Indications and contraindications for vaccination with Comirnaty vaccine of Pfizer - BioNTech

Indications and contraindications:

COVID-19 vaccination for some special groups:
+ Group of people with comorbidities: People with underlying diseases and chronic diseases are at high risk of infection and severe COVID-19 so they need to be vaccinated. However, before vaccination, they need to be carefully screened and vaccinated when the disease has stabilized.
+ Pregnant women: vaccination is not recommended for pregnant women, because there is insufficient data on the risks occurring in pregnant women. However, if the benefits of vaccination outweigh the potential risks of the vaccine for pregnant women. Pregnancy testing before vaccination is not recommended.
+ Breastfeeding women: Get vaccinated if they are in the risk group.
There is no need to stop breastfeeding after vaccination.
+ 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 with autoimmune diseases: Can be vaccinated if they do not have contraindications to vaccination.
+ People with HIV: Can be vaccinated if they are well controlled with antiretroviral treatment and they are in a risk group that needs vaccination.
+ Groups of people with a history of facial paralysis: can be vaccinated if there are no contraindications
+ Groups of people with a history of using monoclonal antibodies or patient plasma to treat COVID-19 before: Vaccinate at least 90 days later to avoid the effect of treatment on the immune response caused by the vaccine.

Contraindications:
+ Have a history of allergic reaction (anaphylactic) to any ingredient of the Comminaty Pfizer - BioNTech COVID-19 vaccine. In particular, it should not be used by people with a history of severe allergic reactions to polyethylene glycol (PEG) or related molecules.
+ People who have an immediate allergic reaction (e.g., anaphylaxis, hives, angioedema, respiratory depression) to the first dose of this vaccine should not receive subsequent doses.

Vaccination at the same time with other vaccines:
+ There is not enough data on the vaccine's ability to be used interchangeably 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

Indications for vaccination: When health conditions are met, there are no abnormalities that require postponing the injection or contraindications
+ Shot 1: Vaccination for people 18 years and older.
+ Shot 2: injected 3 - 4 weeks after shot 1.

Vaccination is contraindicated in the following cases:
+ Have a history of severe anaphylactic reaction of grade 2 or higher to any allergen
+ Other contraindications according to the manufacturer's instructions:
- Have a history of allergic reaction (anaphylactic) to any component of the Pfizer – BioNTech Comirnaty vaccine. In particular, people with a history of severe allergic reactions to polyethylene glycol (PEG) or related molecules should not be vaccinated.
- People who have an immediate allergic reaction (e.g., anaphylaxis, hives, angioedema, respiratory depression) to the first dose of this vaccine should not receive subsequent doses.

Temporarily postpone vaccination
+ Have had COVID-19 within 6 months. Within the previous 90 days, there was immunoglobulin treatment or plasma treatment of a COVID-19 patient.
+ History of other vaccinations within the previous 14 days.
+ People with immunodeficiency, end-stage cancer, splenectomy, decompensated cirrhosis. Within the previous 14 days, there was high-dose corticosteroid treatment (equivalent to prednisolone ≥ 2 mg/kg/day for ≥ 7 days), or chemotherapy or radiotherapy.
+ Suffering from acute illnesses
+ Progressive chronic diseases.
+ Pregnant women, women who are breastfeeding.

Subjects who need to be cautious, must be carefully screened and vaccinated in a hospital or medical facility with sufficient initial emergency resuscitation capacity:
+ People with a history of allergies to other allergens.
+ People aged ≥65 years old.
+ People with underlying, chronic diseases are treated stably.
+ People with a history of blood clotting/hemostatic disorders or are taking anticoagulants.
+ 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)
+ There are abnormal signs when auscultating the heart and lungs
+ People lose consciousness and ability to act.

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