I am due for an operation to remove a kidney, which has a tumour, on January 11. I am obviously concerned with COVID-19 as I think I will be significantly vulnerable after the operation. Is it possible to be prioritised for the vaccine? I am 55 years old – PV

COVID-19 vaccines will reach countries in staggered amounts and hence each country has outlined a prioritisation strategy for vaccine delivery. Vaccination against COVID-19 will likely target first those who are most in need of protection.

Priority groups for vaccination in the first cohort will include healthcare workers and staff working in clinical settings, the elderly residents and staff in homes for the elderly and elderly aged over 85. Everyone needs to take all precautions.

I am 72 years old and have a heart failure condition. I take all prescribed medications. Please advise if I should take the vaccine or not? ‒ John Pace

Individuals with certain underlying health conditions have higher morbidity and mortality from COVID-19 compared to healthy people. These conditions increase the risk of COVID-19-related hospitalisation, Intensive Care admissions and death.

These include diabetes mellitus, chronic cardiovascular disease, chronic res­piratory disease, chronic kidney disease, immunocompromised states (e.g. organ transplant), cancer, chronic liver disease, and certain neurological disorders. The individual risk of hospitalisation and death increases with the number of these underlying conditions. It’s important that people with these conditions take the vaccine to protect themselves.

When are you going to scrap the outdoor masks wearing restriction? – Pete Gable

Throughout and especially in the initial vaccination rollout phases, non-pharmaceutical interventions, such as physical distancing, use of masks, hygiene, mitigation measures and adaptations to the work environment, will continue to serve as the main public health tools to control and manage COVID-19 outbreaks and transmission.

Even with vaccines starting to become available now, it will take time to make a visible impact on the course of the pandemic. Public health measures must therefore continue to be employed until further evaluation along the vaccine rollout.

Is it recommended to do a swab test before taking the vaccine? If one is infected but does not know (e.g. has no symptoms) and takes the vaccine, is it going to either not work or be damaging? – Stephania Bezzina

Vaccinating those who are potentially infected/asymptomatic/incubating COVID-19 infection is not likely to have a detrimental effect on their illness. Vaccination should be postponed in those with confirmed COVID-19 until clinical recovery and at least four weeks after onset of symptoms or four weeks from the first PCR positive specimen in those who are asymptomatic. So there is no need to have COVID-19 test prior to vaccination.

Does immunity from COVID-19 disease differ from that gained through the vaccine?

The protection someone gains from having an infection varies depending on the disease, and it varies from person to person. Since this virus is new, we don’t know how long natural immunity might last and early evidence shows it does not last very long. Some people who have had COVID-19 have apparently had a second, often milder case of the disease.

Vaccine developers boost the effectiveness of a vaccine so that it provides longer immune protection than a natu­ral infection with the coronavirus. The duration of this immunity is still to be determined.

Most of the coronavirus vaccines are given in two doses. The Pfizer and BioNTech vaccine is administered 21 days apart. This second dose is given to increase antibody levels and boost protection. The whole process typically takes about 28 days and is complete soon after the second shot.

I am on warfarin – can I still take the vaccine? – May Micallef

The COVID-19 vaccine can be safely given intramuscularly to individuals on warfarin who are up to date with their scheduled INR testing and whose latest INR is below the upper level of the therapeutic indicated range. A fine needle should be used for the vaccination, followed by firm pressure applied to the injection site without rubbing for at least two minutes. There may be a risk of bruising or haematoma from the injection. If there is doubt about the level of anticoagulation control, consult your caring physician.

Have any questions to ask the superintendent? Send an e-mail to askcharmaine@timesofmalta.com.

Charmaine Gauci, Superintendent for Public Health

Independent journalism costs money. Support Times of Malta for the price of a coffee.

Support Us