Feature Article: Medications and COVID-19 Vaccines: What You Should Know
Published on in Parents PACK
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Published on in Parents PACK
Many people take regular medications, so as they prepare to get the COVID-19 vaccine, they wonder whether their medications will interfere with the vaccine or vice versa. In this article, we will discuss why some medications may be expected to alter the response to the vaccine and others would not. However, given the almost 40 different categories of medications and the thousands of medicinal products distributed, this article will not exhaustively address the topic. With this in mind, individuals should always consider three important points:
Four types of medications have been commonly discussed related to COVID-19 vaccinations, so we will start by addressing these:
Antipyretics are medications that reduce fever, such as salicylates (e.g., aspirin), acetaminophen (e.g., Tylenol®) and non-steroidal anti-inflammatory drugs, or NSAIDs, (e.g., Advil® or Aleve®). Analgesics are medications that reduce pain. Each of the types of medications listed as antipyretics (salicylates, acetaminophen, and NSAIDs) are also analgesics, but stronger medications such as opioids or combination medications (e.g., Tylenol with Codeine) also fall into the category of analgesics.
People commonly view fever and pain as being caused by a pathogen because they occur at the same time as an infection or injury, but in reality they are effects of our own immune responses. Fevers increase the effectiveness of our immune system, and during an infection, they make it more difficult for a pathogen to function effectively. Likewise, pain often occurs at the site of an injury as blood vessels expand and immune cells descend on the injured or infected area, often causing swelling that is felt as pain. Vaccines cause our immune systems to respond, so they, too, can cause fever or pain. Because fever and pain are signals that our immune system is working, taking medications that reduce the fever or mask the pain may alter the immune response.
For COVID-19 vaccinations, public health officials from the Centers for Disease Control and Prevention (CDC) have recommended that individuals not take these medications prior to vaccination in anticipation of experiencing side effects from the COVID-19 vaccine because we do not know what the effects on the immune response will be. However, if individuals are uncomfortable after getting vaccinated, they can take these medications if necessary and medically appropriate.
Also of note, if a doctor has prescribed a regular regimen of one of these medications, such as daily aspirin therapy following a stroke or heart attack, individuals should continue with their usual doses. While these people may have a somewhat lower response to the vaccine, they will still develop some immunity, and the risks of stopping the medication may outweigh the benefits. However, with this said, individuals who have not been prescribed this type of therapy, but use daily aspirin therapy on their own to reduce the chance of a first stroke or heart attack, should consider stopping not only prior to vaccination, but permanently. Studies have shown that daily aspirin therapy does not reduce the risk of first-time stroke or heart attack.
Anticoagulants, or blood thinners, are medications prescribed to decrease the chance for blood clots. Some examples include heparin, Coumadin®, Xarelto® and Eliquis®, among others. Because their blood is less likely to clot, people using anticoagulants are at increased risk of bleeding.
The COVID-19 vaccines currently approved for use in the U.S. are given intramuscularly. On occasion as the needle punctures the skin, capillaries below the surface are disturbed, causing small amounts of bleeding. For a patient on blood thinners, it can be more difficult to stop the bleeding. So, while these individuals can usually get the COVID-19 vaccine, the person administering the vaccine should be made aware of the recipient’s increased risk, so that they can monitor for prolonged bleeding.
Antihistamines are used to decrease allergic reactions caused when the immune system produces excessive histamine. Examples include Zyrtec®, Benadryl®, Allegra®, Alavert® and Claritin®, among others. Because the mRNA vaccines have caused some people to have severe allergic reactions, called anaphylaxis, some have wondered if it would be useful to take an antihistamine prior to vaccination to decrease the chance of experiencing anaphylaxis. Pretreating with antihistamines is not recommended because it does not decrease the chance for anaphylaxis and may mask important signs of an allergic response to the vaccine.
With this said, individuals who typically take antihistamines for an existing condition do not need to stop taking their medication prior to vaccination. Because their body is used to the typical level, an allergic response to the vaccine would likely still be noticeable and these medications do not work in a manner that would be expected to alter the immune response to the vaccine, since it is not a histamine-based response.
Many individuals have reached out to the Vaccine Education Center (VEC) about other medications. Generally, we recommend that they speak with their own healthcare providers, who know why they are taking the medications, what the dose is, and any other details about their medical history that may be relevant. However, we will address a few additional types of medications here:
In sum, many people take medications and some of these might affect the individual’s immune responses — not just to vaccines, but to potential infections or other medications. Therefore, it is important to learn more about the potential effects of any medications you take, refrain from using unnecessary medications, and check with your doctor about medication changes or with other questions.
Categories: Parents PACK April 2021, Feature Article
Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.
You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.