Indications and contraindications for vaccination with Astrazeneca vaccine

Indications and contraindications:

COVID-19 vaccination for some special groups:

• Group of people aged 65 and over: This is a group of people at risk of severe COVID-19 and death proportional to age, so they are identified as a risk group. However, safety and effectiveness data for the AstraZeneca COVID-19 vaccine in people 65 years of age and older are limited.
• Group of people with underlying diseases: People with underlying diseases and chronic diseases are at risk of infection and severe COVID-19. However, get vaccinated when the disease has stabilized.
• Pregnant populations: Vaccination is recommended if the benefits of vaccination for pregnant women outweigh the potential risks of the vaccine, such as if they are healthcare workers at high risk of exposure or have comorbidities that are at high risk for severe COVID-19. Pregnancy testing before vaccination is not recommended.
• Breastfeeding women: Vaccinate if they are in a risk group such as healthcare workers. There is no need to stop breastfeeding after vaccination.
• People with HIV: Can be vaccinated if the subject is in a group at risk of exposure or at risk of severe disease, considering the benefits and risks for each individual. It is not necessary to test for HIV before receiving the vaccine.
• Immunocompromised people: Can be vaccinated if they belong to the risk group. Information and records on immunodeficiency need to be provided to medical staff to advise on benefits and risks as well as monitor and evaluate post-vaccination.
• Groups of people previously infected with SARS-CoV-2: symptomatic or asymptomatic, can be vaccinated after 6 months of recovery.
• Groups of people with acute COVID-19: Do not vaccinate people who are infected and tested positive by PCR. These people may be prescribed injections after 6 months of recovery.
• Groups of people with a history of using anti-COVID-19 antibodies for previous treatment: Vaccination is recommended at least 90 days after anti-COVID-19 antibody treatment.

Contraindications:

• If you have a history of severe reaction after a previous COVID-19 vaccination, you will not receive a second dose.
• Hypersensitivity to the active substance or to any of the excipients contained in the following vaccines: L-Histidine; L-Histidine hydrochloride monohydrate; Magnesium chloride hexahydrate; Polysorbate 80; Ethanol; Sucrose; Sodium chloride; Disodium edetate dihydrate;.

Vaccination at the same time with other vaccines:

• There are insufficient data on the interchangeability of COVID-19 vaccine Astrazeneca with other COVID-19 vaccines. 2 doses of the same COVID-19 vaccine are recommended.
• COVID-19 vaccination should be administered at least 14 days apart from other vaccinations.

Conclusion
1) Indications for vaccination: When health conditions are met, there are no abnormalities that require postponing vaccination or contraindications
+ Shot 1: Vaccination for people 18 years and older.
+ Shot 2: 4 weeks or more after shot 1.
2) Vaccination is contraindicated in the following cases:
+ If you have a history of severe or anaphylactic reaction of grade 2 or higher after a previous vaccination against COVID-19, you will not receive the second dose.
+ Hypersensitivity to the active ingredient or to any excipients contained in the vaccine.
3) Postpone vaccination
+ Suffering from acute diseases, infectious or chronic progressive diseases.
+ Pregnant women, women who are breastfeeding.
+ People with impaired immune response, end-stage cancer, decompensated cirrhosis.
+ Within the previous 14 days, had high-dose corticosteroid treatment (equivalent to prednisolone ≥ 2 mg/kg/day for ≥ 7 days), or chemotherapy or radiotherapy.
+ Have had COVID-19 within 6 months.
+ Within the previous 90 days, had immunoglobulin treatment or plasma treatment of COVID-19 patients.
+ History of other vaccinations within the previous 14 days.
+ People over 65 years old.
+ People with thrombocytopenia and/or blood clotting disorders.
4) Subjects who need to be screened and vaccinated in the hospital:
+ People with a history of allergies to other allergens.
+ People with serious underlying diseases or chronic diseases that have not been treated stably.
+ People lose consciousness and ability to act.
+ People with chronic diseases have abnormal vital signs detected:
• Pulse: < 60 beats/minute or > 100 beats/minute
• Blood pressure: Minimum blood pressure < 60 mmHg or > 90 mmHg
• Maximum blood pressure < 90 mmHg or > 140 mmHg
• Respiratory rate > 25 breaths/minute and/or SpO2 < 94% (if available)

Source: Covid-19 vaccination practice manual, National Immunization Program