The COVID-19 Vaccine and Heart Disease

The Coronavirus Vaccine: What you need to know

The rollout of COVID-19 vaccinations are well underway in Australia, but what does that mean for people with heart disease? If I have a heart condition, should I be worried about side effects? And what about children with CHD? In this video, our Cardiologist Professor Bob Graham answers all the frequently asked questions about the vaccination and your heart.  

Video transcript

Welcome to another update on COVID-19. I’m Professor Bob Graham at the Victor Chang Cardiac Research Institute. We’ve come a long way in the pandemic. Fortunately, Australia has done very well, but I’m sure those of you with heart disease might have more questions now because we’re coming into the time when we’re starting to get the vaccine.

Is the vaccine safe for people with heart disease?

The answer is that both the Pfizer vaccine that’s going to be available for some of us in Australia and the Oxford AstraZeneca vaccine have been shown to be safe in people with heart disease. So, I would urge you to take it because if you don’t, the chances of getting serious illness with COVID are very high in people with cardiovascular disease.

What do heart disease patients need to know before being vaccinated?

There is no indication that the vaccine will interfere with their medication. A lot of the people in the trials that had heart disease were on medications, such as statins, and there were no problems because of that. The only concerns that heart disease patients might have is if they have a known allergy to any of the ingredients in the vaccines or to previous vaccinations, and if they’re on blood thinners, and a lot of heart patients are on blood thinners. It doesn’t preclude you from getting the vaccine. In fact, you should still get it. It may mean that you’ll get a bit more bruising or you get a bit of bleeding at the site where you have the injection, and that can easily be stopped by putting pressure on for a reasonable period of time to stop the bleeding. There’s no contraindication to heart disease patients getting the vaccine.

I have a pre-existing heart condition, should I be concerned about side effects of the COVID-19 vaccines?

The worst-case scenario is if you don’t get the vaccine and you get COVID-19 because you’re at a much higher risk, so the risk-benefit ratio for heart disease patients is enormous. For patients who don’t have heart disease, the risk-benefit ratio is anywhere between 2,200 to one, to 220,000 to one, that you’re going to be worse off if you don’t get the vaccine and you contract COVID. The risk-benefit ratio favours people with heart disease particularly getting the vaccine. There are no contraindications or no known side effects in people who’ve got heart disease in terms of getting the vaccine, so there’s no reason not to get it. 

My child has congenital heart disease (CHD), is the COVID-19 vaccine safe for my child?  

 

At this stage, the role of vaccination against COVID-19 in children is very unclear. There is essentially no data at the present time to guide us as to whether vaccination of children will, firstly, work, and secondly, if that will actually be of benefit to the children. As we know, children do not suffer from the severe complications and bad outcomes of COVID to the same extent that adults do. However, the flip side to this is that if we are to achieve high levels of vaccination across the whole community and the whole population, such that everybody is protected and the virus dies away, then it may be necessary to vaccinate children against COVID-19. This has been the case with previous viral infections, such as measles.  But whether normal, healthy kids get vaccinated is going to require further research. And there’s definitely diverging opinions. 

Early on in the rollout, there will probably be a case for vaccinating vulnerable children, such as those with severe disabilities. For kids with advanced heart failure, for example, it’s probable that they’re going to get vaccinated, down the track as well.  However, not every child with the more minor disease would get it. To learn more about children and COVID-19, see our FAQs page with CHD scientist Professor Sally Dunwoodie and Professor Graham. 

Is it safe to have multiple vaccinations together? For example, the flu vaccine and the COVID-19 vaccine?

There’s no evidence that having more than one vaccine worries people. I mean, don’t forget all of us have had things like DPT, which is the diphtheria pertussis toxin tetanus, which is three vaccines given all at once. And then most of us every year get a flu jab as well. Our body is very good at coping with these vaccines and they stimulate different cells to produce different antibodies, so there’s no evidence that having a heart condition will cause you problems if you have multiple vaccines. And certainly, if you’ve got a heart condition, you should not only have the COVID vaccine, but you should also have a flu shot once a year and probably a Pneumovax to prevent you from getting pneumonia once a year as well.

Which vaccine is suitable for patients with heart disease?

Both vaccines protect people who have got heart disease and they also protect people who are older, and they also protect people from different ethnic groups. They both seem to be very protective. The Pfizer vaccine seems to protect people after you’ve had two doses (both of them require two doses) to the extent of about 94% reducing serious illnesses, and the AstraZeneca about 70%, but even for those who got COVID, none of them required hospitalisation if they’ve had the Oxford AstraZeneca vaccine. Both of them seem to provide very good protection from serious disease.

How long will the protection from the vaccine last?

We don’t know the answer for how long. The COVID virus is mutating. It mutates more slowly than the flu virus. The flu virus has to be given every year. We think and we hope that the COVID vaccine will last a lot longer than that so that hopefully you don’t have to get a jab every year, but if you do, it’s not the end of the world, because it is providing enormous protection.

Are there any grounds for vaccination exemption?

The only grounds for not having a vaccine is If you’ve got a known allergy to any of the constituents of the vaccine, which is very, very rare, or if you’ve got an immune problem where you can’t mount an immune response. And there was a very interesting case recently at Harvard where somebody had a very serious immune response, and what was interesting about that case was that that patient, his virus seemed to change very quickly, and it seemed to evolve much more quickly than normal people. And we think that’s where these new strains are coming from. In fact, people who’ve got immune problems are producing different strains of virus very quickly and they’re exactly the sort of people we need to protect because they’re the ones who then shed the virus and give it out to the community and then it starts to spread.

Will COVID-19 vaccines need to be updated to beat new variants?

Look, every year we have to produce a new vaccine for the flu. As I mentioned before, the SARS-CoV2 virus that causes COVID-19 doesn’t seem to be mutating as quickly, so hopefully, the vaccine will be good, but it wouldn’t surprise me that in a few years’ time, we may need to modify the vaccine so that it is effective against new strains.

Final words?

I would urge you strongly to consider having the vaccine because as I mentioned, the risk-benefit ratio is so much in favour of having the vaccine against not having it. If you don’t have the vaccine and you’ve got a heart problem and you get COVID, your chances of getting serious illness are very much higher than somebody who doesn’t have heart disease, particularly if you’ve got heart function that’s not as good as normal. And they’re the sort of people who’ve got atrial fibrillation, who have had coronary heart disease, who’ve got congenital heart disease, et cetera. They’re the sort of people who should be very much pushing themselves to the front of the queue in getting the vaccine.

Thank you again for joining us at the Victor Chang Cardiac Research Institute for another update on COVID-19, and particularly to those who have cardiovascular heart problems because they’re the group that we’re most interested in. I’m sure if you have heart problems, you’re interested in whether or not you should take the vaccine so I hope this has cleared some of those questions up. As I mentioned, I’d strongly encourage you to have it because the risk-benefit ratio is so much in favour of the vaccine.

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