COVID-19 Vaccine Concerns for Women in Menopause: A Guide - Family Medicine

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Questions related to COVID-19 vaccines?


Hello, I am 52 years old.
Last April, I visited a gynecologist and blood tests indicated that I have entered menopause.
Since then, I have experienced menopausal symptoms such as insomnia, night sweats, anxiety, and palpitations, which have been fluctuating in severity.
In January of this year, I went to the hospital due to palpitations, and the doctor suspected that it might be caused by hyperthyroidism.
However, the test results were normal, and both the electrocardiogram and X-ray showed no abnormalities.
To this day, the aforementioned menopausal symptoms still occur from time to time.
I maintain regular exercise to manage my physical and mental well-being, and I can carry on with my daily life, but I still often feel anxious.

After the COVID-19 situation worsened in May, I started worrying about getting vaccinated, especially concerning whether my palpitations would worsen after vaccination or if I would be able to receive the vaccine if I experienced palpitations in the days surrounding the vaccination.
I am also concerned about whether my body can handle the side effects of the vaccine, among other worries.
I initially registered for the Moderna vaccine, but it seems unlikely that I will be able to get it soon, so I also registered for the AstraZeneca vaccine.
However, I have to wait until those who registered before July 19 are vaccinated before it is my turn, which may take some time.

I would like to ask the doctor if my condition is suitable for vaccination.
Thank you for your response.

K, 50~59 year old female. Ask Date: 2021/08/25

Dr. Xiao Yongxun reply Family Medicine


Dear Ms.
K:
1.
The AstraZeneca COVID-19 vaccine is a non-replicating viral vector vaccine containing the gene for the SARS-CoV-2 spike protein (S protein) and is used for the prevention of COVID-19.
This vaccine has received emergency use authorization from the WHO, the EU, and other advanced countries, including our own.
It is not recommended for individuals with a history of severe allergic reactions to vaccine components, those who have experienced severe allergic reactions or thrombosis with thrombocytopenia syndrome after previous doses of this vaccine, or for those who are currently experiencing fever or acute moderate to severe illness; vaccination should be deferred until their condition stabilizes.
Individuals with compromised immune function, including those receiving immunosuppressive therapy, may have a diminished immune response to the vaccine.
2.
After receiving the AstraZeneca vaccine, individuals should remain at the vaccination site or nearby for 15 minutes to monitor for the extremely rare occurrence of immediate severe allergic reactions.
After leaving, please self-monitor for an additional 15 minutes.
For individuals with a history of acute allergic reactions following vaccination or any injection, it is advised to stay for at least 30 minutes.
Those on antiplatelet or anticoagulant medications, or with coagulation disorders, should apply pressure to the injection site for at least 2 minutes and observe for any bleeding or hematoma.
3.
Common reactions after receiving the AstraZeneca vaccine include pain and swelling at the injection site, which typically resolve within a few days.
Ice packs can be applied, but do not rub or scratch the injection site.
Fever (≥38°C) may occur, usually resolving within about 48 hours.
Other possible reactions include fatigue, headache, muscle pain, elevated temperature, chills, joint pain, and nausea; these symptoms tend to decrease with age and are generally mild, resolving within a few days.
If there is redness, swelling, or a hard lump at the injection site, or if symptoms such as persistent fever or severe allergic reactions (e.g., difficulty breathing, wheezing, dizziness, rapid heartbeat, widespread rash) occur, seek medical attention promptly and inform the physician of your vaccination history for diagnostic reference.
If severe persistent headache, vision changes, seizures, severe and persistent abdominal pain lasting more than 24 hours, severe chest pain or difficulty breathing, swelling or pain in the lower limbs, or spontaneous bleeding, bruising, or petechiae appear within 28 days post-vaccination, seek immediate medical care and provide your vaccination history.
4.
The Moderna COVID-19 vaccine is an mRNA vaccine that encodes the SARS-CoV-2 spike protein (S protein).
This vaccine has received emergency use authorization from the United States, the EU, and our country.
It is not recommended for individuals with a history of severe allergic reactions to vaccine components or those who have experienced severe allergic reactions after previous doses.
Individuals with fever or acute moderate to severe illness should wait until their condition stabilizes before vaccination.
Those with compromised immune function, including individuals receiving immunosuppressive therapy, may have a diminished immune response to the vaccine.
5.
After receiving the Moderna vaccine, individuals should remain at the vaccination site or nearby for 15 minutes to monitor for the extremely rare occurrence of immediate severe allergic reactions.
After leaving, please self-monitor for an additional 15 minutes.
For individuals with a history of acute allergic reactions following vaccination or any injection, it is advised to stay for at least 30 minutes.
Those on antiplatelet or anticoagulant medications, or with coagulation disorders, should apply pressure to the injection site for at least 2 minutes and observe for any bleeding or hematoma.
6.
Common reactions after receiving the Moderna vaccine include pain and swelling at the injection site, which typically resolve within a few days.
Ice packs can be applied, but do not rub or scratch the injection site.
Fever (≥38°C) may occur, usually resolving within about 48 hours.
Other possible reactions include fatigue, headache, muscle pain, elevated temperature, chills, joint pain, and nausea; these symptoms tend to decrease with age and are generally mild, resolving within a few days.
If there is redness, swelling, or a hard lump at the injection site, or if symptoms such as persistent fever or severe allergic reactions (e.g., difficulty breathing, wheezing, dizziness, rapid heartbeat, widespread rash) occur, seek medical attention promptly and inform the physician of your vaccination history for diagnostic reference.
Reports have indicated a very small number of young individuals experiencing adverse events such as myocarditis following mRNA vaccination, mostly occurring within a few days post-vaccination.
It is advised to seek immediate medical attention if symptoms such as chest pain, shortness of breath, or palpitations occur, and to inform healthcare providers of your vaccination history.
7.
The High-End COVID-19 Vaccine (MVC COVID-19 Vaccine) is a protein subunit vaccine containing recombinant SARS-CoV-2 spike protein, used for the prevention of COVID-19.
This vaccine has been approved for emergency use in our country.
It does not contain replicating SARS-CoV-2 viral particles, and vaccination with this vaccine will not cause COVID-19.
Clinical trial results have also shown good safety profiles.
Additionally, analyses of immunogenicity and neutralizing antibody data from convalescent sera indicate that the protective efficacy aligns with standards set by internationally authorized vaccines.
8.
Individuals with a history of severe allergic reactions to the components of the High-End COVID-19 Vaccine should not receive it.
Those with fever or acute moderate to severe illness should wait until their condition stabilizes before vaccination.
Individuals with compromised immune function, including those receiving immunosuppressive therapy, may have a diminished immune response to the vaccine.
9.
After receiving the High-End COVID-19 Vaccine, common reactions include pain and swelling at the injection site, which can be managed with ice packs; do not rub or scratch the injection site.
Common adverse reactions are typically mild to moderate in intensity and most resolve or diminish within 7 days post-vaccination.
If there is redness, swelling, or a hard lump at the injection site, or if symptoms such as persistent fever or severe allergic reactions (e.g., difficulty breathing, wheezing, dizziness, rapid heartbeat, widespread rash) occur, seek medical attention promptly and inform the physician of your vaccination history for diagnostic reference.
10.
The above information provides a brief overview of the COVID-19 vaccines currently used in our country.
It is my belief that the global COVID-19 pandemic emerged very suddenly, and the vaccines in use worldwide have not undergone complete long-term trials, nor are there internationally certified vaccines.
This is why various governments have sought Emergency Use Authorization (EUA) from pharmaceutical companies to help mitigate the risks associated with vaccine production.
Therefore, regardless of what experts or physicians may say, there are still risks, whether large or small.
From a national perspective, vaccination can prevent most severe illness or death; however, not getting vaccinated eliminates the risk of vaccine side effects or adverse events but exposes individuals to the potential for severe illness or death if outbreaks occur domestically.
In the context of the COVID-19 pandemic, each of us inevitably faces risks.
Ultimately, the decision rests with the individual, and they must bear the responsibility.
Some media outlets in our country lack scientific reasoning and critical thinking when reporting on vaccine-related information; therefore, if you find it difficult to discern the truth or identify logical inconsistencies, I recommend following the guidance of the Central Epidemic Command Center, which brings together the country's leading medical and public health experts to provide the most evidence-based recommendations.
11.
Your situation does not present any contraindications for receiving the COVID-19 vaccine.
If you are experiencing palpitations, it may be advisable to consult your obstetrician-gynecologist.
Additionally, it is recommended to avoid beverages that may increase heart rate, such as coffee, tea, and milk tea.
If you have further questions, please discuss them in detail with your family physician or attending physician.

