COVID-19 Vaccination advice for patients on the waiting transplant list/with advanced Heart/lung disease/with a ventricular assist device

Several COVID-19 vaccines are currently in development. Two COVID-19 vaccines have been approved for use in the UK and are currently available for patients. The first is an mRNA based vaccine (Pfizer/BioNTech) and the second is the Oxford/AstraZeneca vaccine. 

If you would like to find out more about vaccines currently in development, please see vaccine tracker sites below:

The International Society of Heart and Lung Transplantation (ISHLT) has issued the following vaccination guidance for transplant recipients: https://ishlt.org/ishlt/media/Documents/COVID19_Vaccine-Recommendations_3-15-2021.pdf 

As your transplant team we have put together a number of questions with answers summarising our advice with regards to vaccination.

The vaccine has been developed with unprecedented speed but based on expertise and research on coronaviruses as well as vaccine development for other novel viruses. All vaccine candidates must meet very strict safety and effectiveness standards as set by our national and international regulatory authorities.  

Although this is the first licensed mRNA vaccine, mRNA vaccines have been extensively researched for cancer and infectious diseases. The mRNA COVID-19vaccine approved has been administered to over 70,000 participants without any significant concerns at the first 2 months follow up. It can cause fevers, muscle aches, and headaches which typically improve within 1-2 days. There are no available data so far regarding any long-term complications/ side effects from the mRNA COVID-19vaccine (or any of the other COVID19 vaccines currently in development) but there has been no indication of long-term risks so far. 

The safety in patients with advanced heart/lung disease is still unknow. However, given the widespread use of other vaccinations in these cohort of patients, we do not expect safety to be different. We believe that the potential advantage of outweighs any concerns for perceived lack of safety.

The efficacy of the first COVID-19  vaccine (Pfizer/BioNTech) is impressive and in the range of >90%. Similarly, the efficacy of the Oxford/AstraZeneca vaccine (currently awaiting approval) is in the range of 70%. Additionally, vaccination appears to protect against severe COVID-19 infection and complications.

We do not know yet how long the vaccination is protective from infection but so far antibody titles appear to be present at 4 months post vaccination.

In general, patients with advanced heart/lung failure were excluded from vaccine trials and efficacy in these populations needs to be investigated further.

We advise you to receive the COVID-19  vaccine. COVID-19 immunization is encouraged by NHS-Blood & Transfusion and the International Society for Heart and Lung transplantation in patients with advanced heart or lung disease and Pulmonary Vascular Disease or in those awaiting or following heart or lung transplantation, when a vaccine is locally available.

You may NOT be suitable for the vaccine in the following case. Please get in touch with us or your referring team to discuss if:

  • You have had a severe allergic reaction (anaphylaxis) to medications, food or vaccines.

The answer is that you should get the vaccine regardless of prior infection with COVID-19 or evidence of humoral immunity (positive antibodies).

Most side effects are mild and should not last longer than a week, such as:

  • Pain at the site of the puncture
  • Tiredness
  • Headaches
  • Aches

No, the vaccines will be offered via your GP. Invitation to attend for vaccination may come via GP practices or from hospitals and all patients may expect to receive their invitation by January/February 2021.

Prioritisation for vaccination is made according to the advice from the Joint Committee on Vaccination and Immunisation (JCVI). 

We will recommend delaying the vaccination between a month to 3-6 months from the transplant surgery.

We will be keeping a register of all our patients who have had the COVID-19vaccine so please let us know that you have had the COVID-19 vaccine by your GP.

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