[Ask Dr Chiu] Should people with chronic illnesses receive COVID-19 vaccine?
HEALTH2021-03-18
5 Mins Read
Death reports of people who took COVID-19 vaccine have unnerved the community. Concerns about the jabs grew: whether severe complications happen whether they should be taken at all.
To fully understand this issue, the first thing to note is that just because A happens before B doesn’t mean A is the cause of B. As the Expert Committee is still studying these cases, it may be a little speculative to jump to any conclusion at this stage. That said, we could see some hint from what we already know.
No worries for healthy people
First, none of the fatalities occurred immediately after vaccination. Medically this implies they are not anaphylaxis, or vaccine-induced severe allergy reaction. Furthermore, all the deceased suffered from some kind of chronic illnesses. Stemming from this, the general healthy public need not worry too much.
Is your chronic disease under control?
The question you may ask is, is it then safe to receive the COVID-19 vaccine if you or your family has a history of chronic disease?
According to the current guidelines, only those with chronic illness that are poorly controlled are advised not to take the vaccine. However, the implication of the term “poorly controlled” may be hard to grasp by lay people. For this key issue, authorities do need to provide a clearer interpretation.
On the flip side, it is probably easier to delineate what “good control” is for chronic illness: for example, no hospital admission due to the illness for the last three months; no need to change drugs or escalate dosage in the same period; and indicators such as blood tests and blood pressure falling within normal limits. The risk of receiving COVID-19 vaccine is probably not high if one is in such condition. If you’re still not certain about the disease control, then it is better to defer vaccination until after your next follow up, where there is a chance to discuss with the doctor about your suitability.
Better take it for chronic illness patients?
Given the risk, some might think, it may be better for chronic illness patients not to receive the vaccine at all.
This saying is incorrect. While receiving vaccine carry risk, that of not receiving vaccine is probably of even higher risk. This could be illustrated by the fact that vast majority of COVID-19 casualties in Hong Kong carry at least one kind of chronic illness which highlights the importance for this group to be vaccinated.
Another interesting point of note is that Israel, a country with 60% of the population being vaccinated- the highest in the world, recently reported a significant drop in the number of COVID-19 related hospitalisation. This clearly demonstrated the protective benefits of vaccination.
Comparing mortality rates of chronic diseases
In Hong Kong, the overwhelming media reports regarding post vaccination mortalities understandably lifted concerns over COVID-19 vaccine safety. As the vaccination programme progresses, people will come to realise that the rate of occurrence of these adverse events is actually not different from the usual baseline. By that time, their confidence for the vaccine will gradually return.
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