Can patients with blood diseases and transplantation get the new coronavirus vaccine?

The COVID-19 pandemic has been holding back the world, and it has entered its second year.

At present, the total number of confirmed COVID-19 cases worldwide has exceeded 100 million, and many countries are gradually carrying out large-scale COVID-19 vaccination. According to the latest reports, the global vaccination volume has exceeded 100 million doses, which has exceeded the total number of confirmed COVID-19 cases. The cumulative number of vaccinations in my country has also exceeded 30 million doses.

So, can patients with blood diseases and transplant diseases be vaccinated with the new coronavirus vaccine?

China's COVID-19 vaccine development route - "Five arrows fired simultaneously"

The inactivated vaccine is now officially launched on the market.

Inactivated vaccines are the most traditional and classic technical route:

That is, the new coronavirus is cultured in vitro and then inactivated to make it non-toxic, but the "corpses" of these viruses can still stimulate the human body to produce antibodies and make immune cells remember the appearance of the virus.

Can patients with blood diseases get the new coronavirus vaccine?

Patients with blood diseases aged 18-59 years old can be vaccinated with the inactivated COVID-19 vaccine after consulting a specialist if the disease is in complete remission, has not undergone recent radio/chemotherapy, and is not taking immunosuppressants.

The Sinovac inactivated vaccine, which was recently approved for marketing, is also suitable for elderly people over 60 years old.

Vaccination should be done with caution in the following situations:

1. Although the blood disease condition is stable, there are acute symptoms such as fever and infection. Vaccination can only be considered after the symptoms are under control.

2. Uncontrolled blood tumor condition, such as acute leukemia, multiple myeloma, malignant lymphoma, etc.

3. Severe thrombocytopenia such as aplastic anemia, ITP, or bleeding diseases.

4. Patients are currently receiving radiotherapy, chemotherapy and/or targeted drug treatment.

5. Long-term use of high-dose hormones and/or immunosuppressive therapy such as cyclosporine.

6. Received anti-CD20 monoclonal antibody treatment within 6 months.

7. Accompanied by other diseases that are difficult to control.

The following situations should not be vaccinated:

1. Women who are planning to have children, pregnant women or breastfeeding women.

2. History of allergic reactions to vaccines, neurological diseases, and mental illnesses.

Regarding individual differences,

The protective effect of antibodies may vary from person to person.

Can transplant patients get the COVID-19 vaccine?

1. It is recommended to vaccinate 6 months after transplantation.

2. Patients with underlying diseases such as congenital immunodeficiency, concurrent graft-versus-host disease (GVHD), or those who are currently receiving immunosuppressive therapy should consult a specialist for advice.

3. However, whether protective antibodies can be produced after vaccination depends on the degree of individual immune reconstruction. Generally speaking, the longer the time after transplantation, the better the vaccination effect.

Three things to note when getting the COVID-19 vaccine

1. After vaccination, it is recommended to stay at the vaccination site for at least 30 minutes.

2. After vaccination, the vaccination site must be kept clean. Pain, tenderness, redness, swelling and itching may occur at the vaccination site, which will disappear on its own within 2-3 days in most cases;

3. Pay attention to observe physical signs within 1 day after vaccination. If symptoms such as continuous fever occur, go to a nearby hospital for treatment and report to the vaccination unit.

4. The protective effect of vaccination is not 100%, and it takes a certain amount of time to produce protective antibodies. It is recommended to maintain good hygiene habits and take personal protection after vaccination.

5. Avoid combined vaccination. If you have received other inactivated vaccines within 14 days or other live attenuated vaccines within 28 days, you should postpone the COVID-19 vaccine.

Union Hospital Affiliated to Fujian Medical University

Contributed by the Hematology Branch of the Fujian Provincial Medical Doctors Association

References:

1. Instructions for use of China National Biotec Group’s COVID-19 inactivated vaccine, Sinopharm Group

2. Can patients with blood diseases receive the new coronavirus vaccine?

https://www.haodf.com/zhuanjiaguandian/jiajinsong_9029820758.htm

3. COVID-19 vaccine tutorial for patients with blood diseases

https://www.haodf.com/zhuanjiaguandian/heguangsheng_8997998384.htm

4. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58(3):309–318

5. Immunization of patients undergoing hematopoietic stem cell transplantation. Chinese Journal of Hematology. 2019; 40(4): 344–347

(Photo and text editor: Li Nan, Science Popularization China photo and text editor: Huang Xiafei)