… don't worry, no side effects of the vaccine have been shown during pregnancy. And if you are looking to get pregnant, it is reasonable to postpone the pregnancy until 2 weeks after vaccination but ... you do not have to take a pregnancy test before getting vaccinated!
Question: I have a baby that I breastfeed. Can I get vaccinated?
Answer: Yes.
The vaccine is considered safe during breastfeeding.
Sources:
Consejo Interterritorial del Sistema Nacional de Salud del Reino de España.
CDC: Centros para el Control y la Prevención de Enfermedades.
Agencia Española de Medicamentos y Productos Sanitarios