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Sunday June 20th, 2021
Health

Get specialist opinion before getting jabbed, Sri Lanka MoH tells chronic patients

ECONOMYNEXT – Sri Lanka’s health authorities recommend that people who suffer from certain underlying conditions get a medical specialist’s opinion before receiving any of the COVID-19 vaccines currently being rolled out.

This is amid unconfirmed reports that people with high blood pressure, diabetes and other chronic conditions were turned away at a number of vaccination centres in Colombo today.

EconomyNext could not independently verify these claims at the time of writing. However, the Ministry of Health’s official guidelines on both the Russia-made Sputnik V jab and the Chinese Sinopharm jab recommend that people with the following conditions consult a specialist prior to getting the shot.

Sputnik V

  1. Anyone allergic to any component of this product (including excipients)
  2. Immediate or delayed onset allergic /anaphylactic reactions after a previous dose of the same vaccine.
  3. Immediate or delayed onset anaphylactic or severe allergic reaction to vaccines or injectable therapies, pharmaceutical products, food-items etc
  4. Pregnant and lactating women (lactation is considered only for the initial six months after delivery). (reason: due to unavailability of clinical trial data)
  5. Chronic liver and kidney diseases, endocrine disorders (apparent thyroid function abnormalities and diabetes mellitus in decompensation stage), serious diseases of the hematopoietic system, epilepsy and other CNS diseases, acute coronary syndrome and acute cerebrovascular event, myocarditis, endocarditis, pericarditis
  6. Due to lack of data not indicated for persons with:
  • autoimmune diseases (stimulation of the immune system can lead to an exacerbation of the disease, special caution should be exercised with patients with an autoimmune disorder that tend to lead to severe and life-threatening conditions)
  • malignant neoplasms
  1. Special precautions should be followed in persons with a history of any bleeding or coagulation disorders (e.g. clotting factor deficiency, coagulopathy, platelet disorders) before intramuscular injection.
  2. Vaccination will be postponed for citizens who were recently discharged from hospitals having being treated for COVID-19
  • Any signs and symptoms suggestive of acute SARS-CoV 2 infection or suffering from any other acute illness who are not fit for the vaccination
  • Already diagnosed SARS-CoV 2 patient who has received anti-CoV 2 monoclonal antibodies or convalescent plasma as a treatment option

However, the guidelines do indicate that patients with these conditions other than those who have recovered from COVID-19 can be vaccinated with caution, only if the treating clinician or a consultant physician or emergency care physician has assessed the individual and recommended vaccination under his or her care.

“The decision to vaccinate for any person not indicated for vaccination should be based on a proper risk-benefit assessment by the treating physician or by the recommendations of an expert from the relevant specialty under his guidance,” the guidelines state.

State Minister Sudharshani Fernandopulle confirming the guidelines told EconomyNext today that after studying available data on the vaccines, health authorities have recommended not giving the jab to people with a history of allergic reactions  to other vaccines and sever underlying conditions.

“Sputik V is not recommended for people with severe allergic reactions and other underlying conditions,” she said.

Sinopharm

As per the guidelines issued for Sinopharm, people with the following conditions are not recommended to receive the vaccine.

  1. Individuals who are allergic to any component of this product (including excipientsDisodium hydrogen phosphate, Sodium chloride, Sodium dihydrogen phosphate, Aluminium hydroxide).
  2. Immediate or delayed onset allergic /anaphylactic reactions after a previous dose of the SARS-CoV-2 (Vero Cell), Inactivated Vaccine.
  3. Patients with uncontrolled epilepsy or other progressive nervous system diseases, with a history of Guillain-Barre syndrome and any adverse nervous system reaction occurred after a previous dose of the same vaccine product.
  4. Pregnant and lactating women lactation (lactation is considered only for the initial 6 months after delivery) [not done clinical trials so far for adequate evidence).
  5. Below 18 years of age (not done clinical trials so far)
  6. Use with caution in patients with acute diseases, acute onset of chronic diseases, severe chronic diseases, allergies and fever – advised to get clinician advise if necessary.
  7. Use with caution in patients who have diabetes and those with a history or family history of convulsions, epilepsy, encephalopathy or mental illness.
  8. Use with caution in patients who have decrease in platelets or clotting disorders (e.g. clotting factor deficiency, coagulopathy, platelet disorders) because of the risk of bleeding which may occur during intramuscular administration of the vaccine. Need to get specialized opinion if need of the disease condition.
  9. Use with caution in patients with impaired immune function (such as malignant tumor, nephrotic syndrome, AIDS patients, etc.) because the safety and efficacy data are not available, and such population should be vaccinated on an individual basis.
  10. People injected with immunoglobulin should be vaccinated with this product at least 1 month apart, so as not to affect the immune efficacy.

State Minister Fernandopulle said the Sinopharm vaccine will be given to people above 60 years of age in addition to the current 30-to-59 category, following discussions held at Sri Lanka’s COVID-19 task force.

Sri Lanka has administered the first dose of Sinopharm and Sputnik V to 147,741 and 14,673 citizens respectively so far.

Meanwhile, from April 23 to May 13, 231,557 people out of the 925,242 including frontline workers received their second dose of AstraZeneca. (Colombo/ May 13/2021)

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