COVID vaccine information for APS patients
While the vast majority of people are still vulnerable to COVID-19, a vaccine could help teach our bodies to fight the virus by stopping us from being infected or, at least, make COVID-19 less deadly.
There are now three different COVID vaccines currently available in the UK: the Pfizer/BioNTech, the Oxford AstraZeneca and Moderna.
Until 7th April 2021, the government advice from the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) and the Joint Committee on Vaccination and Immunisation (JCVI) has been that each of the available COVID vaccines can be used in any patient group.
There was no evidence to suggest that patients with APS were at increased risk of complications from any of the available COVID vaccines.
On 7th April 2021, the government released new guidance based on the analysis of a small number of people who have suffered very rare adverse events of clots and low platelets in patients who received the first dose of the Astra Zeneca vaccine. Adverse events have not been reported after the second dose.
According to the data on the government website, there have been 79 cases of this adverse event, whereas over 20 million people have been given the Astra Zeneca vaccine in the UK. So, for every one million people receiving the vaccine, four could develop this adverse event. This is an extremely low risk.
The new advice is that patients who have a higher risk of blood clots due to their medical condition should receive the Astra Zeneca vaccine only if the benefit outweighs the risk of clots. It is not clear whether this means that they and their healthcare practitioners will be able to choose one of the other two vaccines (Pfizer or Moderna) instead, so APS Support UK is asking the MHRA for clarification on this point.
The MHRA has been in touch with us directly since December 2020 when the vaccines were first approved and has provided our charity with guidance for people with antiphospholipid syndrome. They have acknowledged our email request on 11th April 2021 so we hope to hear from them shortly and will update this page as soon as we hear from them.
COVID-19 vaccine and anticoagulation
Thank you to Thrombosis UK and Professor Beverley Hunt (OBE) for providing this update:
The COVID-19 vaccine is given as an injection into your upper arm (intramuscular).
Individuals receiving direct oral anticoagulant (apixaban, dabigatran, edoxaban & rivaroxaban) or warfarin in therapeutic INR range, on full dose heparin or fondaparinux injections or antiplatelet medications such as aspirin and clopidogrel can all receive the COVID-19 vaccination.
Please beware of the following issues:
- There is a risk of bruising at the injection site, but we do not anticipate any serious effects related to anticoagulation
- We suggest that after the injection prolonged pressure (at least 5 minutes) should be applied to the injection site to reduce bruising
- Patients on warfarin with supra-therapeutic INR should wait until their INR is <4.0
- We encourage patients to have vaccinations and they should not be avoided on the basis of being on anticoagulation treatment
Please click here: https://www.versusarthritis.org/covid-19-updates/vaccines-for-covid-19-your-questions-answered/ if you would like to learn more about the vaccine programme and current advice for patients.
shield, but remain in any doubt about your individual situation you should contact your GP.