Essential Covid-19 vaccine information for patients with underlying health conditions requiring regular medication

Condition

Advice

Coronary artery disease

Vaccine can be administered except where acute symptoms present, the condition is unstable, or there are other symptoms that could place the patient in danger. In such cases, the patient’s doctor should make the decision as to whether they are prepared to receive the vaccine.

Chronic kidney disease requiring dialysis therapy

Vaccine can be administered except where acute symptoms present, the condition is unstable, or there are other symptoms that could place the patient in danger. In such cases, the patient’s doctor should make the decision as to whether they are prepared to receive the vaccine.

Patients who have undergone organ transplant surgery

It is recommended to wait at least one month following surgery and to ensure that the condition is deemed stable by the patient’s doctor before the vaccine can be administered.

Chronic obstructive pulmonary disease / asthma

Vaccine can be administered except in cases where acute symptoms present or where the condition is unstable. In such cases, it is recommended to wait 2–4 weeks after any symptoms have improved before the vaccine can be administered.

Cancer

Vaccine can be administered, except in the following circumstances:

• Patients undergoing chemotherapy or about to undergo cancer surgery should consult their doctor before receiving the vaccine.
• Patients suffering with hematologic cancers who have received a bone marrow transplant should allow 3 months to pass before they receive the vaccine.

Diabetes and obesity

(Weighing over 100 kg or having a BMI of more than 35/m2)

Vaccine can be administered except where acute symptoms occur, or the condition is unstable.

AIDs

Vaccine can be administered except in cases where the infectious disease has just been contracted and therefore requires careful management.

Rheumatoid arthritis and autoimmune diseases

Vaccine can be administered except where acute symptoms occur, or if the condition is unstable.

Immune neuropathy disorders, such as
autoimmune encephalitis,
multiple sclerosis, neuromyelitis optica, myelitis, acute polyneuropathy, Guillain-Barre syndrome, chronic polyneuropathy, myositis, Bell’s palsy, and cranial neuritis.

Vaccine can be administered except in cases where acute symptoms present or where the condition is unstable. In such cases, it is recommended to wait 4 weeks after any symptoms have improved before the vaccine can be administered.

Cerebrovascular disease

Vaccine can be administered except in unstable cases or where symptoms may pose a danger. In such cases, the patient’s doctor should make the decision as to whether the patient is able to receive the vaccine.

Epilepsy

There are no limitations to receiving a vaccine.

Other neurological disorders, such as Parkinson’s disease, dementia, motor neuron disease, and genetic or age-related musculoskeletal and neuropathy disorders.

There are no limitations to receiving a vaccine.

Medication

Recommendation

Corticosteroids

(Prednisolone 20 mg; equivalent to Dexamethasone 3 mg and Methylprednisolone 16 mg)

For Prednisolone dosage of 20 mg per day or other corticosteroids of equivalent dosage, vaccination may be administered without stopping medications.

For a dosage of more than 20 mg per day, or if the patient is in the process of reducing drug dosage, the patient must  exhibit stable symptoms before receiving vaccination.

Immunosuppressants such as Azathioprine, IVIG, and oral route Cyclophosphamide

Vaccination may be administered without stopping medications.

Cyclophosphamide intravenous route

Vaccination may be administered if symptoms are stable, with a recommendation to discontinue taking the medication for 1 week following vaccination.

Mycophenolate

Vaccination may be administered if symptoms are stable, with a recommendation to discontinue taking Mycophenolate for 1 week following vaccination.

Methotrexate

Vaccination may be administered if symptoms are stable, with a recommendation to discontinue taking Methotrexate for 1 week following vaccination.

Hydroxychloroquine, Sulfasalazine, Leflunomide

Not necessary to adjust dosage or postpone vaccination.

Anticoagulant Warfarin

Vaccine may be administered to patients with an INR of less than 4, using a 25G or 27G syringe, and the muscle should not be kneaded after vaccination. After vaccination, the injection site should be pressed for 2-5 minutes until it is certain there is no bleeding.

Antithrombotic agents, such as Fondaparinux

Vaccination may be administered, but should be administered before injection of this type of medication. 

Non-Vitamin K Antagonist Oral Anticoagulants (NOAC), such as Dabigatran ,Rivaroxaban, Apixaban and Edoxaban

Vaccination may be administered, but a 25G or smaller syringe should be used and the muscle should not be kneaded after vaccination. After vaccination, the injection site should be pressed for at least 2-5 minutes until it is certain there is no bleeding.

Antiplatet drugs, such as Aspirin, Clopidogrel, Colostazol, Ticagrelor or prasugrel

Vaccination may be administered, but a 25G or smaller syringe should be used and the muscle should not be kneaded after vaccination. After vaccination, the injection site should be pressed for at least 2-5 minutes until it is certain there is no bleeding.

Antibody drugs (drugs ending in -mab)

Rituximab: Recommended to administer vaccination 14 days prior to the first dose of this medication or 1 month after taking this drug.

Omalizumab, Benralizumab, Dupilumab: Recommended to administer vaccination 7 days before or after taking these medications.