Vaccination Concerns for Elderly Patients with Cardiovascular Issues

Challenging vaccines

Hello Doctor, my grandmother is 80 years old and had a stroke three years ago.
Her carotid artery is completely blocked, and she is unable to have a stent implanted.
She is currently managing her condition with medication and by drinking plenty of water, and she takes one (Bergamot) supplement along with antihypertensive medication.
Recently, considering her health status, she has some hesitation about receiving the vaccine (she has no discomfort on a daily basis).
I would like to ask if a patient with complete carotid artery blockage and hypertension can receive the AZ vaccine? Thank you very much for taking the time to respond amidst your busy schedule.
I truly appreciate it.
Sometimes, family members suddenly think of questions, and I find myself asking again online for answers.
I apologize for any impropriety or discourtesy in doing so, and I sincerely apologize for any inconvenience caused!

Da Pang Mao, 30~39 year old female. Ask Date: 2021/06/20

Dr. He Dongjin reply Cardiology

Hello, any procedure carries risks.
Patients with carotid artery blockage and hypertension are not contraindicated for the AstraZeneca vaccine.
If blood pressure and heart rate are normal before vaccination, and there are no issues such as fever, edema, bruising, or shortness of breath, they can receive the vaccine.
If someone is physically weak and has not been going out, and has had minimal contact with the outside world, it may be worth considering delaying the vaccination.
Otherwise, the benefits generally outweigh the risks.
Each individual's body reacts differently to each medication.
If there are concerns about AstraZeneca, then waiting for other brands might be an option.
My own father, who is 90 years old, has had a stent placed, is on dialysis, and has already received the AstraZeneca vaccine, and he is currently doing well.
I also pray for your grandmother's safety.
Changhua Hospital cares about you.

Reply Date: 2021/06/20

More Info

Vaccination for elderly patients, particularly those with cardiovascular issues, is a critical topic, especially in the context of the COVID-19 pandemic. Your concerns regarding your grandmother's health and her eligibility for the AstraZeneca (AZ) vaccine are valid and important to address.

Firstly, it is essential to understand that elderly individuals, especially those with a history of cardiovascular diseases such as hypertension and previous strokes, are at a higher risk for severe complications from COVID-19. The risk of severe illness, hospitalization, and death from COVID-19 far outweighs the potential risks associated with vaccination. Studies have shown that the benefits of vaccination in preventing COVID-19 and its complications significantly surpass the risks of vaccine-related adverse events, including the rare occurrence of thrombosis associated with the AZ vaccine.

In the case of your grandmother, who has a history of carotid artery occlusion and hypertension, it is crucial to consider her overall health status. While her condition may raise concerns about the risk of thrombosis, the current medical consensus indicates that patients with a history of stroke or cardiovascular issues can safely receive the COVID-19 vaccine, including the AZ vaccine. The key is to ensure that her medical conditions are well-managed and that she is under the care of a healthcare provider who can monitor her health closely.

Regarding the specific concerns about the AZ vaccine and its association with blood clots, it is important to note that while there have been reports of thrombosis, these events are extremely rare. The benefits of vaccination, particularly in preventing severe COVID-19 outcomes, are substantial. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) continue to recommend COVID-19 vaccination for older adults, including those with underlying health conditions.

As for the timing of medication in relation to vaccination, it is generally advised that patients continue their prescribed medications unless specifically instructed otherwise by their healthcare provider. Stopping medications, especially those for hypertension or other chronic conditions, could lead to adverse health effects. Therefore, it is best to consult with her physician regarding any adjustments to her medication regimen around the time of vaccination.

In summary, your grandmother can receive the AZ vaccine despite her history of carotid artery occlusion and hypertension. The potential benefits of vaccination in protecting her from COVID-19 complications far outweigh the risks. It is crucial to maintain open communication with her healthcare provider to ensure her conditions are managed effectively and to address any concerns she may have about the vaccination process. Encouraging her to get vaccinated is a proactive step in safeguarding her health during this pandemic.

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