Image: Getty Images
Image: Getty Images

ScienceSeptember 27, 2021

Who *can’t* get the Covid-19 vaccine?

Image: Getty Images
Image: Getty Images

As vaccination rates continue to climb, the advice is clear that almost everyone 12 or over can safely roll up their arm for the Pfizer. But who can’t? Mirjam Guesgen sorts the rumour from the fact.

Quick note to start: we’re not doctors. Consult your GP or Healthline for any specific medical advice. The below is based on guidelines and recommendations from government and vaccine manufacturers.

Who can get the vaccine in New Zealand?

The vaccine being used in Aotearoa is the Pfizer-BioNTech (also known as Comirnaty). It has been cleared by the regulator as safe for almost everyone 12 and over.

So who in that group can’t get the vaccine?

Anything, like a symptom or medical condition, that is reason for someone not getting a particular medical treatment or procedure because it could be harmful is called a “contraindication”.

According to the Ministry of Health, the contraindications for Pfizer are:

  1. If you have a history of a severe allergic reaction (anaphylaxis) or immediate allergic reaction, even if it wasn’t severe, to any of the ingredients in the vaccine.
  2. If you had anaphylaxis to a previous dose of the vaccine.

The ingredients of the Pfizer vaccine are listed on the Ministry of Health website.

What should you do if you’ve had a severe allergic reaction to the ingredients or the drug in the past?

Don’t get the vaccine and seek professional advice.

Are there currently any Covid-19 vaccination options available for those people?

Not yet.

The ministry will consider rolling out the Janssen vaccine once doses have been delivered in the final quarter of 2021. 

A ministry spokesperson told The Spinoff: “While no decisions have been made to date about the use of the AstraZeneca or Janssen Covid-19 vaccines in New Zealand, we recognise that there may be merit in providing a different vaccine for those individuals unable to, or hesitant to take an mRNA-based vaccine.”

What if I’m allergic to something else (food, pets, other oral drugs, pollen, grasses, latex, eggs, gelatin)?

You can still get the vaccine, says the Ministry of Health. These allergies aren’t considered contraindications, but precautions.

The ministry recommends talking to your doctor before getting vaccinated if you’re concerned. When you’re vaccinated, you’ll need to wait for 30 minutes after, instead of the usual 15. Vaccination centres also have drugs on hand that can treat anaphylaxis if it occurs. 

Can I get vaccinated if I’m immunocompromised?

Yup. Immunocompromised people are at a higher risk of getting a serious infection if they’re around the Covid-19 virus, and vaccination can protect against that.

But your body might not be as good at building that immune response as someone with a tip-top immune system. 

That includes people who got an organ transplant or are getting some treatment that suppresses their immune system. 

The Ministry of Health recommends getting vaccinated before starting any immunosuppression but you can get vaccinated at any stage of treatment and shouldn’t hold off on getting treated. The ministry recommends discussing timings with your specialist.

What about if I have HIV?

Yup. Get that vaccine. Like other immunocompromised people, you’re at more risk of getting severely sick from the Covid-19 virus and should get vaccinated.

There’s also emerging evidence out of Africa that new variants of the virus can spring up in immunocompromised people who have been infected for a long time.

Pfizer is safe for people with HIV and it doesn’t interfere with antiretroviral medications. 

And if I have cancer?

Again, yes. People with cancer are at greater risk of getting a serious Covid-19 infection and should get the jab.

The Ministry of Health says that even if you’re currently getting treated, you can get vaccinated, just chat about the timing with your cancer doctor. There’s no evidence that the vaccine interacts with cancer treatments and there’s no evidence that your side effects will be any worse.

Should I get a third dose if I’m immunocompromised/have HIV?

The CDC and FDA in the US, the UK’s Joint Committee on Vaccination and Immunisation and the National Advisory Committee on Immunisation in Canada are now encouraging people who are immunocompromised, including those who have HIV, to get a third dose of the vaccine.

But according to the Ministry of Health, there isn’t currently enough evidence to support the widespread need for a third dose. The ministry is monitoring the emerging evidence carefully, it says, and it expects to have more certainty around third doses over the coming months. 

Can I get the vaccine if I’m pregnant, trying to get pregnant or breastfeeding?

Sure can. You can get the Covid jab at any stage of the pregnancy journey.

There are no extra safety concerns with getting the jab, based on evidence from people worldwide getting the vaccine. There’s also no evidence that getting the vaccine makes you more likely to miscarry. 

What’s really cool is that you might actually be protecting your baby too by getting vaccinated. There’s evidence that you can pass Covid-19 antibodies to your baby through the umbilical cord or breastmilk.

Can I get the jab if I have diabetes (type 1 or 2)?

Yup. Same deal as people who are immunocompromised, have cancer or HIV. You’re more at risk of Covid-19 so it’s a great idea to get vaccinated.

The vaccine is safe and effective for people with diabetes, based on clinical trials that included people with diabetes (although it’s not clear what type or if both were included).

And if I’m getting another vaccination (flu, MMR, whooping cough) soon or have just had one?

That doesn’t stop you getting the Covid-19 vaccine but you might need to wait a little while in between jabs. 

The Ministry of Health website gives recommendations for timing your vaccinations and which one to get first. Those timings depend on what vaccine you’re getting and whether you’ve had your other jab already or not.

What if I’m taking a blood thinner?

Book on in for that vaccine. But let your vaccinator know. It’s not about having a bad drug reaction, it’s that the Pfizer jab is injected into the upper arm muscle and that can make people on blood thinners more likely to bleed. 

Anything else?

None of these are reasons not to get immunised in general, including with the Covid jab, according to the Ministry of Health: 

  • Asthma, hay fever, eczema, “snuffles”, allergy to house dust
  • Taking antibiotics or locally acting steroids (as long as you feel well)
  • Neonatal jaundice
  • Low weight in an otherwise healthy child
  • Stable neurological conditions, such as cerebral palsy
  • Family history of vaccine reactions
  • Family history of seizures
  • Family history of sudden unexpected death in infancy

The full list is on the ministry website. Again, any concerns, chat to your doctor first.

If you have cold or flu symptoms, you should call Healthline first, not because it’s dangerous to get the vaccine, but because if you have Covid you don’t want to be wandering into a vaccination centre. 

Keep going!