Who should be vaccinated?

All of these vaccines have been approved for 18 years and older; priority has been given to older age, people with comorbidity & frontlines. As of now, there is not much data on the paediatric population, therefore, the vaccines have not been approved for children.  


Is the vaccine safe for ages above 60 years?


These vaccines have been well studied among the adult population of a wide range. There have been some public concerns, especially among the Chinese vaccines (Sinopharm & Sinovac) which don’t have much data on populations above 60 years due to the small number of participants in clinical trials. Nevertheless, there is no difference in safety profile expected among older adults as compared to younger. Hence, WHO has recommended the use of these vaccines even in people more than 60 years, while maintaining active safety monitoring 


Is the vaccine safe for pregnant females? 

YES > No.

There is insufficient data on efficacy & vaccine-associated risks in pregnancy, while trials have been underway. Among the vaccines that are EUA approved by WHO, the recommendation has been to vaccinate pregnant women only if the benefits outweigh the risk of vaccination. Also, the WHO does not recommend pregnancy testing before vaccination. WHO does not recommend delaying pregnancy or terminating the pregnancy because of vaccination. Generally, pregnant females are at higher risk of developing severe COVID-19 infection compared to non-pregnant females. Pregnant women who are aged 35 years or older, or have a high body mass index, or existing comorbidity such as diabetes or hypertension, are at particular risk of serious outcomes from COVID-19.  To help pregnant females make informed decisions, they should be provided about the risk of COVID-19 infection during pregnancy, the likely benefit of vaccination in the context of current epidemiology, and the relative lack of data on safety in pregnancy. No official recommendation can be made for or against vaccination with Sputnik V & Covaxin among pregnant females at the moment. Sputnik V is a vector vaccine-like AstraZeneca while Covaxin is an inactivated virus vaccine-like Sinopharm & Sinovac-CoronaVac. 


Is the vaccine safe for Lactating females?  


There is limited data on the safety & efficacy of COVID19 vaccines among lactating females. However, it's a known fact that vaccinated females pass antibodies (IgA & IgG) to their babies. On this ground, WHO has recommended vaccination among lactating females if they fall within the priority list. WHO does not recommend discontinuing breastfeeding after vaccination. Similar recommendations can be made for other vaccines awaiting WHO’s EUA approval (Sputnik V & Covaxin). 


Is the vaccine safe for people with comorbidities or immunosuppression?  


People with certain comorbidities (heart diseases, Diabetes, Hypertension) or immunosuppression (e.g. Cancer patients, transplant patients) are at higher risk of severe COVID-19 infections, so they should be given very high priority. The vaccines are safe among these people just like others. However, since the efficacy of the vaccine is also dependent on the immunity of the individual, people with comorbidities or immunosuppression may get efficacy similar or slightly less than expected compared to the healthy adults of the same age group 


Is the vaccine safe for people with blood thinners?  


People on blood thinners (like Aspirin, Clopidogrel, Warfarin, etc) have no contraindication to vaccination. Due to the increased risk of bleeding, they should hold the injection site for approximately 5 minutes & watch for any excessive bleeding. The medicines need not be held prior to the vaccination & can be continued without stopping after the vaccination. 


If one can still get infected despite vaccination, why should he/she get vaccinated?

 Based on studies so far, most COVID-19 vaccines are highly effective in preventing severe/critical COVID-19 infections & mortality. Also, fully vaccinated people are less likely to have an asymptomatic infection or transmit the SARS-CoV-2 virus to others. Hence, vaccination not only helps to prevent death but also helps to break the chain. That’s why, WHO & US-FDA have approved any vaccine with an efficacy of at least 50 % or more, as that will still slow down the epidemic. To prevent possible disease transmission, it is recommended that strict preventive measures (using masks, maintaining 6 feet distance, etc) be strictly followed by all people, regardless of vaccination status. 


Can recently covid-19 infected people get vaccinated?  


Once infected, available data show that symptomatic reinfection is uncommon for the first 6 months. However, due to variants of concerns with evidence of immune escape circulating around the world, there is a possibility of re-infection earlier than expected. There is no optimum wait time based on data. Generally, it is recommended that a person waits 2-4 weeks from symptom onset, until full recovery before getting vaccinated. WHO does not recommend checking for prior infection by any viral or serological method. 


How long to wait among people treated with Convalescent Plasma therapy or Monoclonal Antibody? 

There is no data regarding this scenario. However, WHO recommends waiting at least 90 days to avoid interference of the antibody treatment with vaccine-induced immune response 


Can I switch to the next vaccine for the second dose?  

There is not enough data on the safety & efficacy of switching between different vaccines. However, one can generally wait 2-4 weeks before switching to the other vaccine for a second dose.  


 Who should not take this vaccine?  

 People with a history of a severe allergy to vaccines - people with fever or active COVID-19 infection.


 Will it work against the new variants in Nepal? 

As the SARS-CoV-2 virus undergoes constant mutations, there is always a chance of new variants associated with higher transmissibility, worse severity of immune/vaccine escape. So, we need constant vigilance of disease epidemiology & to perform timely research including vaccine trials. 


Variants of concern : 



Apparently, Nepal has three variants circulating: Alpha (B.1.1.7), Delta (B.1.617.2), and Kappa (B.1.617.1), with Delta being the most dominant. There is very limited data on vaccine efficacy against these various strains. AstraZeneca, Sinopharm has been reported to be effective against the Alpha variant. There is further study pending on the remaining strains.