Is It Safe for Heart Patients to Get the COVID Vaccine?

Am I suitable for receiving the COVID-19 vaccine in my situation?

Dear Director He,
Thank you for your response last year regarding the issue of myocardial bridge and medication.
However, at the beginning of this year, I experienced cardiac arrhythmia with rapid heartbeats and was sent to the emergency room, where I was diagnosed with atrial fibrillation.
My current medications are: 1.
Pitavastatin 4mg half tablet 2.
Isosorbide 60mg half tablet 3.
Bisoprolol 5mg 1 tablet 4.
Amiodarone 200mg 1 tablet 5.
Edoxaban 30mg 1 tablet.
I would like to ask you:
1.
Is there a causal relationship between myocardial bridge and atrial fibrillation?
2.
Regarding the long-term use of Amiodarone, what are the potential adverse effects on the thyroid and lungs, and what is considered "long-term"?
3.
Given my current condition, am I suitable for receiving the COVID-19 vaccine? Which one would be more appropriate, Moderna or AZ?
4.
If I am eligible for vaccination, should I discontinue the anticoagulant Edoxaban? If so, how many days prior to vaccination should I stop?
Thank you!

David, 60~69 year old female. Ask Date: 2021/06/25

Dr. He Dongjin reply Cardiology

Hello, there is no causal relationship between myocardial bridge and atrial fibrillation.
Long-term use of certain medications may have adverse effects on the thyroid and lungs, which can vary from person to person.
Generally, long-term use is considered to be over a year.
Engaging in any activity carries risks, including vaccination.
The consideration is whether the risks of vaccination are greater than the risks of not vaccinating; essentially, not vaccinating is considered to be more dangerous.
If there are no specific discomforts on the day of vaccination, such as stable blood pressure and heart rate, and no edema or bruising, you can proceed with the administration of Moderna or AstraZeneca vaccines, as both are officially recommended.
Anticoagulant Edoxaban should not be discontinued and can be continued.
Peace and care from Changhua Hospital.

Reply Date: 2021/06/25

More Info

When considering whether heart patients, particularly those with conditions like atrial fibrillation, can safely receive the COVID-19 vaccine, it is essential to evaluate several factors, including the patient's medical history, current medications, and the specific vaccine being considered.

1. Heart Conditions and Vaccine Safety: Patients with heart conditions, including atrial fibrillation, are generally encouraged to receive the COVID-19 vaccine. The risks associated with COVID-19 infection, including severe illness, hospitalization, and complications such as blood clots, often outweigh the potential risks of vaccination. Studies have shown that the benefits of vaccination in preventing COVID-19 far exceed the risks of potential adverse effects, including those related to heart health.

2. Specific Concerns About Atrial Fibrillation: Atrial fibrillation (AF) is a common arrhythmia that can lead to increased risk of stroke and other cardiovascular complications. There is no established causal link between AF and the COVID-19 vaccines. In fact, vaccination may help protect against severe outcomes from COVID-19, which can exacerbate heart conditions.
3. Long-term Use of Amiodarone: Amiodarone, a medication used to manage heart rhythm disorders, can have side effects, particularly with long-term use. These may include thyroid dysfunction and pulmonary toxicity. The term "long-term" typically refers to use over a year or more, but individual responses can vary. Regular monitoring by a healthcare provider is essential to manage these risks.

4. Choosing Between Vaccines: Regarding the choice between mRNA vaccines (like Moderna) and viral vector vaccines (like AstraZeneca), both have been shown to be effective in preventing COVID-19. Current evidence suggests that mRNA vaccines may have a slightly better safety profile in terms of cardiovascular effects. However, both types of vaccines are considered safe for individuals with heart conditions. It is advisable to consult with your healthcare provider to determine which vaccine is best suited for your specific health situation.

5. Anticoagulant Considerations: If you are taking Edoxaban, an anticoagulant, it is generally recommended to continue this medication during vaccination. There is no need to stop anticoagulants before receiving the vaccine, as doing so could increase the risk of thromboembolic events. However, it is crucial to discuss this with your healthcare provider, who can provide personalized advice based on your overall health and medication regimen.

In summary, heart patients, including those with atrial fibrillation, are typically safe to receive the COVID-19 vaccine. The benefits of vaccination in preventing severe illness from COVID-19 outweigh the risks associated with potential side effects. It is important to maintain open communication with your healthcare provider regarding your specific health conditions and medication management, especially when considering vaccination. Regular follow-ups and monitoring can help ensure that any potential issues are addressed promptly, allowing for a safe and effective vaccination experience.

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