As much as we want everyone to get vaccinated and protected, there are some folks who shouldn’t get a COVID vaccine, especially those with contraindications to getting vaccinated.
And no, it shouldn’t be because you think the COVID vaccine is a bioweapon!
COVID Vaccine Contraindications
So what are the real COVID vaccine contraindications?
Fortunately, as with other vaccines, there aren’t that many of them.
They do include:
- having a history of a severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a component of the vaccine
- having a history of an immediate allergic reaction (any hypersensitivity-related signs or symptoms consistent with urticaria, angioedema, respiratory distress (e.g., wheezing, stridor), or anaphylaxis that occur within four hours following administration) of any severity after a previous dose or known (diagnosed) allergy to a component of the vaccine
And with one of these contraindications, you should not get that COVID vaccine.
There is a possibility that you could get a different COVID vaccine though. For example, if you had a severe allergic reaction to PEG, then you could probably get the Janssen COVID vaccine.
“Polyethylene glycol (PEG) is an ingredient in both mRNA COVID-19 vaccines, and polysorbate 80 is an ingredient in Janssen COVID-19 vaccine. PEG and polysorbate are structurally related, and cross-reactive hypersensitivity between these compounds may occur. People with a contraindication to mRNA COVID-19 vaccines (including due to a known allergy to PEG) have a precaution to Janssen COVID-19 vaccine. Among people who received one mRNA COVID-19 dose but for whom the second dose is contraindicated, consideration may be given to vaccination with Janssen COVID-19 vaccine (administered at least 28 days after the mRNA COVID-19 dose). People with a contraindication to Janssen COVID-19 vaccine (including due to a known allergy to polysorbate) have a precaution to mRNA COVID-19 vaccines. For people with these precautions, referral to an allergist-immunologist should be considered.”
Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States
What about blood clots?
“Janssen COVID-19 Vaccine (Johnson & Johnson): Effective April 23, 2021, CDC and FDA recommend that use of the Janssen COVID-19 Vaccine resume in the United States. However, women younger than 50 years old especially should be made aware of a rare risk of blood clots with low platelets following vaccination and the availability of other COVID-19 vaccines where this risk has not been observed”
Janssen COVID-19 Vaccine (Johnson & Johnson)
While there is a warning because of the rare risk of blood clots in young women with the Janssen COVID vaccine, that isn’t a contraindication if someone prefers that one-dose vaccine.
COVID Vaccine Precautions
Are there any other COVID vaccine contraindications or precautions?
Well, if you have an active COVID infection and are still contagious, then you shouldn’t get vaccinated yet. You should be in isolation so that you don’t get anyone else sick!
“Any currently authorized COVID-19 vaccine can be administered to people with underlying medical conditions who have no contraindications to vaccination…”
nterim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States
And talk to your provider if you have any complex medical problems, although in general, most of these people are at high risk for complications if they get a natural COVID infection and should get vaccinated and protected.
Also be aware that:
- if you have a history of MIS-C or MIS-A, then you should consider delaying getting their COVID vaccine for 90 days after the date of their diagnosis and until they have recovered
- if you received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment should consider delaying getting their COVID vaccine for at least 90 days
- people with a history of an episode of an immune-mediated syndrome characterized by thrombosis and thrombocytopenia, such as HIT, should be offered an mRNA vaccine (Pfizer or Moderna COVID vaccines) instead of the Janssen COVID vaccine if it has been ≤90 days since their illness resolved
- people with risk factors for venous thromboembolism (VTE) (e.g., inherited or acquired thrombophilia including Factor V Leiden; prothrombin gene 20210A mutation; antiphospholipid syndrome; protein C, protein S or antithrombin deficiency), or a prior history of other types of thromboses (including cerebral venous sinus thrombosis [CVST]) not associated with thrombocytopenia can receive any FDA-authorized vaccine, including the Janssen COVID-19 vaccine
- the currently FDA-authorized COVID-19 vaccines are not live vaccines and therefore can be safely administered to immunocompromised people
- people with autoimmune conditions may receive any FDA-authorized COVID-19 vaccine
- antibody testing is not recommended to assess for immunity to SARS-CoV-2 following COVID-19 vaccination
Still not sure if you have a contraindication or precaution to getting a COVID vaccine?
“Healthcare providers or health departments in the United States can request a consultation from CISA COVIDvax for a complex COVID-19 vaccine safety question that is (1) about an individual patient residing in the United States or vaccine safety issue and (2) not readily addressed by CDC or Advisory Committee on Immunization Practices (ACIP) guidelines.”
Clinical Immunization Safety Assessment (CISA) Project
You might see an Immunologist for some extra help or ask your health care provider to request a COVID-19 CISA clinical consult.
More on COVID Vaccine Contraindications
- COVID-19 Vaccination Questions and Answers
- The Truth About COVID-19 Vaccines
- Alternative COVID Vaccine Facts
- What Are the COVID-19 Vaccine Side Effects?
- Fainting After Getting a COVID-19 Vaccine
- Is Paralysis a COVID Vaccine Side Effect?
- Can COVID-19 Vaccines Cause Myocarditis?
- COVID-19 Vaccines Are Not Associated With Bell’s Palsy
- Breakthrough COVID-19 Infections and Deaths
- Coadministration of COVID Vaccines with Other Vaccines
- Autoimmunity as a Contraindication to Getting Vaccinated
- More Questions to Help You Become a Vaccine Skeptic
- CDC – Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States
- CDC – Janssen COVID-19 Vaccine (Johnson & Johnson)
- IAC – Ask the Experts about COVID-19 Vaccines
- Clinical Immunization Safety Assessment (CISA) Project