By Sola Ogundipe
Recently, the World Health Organisation, WHO, in its Strategic Advisory Group of Experts on Immunisation, SAGE, issued its policy recommendations for the rollout of the first COVID-19 vaccine approved for emergency use – the Pfizer-BioNTech COVID-19 vaccine.
According to SAGE, the Pfizer-BioNTech COVID-19 mRNA vaccine is safe and effective and there are specific populations for whom vaccination is not recommended, either due to contraindications, lack of supply, or limited data.
These populations currently include people with a history of severe allergies, most pregnant women, international travellers who are not part of a prioritised group, and children under 16.
The priority is to start vaccinating health workers at high risk of exposure, followed by older adults, before vaccinating the rest of the population.
People who should not be vaccinated
According to the WHO, people with allergies should not be vaccinated if they have a history of a severe allergic reaction to any component of the vaccine should not take the vaccine.
Pregnant women are at higher risk of severe COVID-19 than non-pregnant women and COVID-19 has been associated with an increased risk of pre-term birth, but vaccination of pregnant women at this time is not recommended.
But in the event that a pregnant woman has an unavoidable risk high of exposure, vaccination may be considered.
The WHO says a woman that takes the vaccine is not recommended to get pregnant for 2 to 3 months post-vaccination.
A breastfeeding woman can be vaccinated if she is part of a group (such as health workers) recommended for vaccination. Breastfeeding shouldn’t be discontinued by such women after vaccination.
The vaccine has only been tested in children above 16 years of age, therefore, children below 16 years of age are not recommended to be vaccinated even if they belong to a high-risk group.
The vaccine has been found to be safe and effective in people with various conditions that are associated with an increased risk of severe disease.
This includes hypertension, diabetes, asthma, cancer, pulmonary, liver, or kidney disease, as well as chronic infections that are stable and controlled.
For persons who are immune-compromised, they may be vaccinated if they are part of a group recommended for vaccination when possible, but not before receiving information and counselling.
Persons living with HIV are at higher risk of severe COVID-19 disease. But limited safety data exists on HIV-infected persons with the well-controlled disease from the clinical trials.
Vaccination can be offered to people who have had COVID-19 and recovered, however, they may wish to defer their own vaccination for up to six months from the time of infection.
Testing for prior infection is not recommended for the purpose of vaccine decision-making.
At present, WHO does not support the introduction of requirements for proof of vaccination against COVID-19 for international travelers as a condition for exiting or entering a country or for travelling internationally.
Safe and effective vaccines will be a gamechanger, for the foreseeable future, but everyone must continue to wear masks, physically distant, avoid crowds, and apply other health measures.
Vaccination is not cure
Being vaccinated doesn’t mean you can throw caution to the wind and put yourself and others at risk. It is still not clear the degree to which the vaccines can protect not only against disease but also against infection and transmission.