Can a 92-Year-Old with Arrhythmia Safely Receive the AZ COVID Vaccine?

A 92-year-old patient with arrhythmia receiving the COVID-19 vaccine?

Hello Dr.
Hong: My father is scheduled to receive the AZ COVID-19 vaccine on June 16.
He regularly takes antiarrhythmic medication, Rytmonorm, one tablet in the morning and one in the evening, which may be related to anticoagulation.
Is it safe for him to receive the AZ COVID-19 vaccine?

FU OPEN, 50~59 year old female. Ask Date: 2021/06/12

Dr. Hong Yuanbin reply Internal Medicine

Hello, the antiarrhythmic medications you mentioned are not listed as contraindications for the AZ vaccine either domestically or internationally, nor have they been indicated as unsuitable for vaccination.
Thank you for your inquiry.

Reply Date: 2021/06/12

More Info

When considering whether a 92-year-old patient with arrhythmia can safely receive the AstraZeneca (AZ) COVID-19 vaccine, several factors must be taken into account. Given your father's age and his ongoing treatment for arrhythmia with Rytmonorm (which is used to manage heart rhythm disorders), it is crucial to evaluate both the benefits and potential risks associated with vaccination.

Firstly, older adults, particularly those with underlying health conditions such as arrhythmia, are at a higher risk for severe complications from COVID-19. The risk of hospitalization, severe illness, and mortality from COVID-19 significantly outweighs the potential risks associated with vaccination. Studies have shown that the AZ vaccine is effective in providing protection against COVID-19, and its benefits in preventing severe disease and death are particularly pronounced in older populations.

Regarding the specific concerns about arrhythmia and the use of anticoagulants, it is essential to note that the AZ vaccine has been associated with a very small risk of thrombosis with thrombocytopenia syndrome (TTS), a rare condition involving blood clots and low platelet counts. However, the incidence of TTS is extremely low, and the overall risk of developing serious complications from COVID-19 is much higher for individuals with arrhythmias and other cardiovascular conditions.

In terms of medication management, your father should continue taking his prescribed medications, including Rytmonorm, as directed by his healthcare provider. There is no requirement to stop anticoagulant therapy before receiving the vaccine, but it is advisable to inform the healthcare provider administering the vaccine about his current medications. This will allow them to monitor him appropriately for any potential adverse reactions post-vaccination.

After receiving the vaccine, it is recommended that he be observed for a short period (typically 15-30 minutes) to monitor for any immediate allergic reactions or side effects. Common side effects of the AZ vaccine include mild to moderate symptoms such as pain at the injection site, fatigue, headache, and mild fever, which usually resolve within a few days.

In summary, your father can safely receive the AZ COVID-19 vaccine despite his age and arrhythmia. The benefits of vaccination in preventing COVID-19 complications far outweigh the risks associated with the vaccine. It is crucial to maintain open communication with his healthcare provider to ensure that all aspects of his health are considered before vaccination. If there are any specific concerns or if his condition changes, it is always best to consult with his doctor for personalized medical advice.

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