Professor Karina Butler, consultant paediatrician and Chair of the National Immunisation Advisory Committee, and Dr Cillian De Gascun, Director of the National Virus Reference Laboratory, have been answering the questions of RTÉ Drivetime listeners on Covid-19 vaccines.
Q. Margaret suffers from allergic reactions to a large number of medicines, NSAIDS (Non-steroidal anti-inflammatory drugs), penicillin and live vaccines. Hilda has an epipen, is 73 years old, allergic to aspirin and kiwi fruit. Lynn also carries an epipen, is allergic to NSAIDs and had no trouble with flu or pneumonia vaccine. Can they safely get this vaccine?
A. Professor Butler said on a precautionary principle, people who have had anaphylactic reaction, difficulty breathing, collapse, blood pressure problems, should not get the vaccine for now, while it is being investigated. Talk to their GP to see what the nature of their allergy was.
Q. Philip writes: I suffered from an allergy to some unknown substance from my early teens until my mid 40s. I have had no allergic reactions since and I am wondering if it is safe for me to get immunised now at age 76?
A. If there is a significant history of severe anaphylaxis you should hold off for now. On a precautionary basis seek advice from your GP or an immunologist.
Q. Elizabeth is epileptic, 57, has been seizure-free for over ten years. However, she is in two minds about taking a vaccine – is this vaccine safe?
A. Yes. With an underlying condition that is well managed, I do not see any reason why she would not be able to get the vaccine.
Q. Patricia is 71, had an aortic valve replacement and aortoplasty in 2019. She also suffers from hypothyroidism and vertigo – will any of these conditions prevent her from having the vaccination?
A. None of them will prevent her from having the vaccine and the fact that she has had all of those conditions puts her at a high risk of severe consequences from Covid. You are weighing up the risks and the balances. The very real risk of Covid far outweigh any small unknown risk related to the vaccine. I would be encouraging her to get the vaccine and she should be prioritised.
Q. Ailish asks will the vaccine work on people with a high BMI?
A. Yes. The vaccine will work and this is a group of people who we know stand out as being at risk, so they are very much a group that should get the vaccine.
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Q. Anne has had a liver transplant and is on Advagraf, Kathleen had a liver transplant five years ago and is on immuno-suppressants – can they get the vaccine?
A. Absolutely. People who have been through solid organ transplant are groups identified as being high-risk from Covid so they should get the vaccine.
Q. Siobhan’s husband suffering from ongoing post-Covid Inflammatory Syndrome, has been unwell for past ten months and he is 75. Is it safe for him to get this vaccine?
A. We are still learning about post-Covid syndromes so he should get the advice from the consultant or doctor who is looking after him. We do know that the vaccine was safe for those who were in the trial who had Covid before.
Q. Timothy asks what procedures will be place to ensure that people who have had to have their immune systems suppressed and are not offered a vaccine containing a live virus. Are there any vaccines that could be offered?
A. This vaccine does not contain any live virus. The Messgener RNA vaccine takes a set of instructions to the host cell as to how to make the antigen that is going to stimulate a pro-immune response. A non-live vaccine therefore does not pose any specific hazard, but sometimes a person who is immuno-suppressed will not get as a good a protection. This vaccine cannot cause infection.
Q. What about children with underlying conditions? They are last on the list. When is the vaccine going to be given to them and has the Pfizer vaccine been tested on children under 18?
A. There are no children on the list of those to receive the vaccine in this roll-out. Trails are ongoing, so we need to wait for more safety data before making a decision about giving the vaccine to children.
Q. Ailish asks would you recommend that children get the vaccine?
A. We need to wait for more information before we recommend that children are vaccinated. They are part of a cohort that if they get the virus, they have a much lower risk of having severe outcomes. We anticipate that we will have more data on this in coming months about the efficacy of the vaccine in children.
Q. What about someone going through IVF? Or trying to have a baby?
A. Like any non-live vaccine there is no reason why it should cause a problem, but we do not have enough data to confirm this yet.
It is recommended that people who are in this group should if possible, get the vaccine and wait three months before starting the IVF process or trying to have a baby, but that is being very cautious, Prof Butler said.
Q. If a woman is breastfeeding – is it safe for her to get the vaccine?
A. There is no theoretical risk why the vaccine would cause any harm, but we do not have enough data on that yet.
Q. Is any one vaccine better than the other?
A. There have not be head-to-head trials, but on paper it looks like the Messenger RNA vaccine is superior. People should be encouraged to take whatever vaccine that is available to them.
Q. Could you pay to get the vaccine privately?
A. Prof Butler said: “I doubt there will be free market supply and if there was I would be cautious of where it is coming from.”
Q. Will we still have to wear masks after we get the vaccine?
A. The public health measures are likely to be in place for some time, possibly until we get to a population level of immunity, which would require 80% of people being vaccinated.
Q. If you have had Covid-19 do you still have to get the vaccine?
A. Yes.
Q. Can you donate blood if you have had the vaccine?
A. No reason why you should not be able to.
Q. Is it free?
A. Yes.