Recommended Vaccines for the Covid-19 Era

• Pneumonia and influenza have symptoms similar to COVID-19, including high fever, coughing, shortness of breath, breathing difficulties, headaches, cold shivers, and a sore throat, which makes accurately identifying COVID-19 difficult to do.
• The World Health Organization (WHO) recommends that adults receive the pneumococcal conjugate (PVC) vaccine and the influenza vaccine to boost immunity following a COVID-19 vaccination program, although at least 2–4 weeks should pass before receiving these additional vaccines.

Most people are now eager to receive a COVID-19 vaccine at the earliest opportunity as this virus has caused previously unimaginable damage to the health, economy, and lives of people around the world. However, there are vaccines available for other illnesses which also come highly recommended.

Advice regarding vaccines has been prevalent throughout the COVID-19 pandemic, with both the Infectious Disease Society of Thailand and the Pediatric Infectious Disease Society of Thailand recommending that “Every person should receive their regular course of vaccinations as close to their original schedule as possible because any postponing of vaccines could result in preventable diseases, such as measles, polio, and the flu, making an unwanted comeback. Such outbreaks could place more strain on an already stretched public health system that is struggling with the current COVID-19 pandemic.” Therefore, adults and children—especially those with underlying health conditions—the elderly, and those with weakened immune systems should receive all vaccinations as scheduled.²

Benefits of receiving vaccinations as scheduled²

• A reduction in the chance of contracting a preventable disease which may be potentially life-threatening.
•  A reduction in the risk of co-infection along with a COVID-19 infection, such as influenza and pneumococcus.
• Decreased strain on the public health system.

Nonetheless, should any person be concerned that a trip to hospital to receive a vaccine may be placing them at risk of contracting COVID-19, whether that risk is on the way to, or within, the hospital itself, vaccine appointments may be postponed. For instance, booster shots for children can be postponed by anywhere between 1 week and 1 month. However, any delay to a timetabled vaccination must be as short as possible.

The WHO,¹ the Infectious Disease Society of Thailand, and the Pediatric Infectious Disease Society of Thailand² all offer similar advice, namely that the following vaccinations should not be postponed:

1. Vaccinations that protect against post-exposure infections, such as rabies, tetanus, measles, chickenpox, and hepatitis B. For example, if a patient has been bitten by an animal and does not receive a vaccine straight away, it could cause a potentially life-threatening infection.
2. Vaccines for new-born infants, including the BCG vaccine and the hepatitis B vaccine first injection, which should be administered between birth and when the infant returns home due to their immune system not being fully developed, thus placing them at risk of infection.
3. Adult vaccines, such as the pneumococcal vaccine and influenza vaccine, are highly recommended to prevent disease and to reduce the likelihood of developing serious symptoms.² The most vital reasons behind staying up to date with these vaccines are:
   • Annual outbreaks of the novel coronavirus (COVID-19) or influenza cause damage to the tissue of the respiratory system, which weakens it and places it at greater risk of complications arising from bacterial infections.
   • Up to 59.5% of COVID-19 infections in China have been found to involve complications associated with pneumococcal infections (from a study of 257 COVID-19 patients in Jiangsu province carried out between 22 January to 2 February 2020)⁸.
   • Both pneumonia and influenza are easily transmitted conditions that can be contracted via contact with contaminated sputum found in droplets of coughs and sneezes from infected patients. Both conditions lead to symptoms similar to COVID-19, including high fever, cough, shortness of breath, breathing difficulties, headaches, cold shivers, and sore throat,^3,4,5 which makes accurately identifying COVID-19 difficult to do. Indeed, should such a distinction be necessary, the patient must undergo additional diagnostic procedures.
   • Pneumonia resulting from a pneumococcus infection cannot be treated at home like the flu because it is a more serious condition. Some patients even develop sepsis⁶ and must receive hospital treatment for weeks at a time, which can often lead to time spent on a ventilator in ICU.

Both the pneumococcal and flu vaccines are completely safe for use among adults, with both having been used throughout the world for some time. Common side effects include pain, swelling, and redness at the injection site, which can sometimes be accompanied by a low fever. These vaccines are only unsuitable for use with patients who are allergic to their ingredients.

Groups who are at high risk of contracting pneumonia and the flu, and who are also at risk of contracting a serious COVID-19 infection, include:

• Those over the age of 65 years
• Patients with underlying diseases, such as heart disease, diabetes, lung disease, cancer, liver disease, kidney disease, and chronic respiratory disease

• The influenza vaccine is a one-time shot administered annually.⁹
• The pneumococcal vaccine: the 13-strain conjugate vaccine is administered first to ensure long-lasting¹¹, strong¹⁰ immunity, with the pneumococcal polysaccharide vaccine following at least one year after that.
• Both the influenza and pneumococcal vaccines can be administered on the same day.

• COVID-19 vaccines can still be administered, although patients must allow 2–4 weeks¹² to pass before doing so.