Reply Date: 2021/08/25

More Info


When considering the COVID-19 vaccine for women in menopause, especially those experiencing symptoms such as palpitations, anxiety, and sleep disturbances, it's essential to approach the situation with a comprehensive understanding of both the vaccine's safety and the individual's health status.

Firstly, it's important to note that the COVID-19 vaccines, including Moderna and AstraZeneca (AZ), have been shown to be safe and effective for the general population, including those who are menopausal. The Centers for Disease Control and Prevention (CDC) and other health organizations recommend vaccination for all eligible individuals, as the benefits of vaccination in preventing severe illness from COVID-19 outweigh the potential risks.

In your case, since you have a history of palpitations and have undergone tests that returned normal results, it is crucial to consult with your healthcare provider before proceeding with vaccination. They can assess your overall health, including your menopausal symptoms and any underlying conditions that may contribute to your heart palpitations. If your healthcare provider deems it safe, you should be able to receive the vaccine.

Regarding your concerns about the vaccine exacerbating your heart palpitations, research has shown that while some individuals may experience mild side effects after vaccination, such as fatigue, headache, or mild fever, serious side effects are rare. Palpitations can occur due to anxiety or stress, especially in the context of receiving a vaccine. If you experience palpitations around the time of vaccination, it is advisable to monitor your symptoms closely. If they worsen or become concerning, you should seek medical attention.

As for the timing of the vaccine, if you are experiencing significant symptoms on the day of your scheduled vaccination, it may be prudent to postpone until you feel more stable. However, if your symptoms are manageable, vaccination should not be delayed unnecessarily, as the risk of COVID-19 remains a significant concern.

In terms of the specific vaccines you mentioned, both Moderna and AZ have been shown to be effective in preventing COVID-19 and its complications. If you are unable to receive one due to supply issues, the other is a suitable alternative. There is no evidence to suggest that switching between vaccine types negatively impacts efficacy or safety.

Lastly, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help manage menopausal symptoms and improve overall well-being. Engaging in relaxation techniques, such as mindfulness or yoga, may also alleviate anxiety and stress, which can contribute to palpitations.

In summary, it is advisable to consult with your healthcare provider regarding your specific health concerns and the appropriateness of receiving the COVID-19 vaccine. If cleared for vaccination, you can proceed with confidence, knowing that the benefits of vaccination significantly outweigh the risks, especially in the context of the ongoing pandemic. Stay informed, prioritize your health, and do not hesitate to reach out to your healthcare provider for support and guidance.

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