Optimise comorbidities before taking vaccine, say Indian health experts

Health experts in India have cautioned those with comorbid conditions opting for the vaccine to first get a thorough health checkup and control their comorbidities The warning comes as the United Kingdom UK and the European Union EU temporarily halted the use of the AstraZeneca vaccine which is suspected to have caused clotting of blood in some recipients Those who have taken the jab have been advised to watch out for discomfort or pain around the calf areaSenior citizens take selfies after getting vaccinated on TuesdayDr Ketan Vagholkar professor of Surgery at D Y Patil Medical College said ldquoIndia needs to proactively monitor similar effects especially in those with comorbidities Such instances have not been reported in India so far But the warning from Europe cannot be ignoredrdquoDr Vagholkar added ldquoIt is advisable that those above the age of 45 years who have taken or plan to take the vaccine get a health checkup before taking the jab The purpose would be to diagnose underlying comorbid ailments Those who already have comorbid ailments should be optimised controlling diabetes blood pressure and heart ailments Adequate hydration is essential during and postvaccination A flulike illness usually follows the vaccination This can lead to thrombotic complications in dehydrated individuals Watch out for pain swelling in the legs calf muscles breathlessness chest discomfort and headache Seek medical assistance immediately if symptoms are observedrdquolsquoNeed careful introspectionrsquoDr Wiqar Shaikh professor of Medicine Grant Medical College and Sir JJ Group of Hospitals expressed serious concern about the development Dr Shaikh emphasised that there are guidelines for administering COVID vaccines People suffering from allergies autoimmune disorders rheumatoid arthritis SLE pregnant women etc are already exempted from taking the vaccine ldquoBlood clotting is a worrisome sideeffect particularly when it results in death as has been seen in some vaccine recipients in Europe and we need to carefully study the decisions taken by European countries before allowing further vaccination by AstraZenecardquo said Dr ShaikhFrontline workers get vaccinated at Nair Hospital PicAshish RajeDr Shaikh said to monitor pain in the calf area followed by breathlessness ldquoThis indicates a blood clot in the leg that can reach the lung causing a pulmonary embolism It can also travel to any other part of the body Clotting of blood may take several hours or days post the jab and cannot be ignoredrdquo he saidDr Subhash Hira professor of Global Health at the University of WashingtonSeattle USA said ldquoIt is not unreasonable to hypothesise that genetic COVID vaccines such as Pfizer and Moderna may also directly infect platelets and lead to autoimmune response resulting in autocoagulation It is also known that the adenovirus used as a carrier of lsquoSrsquo and lsquoNrsquo proteins of Coronavirus AstroZaneca vaccine or even the dengue virus itself on its own can stimulate similar autoimmune response leading to a lsquocytokine stormrsquo causing hypercoagulation But it is much safer to get the vaccine to prevent COVID which causes a cytokine storm in nearly two per cent patients than to worry of clotting due to the vaccine seen in 00003 per cent recipientsrdquoWhat AstraZeneca saysThe company said in a statement ldquoAcross the EU and UK there have been 15 events of DVT deep vein thrombosis and 22 events of pulmonary embolism among those given the vaccine based on the number of cases the Company has received as of 8 March In clinical trials even though the number of thrombotic events was small these were lower in the vaccinated group There has also been no evidence of increased bleeding in over 60000 participants enrolledrdquoAnn Taylor Chief Medical Officer AstraZeneca said ldquoAround 17 million people in the EU and UK have now received our vaccine and the number of cases of blood clots reported in this group is lower than the hundreds of cases that would be expected among the general population The nature of the pandemic has led to increased attention in individual cases and we are going beyond the standard practices for safety monitoring of licensed medicines in reporting vaccine events to ensure public safetyldquoAdditional testing has and is being conducted by ourselves and independently by European health authorities and none of these retests have shown cause for concern During the production of the vaccine more than 60 quality tests are conducted by AstraZeneca its partners and by more than 20 independent testing laboratoriesldquoThe Company is keeping this issue under close review but available evidence does not confirm that the vaccine is the cause To overcome the pandemic it is important that people get vaccinatedrdquo17 mnNo of people in UK and EU who have received the AstraZeneca vaccine