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Who should not get the COVID-19 vaccine?


who should not get

Contraindications

Below are the age groups authorized to receive COVID-19 vaccines, as approved by the U.S. Food and Drug Administration (FDA) under Emergency Use Authorization (EUA):1

  • Pfizer-BioNTech mRNA vaccine is authorized for persons 16 years of age and older. Persons under than 16 years of age should not receive this vaccine.
  • Moderna mRNA vaccine is authorized for persons 18 years of age and older. Persons under 18 years of age should not receive this vaccine.
  • Janssen/Johnson & Johnson viral vector vaccine is authorized for persons 18 years of age and older. Persons under 18 years of age should not receive this vaccine.

No data is available on the safety of administering mRNA COVID-19 vaccines with other vaccines. Health officials recommend that COVID-19 vaccines be administered alone, and not within 14 days of receiving another vaccine.2

According to CDC interim clinical consideration guidelines for use of mRNA COVID-19 vaccines published March 5, 2021, contraindications to receiving the Moderna, Pfizer-BioNTech, and/or Janssen/Johnson & Johnson vaccine include a history of:3

  • Severe allergic reaction to any ingredient contained within the vaccine or after a previous dose of the COVID-19 vaccine;
  • Immediate allergic reaction of any seriousness to any ingredient contained within the vaccine (including polyethylene glycol [PEG) or diagnosed allergy to a COVID-19 vaccine ingredient;

The CDC also states that persons that have a contraindication to one of the mRNA COVID-19 vaccines should not receive a second dose, and may be able to receive the Janssen/Johnson & Johnson COVID-19 vaccine, and vice versa, provided precautions are followed.  

Persons with an allergy to polysorbate may receive mRNA COVID vaccines, though previously this was considered a contraindication due to potential cross-reactive hypersensitivity to the polyethylene glycol (PEG) contained in these vaccines. However, a polysorbate allergy remains as a contraindication to receiving the Janssen/Johnson & Johnson COVID-19 vaccine. Guidance encourages providers to make distinctions between true allergic reactions versus other types of reactions, such as syncope or other vaccine side effects, to more accurately determine if a person who has reacted should receive a second dose of an mRNA COVID-19 vaccine.4

Precautions

Individuals with a history of previously receiving dermal fillers have experienced swelling near or at the site of filler injection after mRNA COVID-19 vaccine. While a history of receipt of dermal fillers is not a contraindication to receiving mRNA COVID-19 vaccines, the CDC advises that anyone who experiences swelling after vaccination should contact their health care provider immediately.5

The CDC cautions on the use of mRNA COVID-19 vaccines in persons who have a history of immediate allergic reaction to any injectable therapy or other vaccine, and states that precautions should be considered in consultation with an allergist-immunologist as follows:6

  • Persons with a contraindication to mRNA COVID-19 vaccines (including known PEG allergy) may be given to vaccination with Janssen/Johnson & Johnson COVID-19 vaccine.
  • Persons who have received the first dose of an mRNA COVID-19 and who have a contraindication to the second dose, should wait at least 28 days before receiving the Janssen/Johnson & Johnson COVID-19 vaccine.
  • Persons with a contraindication to Janssen/Johnson & Johnson COVID-19 vaccine (including diagnosed polysorbate allergy) may be given mRNA COVID-19 vaccines, and notes that polysorbate allergy is a precaution.

Special Populations and Conditions

There is no data on the safety of COVID-19 vaccines in persons with immunocompromising conditions or HIV infection, or in persons with auto-immune disorders and data is limited related to timing for individuals intending to receive immunosuppressive therapies. However, CDC guidance states that these vaccines may be given to these populations, with the provision that HIV infected individuals are stable and consideration on possible delay of immunosuppressive therapy.7

According to the Food and Drug Administration (FDA), reported cases of Bell’s Palsy during clinical trials do not exceed the frequency of occurrence in the general population and have not been determined as related to COVID-19 vaccines.8

There is a lack of safety data on the use of mRNA COVID-19 vaccines in persons who have been treated for COVID-19 illness using monoclonal antibodies or convalescent plasma. As evidence appears to indicate that reinfection with SARS-CoV-2 virus is uncommon within 90 days of initial infection, health officials recommend that COVID-19 vaccination be deferred for at least three months following receipt of antibody therapy.

There is insufficient data to determine the safety of mRNA COVID-19 vaccines in pregnant women, and it is not known whether these vaccines can cause harm to the mother or developing baby. There is also no safety data on the use of mRNA COVID-19 vaccines in lactating women, or the effects of the vaccine on the breastfed baby.9

IMPORTANT NOTE: NVIC encourages you to become fully informed about covid-19 and the covid-19 vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.

« Return to Vaccines & Diseases Table of Contents

References

1 U.S. Centers for Disease Control and Prevention. Authorized age groups. In: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Mar. 5, 2021.

2 U.S. Centers for Disease Control and Prevention. Coadministration with other vaccines. In: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Mar. 5, 2021.

3 U.S. Centers for Disease Control and Prevention. Contraindications and precautions. In: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Mar. 5, 2021.

4 U.S. Centers for Disease Control and Prevention. Contraindications and precautions. In: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Mar. 5, 2021.

5 U.S. Centers for Disease Control and Prevention. Considerations for vaccination of people with certain underlying medical conditions. In: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Mar. 5, 2021.

6 U.S. Centers for Disease Control and Prevention. Contraindications and precautions. In: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Mar. 5, 2021.

7 U.S. Centers for Disease Control and Prevention. Considerations for vaccination of people with certain underlying medical conditions. In: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Mar. 5, 2021.

8 U.S. Centers for Disease Control and Prevention. Considerations for vaccination of people with certain underlying medical conditions. In: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Mar. 5, 2021.

9 U.S. Centers for Disease Control and Prevention. Contraindications and precautions. In: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Mar. 5, 2021.


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