10 reasons not to get the Covid-19 vaccine that scientifically don't hold up

From allergies to adverse effects, here is a list of the most often given reasons for obtaining exemption from vaccination, which have no scientific basis

(photo: Clay Banks / Unplash) Since the green pass was introduced to access an increasingly wide range of activities, and since vaccination against the Sars-Cov-2 coronavirus has become mandatory for some professional categories, the issue of who is exempt from undergoing the administration of an anti Covid-19 vaccine is become central. In fact, there is often a lot of talk about people who would be unable to receive the vaccine, and who therefore ask for the alleged exemption to be formalized in black and white by doctors. So as to circumvent various constraints and limitations.

Although in general it is possible - and it is obviously required by the regulations - that there are people for whom vaccination is contraindicated and therefore to be avoided, these are extremely rare cases and sporadic, which concern people who are in very particular conditions and in fact "exceptional".

The reasons for the postponement

In most cases, the vaunted reasons for exemption are in reality of the simplest reasons for postponement, ie conditions for which it may be sensible to postpone the vaccination for a few days, a few weeks or a few months (maximum 6), but not suspend it completely. For example, it is preferable to postpone the administration of the vaccine for people who have an ongoing Sars-Cov-2 infection (currently positive) who are in quarantine and therefore isolated at home, who have recovered for less than 6 months (in in this case, the postponement is acceptable, more than sensible), who have suspicious symptoms and are awaiting the outcome of a swab, or who have received a therapy based on monoclonal antibodies against Covid-19 for less than 3 months.

Or again, the postponement is foreseen in all those cases in which the acute phase of a disease or a serious clinical condition is in progress, such as a bacterial or viral infection of an organ, an adverse cardiovascular event (heart attack, stroke, ...), acute hepatitis, a post-operative course and so on. Of course, in these cases there is no fixed duration of the postponement, but it depends on the time necessary for the acute condition to be resolved and overcome.

Most of the other cases, on the other hand, fall within those that the Italian Society of general medicine and primary care (Simg) has recently defined "false cointroindications to the vaccination against Covid-19", which is essentially a set of hoaxes, false myths, unfounded fears, concerns without scientific basis, incorrect information and strange beliefs. We have collected 10 of them below, among the most talked about and frequent, in a list that includes the various possible individual conditions that in fact are reasons that do not hold up for not getting the vaccine. However, all the various reasons of an ethical, legal, conspiracy, ideological, political and general sense of vaccinations remain outside this list, which constitute an infinity of other possible ramshackle arguments, but which have little to do with science. and they are another story.

1. Allergy to another vaccine or drug

The fact that you have had an allergic reaction in the past - even as severe as anaphylactic shock and also immediate - to another vaccine formulation or another drug used for different pathologies (and which has nothing to do with the components of the vaccine formulations in question) does not in itself represent a valid reason for not receiving the Covid-19 vaccine . This kind of allergy is, in technical terms, not a contraindication but a precaution, that is a condition that may deserve further study and require, for example, vaccination in a protected environment, i.e. in the hospital (where one is more ready to intervene). instead of in the classic vaccination hub.

As Simg herself has specified, however, first of all it is necessary that the doctor can verify the actual severity of the allergic reactions he had in the past, and the "reliability of the information" provided by the patient . In more blunt terms, unspecified allergic reactions and referred to alleged past episodes that are not adequately documented have a substantially null value.

2. Allergic reaction to foods, animals or materials

This case it is a milder version than the previous one, so much so that it is neither a contraindication nor a precaution. Being allergic, in a severe form or even more so in a mild form, to some foods, the hair of certain pets, the poison of certain insects, pollen, mites, latex and so on is considered irrelevant from the point of view of the Covid-19 vaccination.

The same thing also applies to people who have a family history of allergies, such as a parent prone to severe allergic reactions, including the case of drugs or vaccines. The reason is that all this information has no bearing on the likelihood of developing adverse reactions to Sars-Cov-2 vaccines.

3. Allergy to ingredients of Covid-19 vaccines

A situation of this kind - real allergy or hypersensitivity - is slightly more complex but almost always manageable. The fact of having a specific contraindication for one or more of the ingredients used in vaccine formulations against Covid-19 is certainly an element not to be overlooked. Among those that are most frequently associated with allergies and hypersensitivity are, for example, tromethamine, polysorbate, Peg (polyethylene-glycol-2000) and Peg2000 Dmg (methoxy-polyethylene-glycol-2000), but the solution is there: use a vaccine formulation that does not contain that ingredient.

Except for some basic ingredients common to many formulations and which certainly cannot be responsible for allergies (water, sucrose, sodium chloride, 'rna, ethanol, ...), excipients vary from one type of vaccine to another, as listed on page 8 of this document. Therefore, if one of the vaccines is contraindicated, it is always possible to administer one of the others available, which does not contain the ingredients considered problematic. Cases in which a combination of hypersensitivity makes all 4 vaccines currently approved for Italy (Pfizer, Moderna, AstraZeneca and Janssen) contraindicated at the same time are very rare, substantially exceptional.

4. Reaction allergic or serious adverse effect at the first dose

The case in which the first vaccination administration has provoked (with a cause-effect relationship and not only by temporal concomitance) a serious allergic reaction or serious health consequences is the one that most everyone deserves attention and an accurate medical evaluation. Where the word "serious", for the avoidance of doubt, means that it represented a concrete danger for the patient's survival, with hospitalization or prolonged treatments.

Not even in this case is it absolutely contraindicated proceeding with the vaccination, although obviously it will be considered to administer a different formulation for the second dose. Among the cases that fall into this category, in addition to hypersensitivity to the ingredients of the vaccine, there are also episodes of thrombotic syndrome associated with thrombocytopenia and capillary leak syndrome with the leakage of liquids from the capillaries themselves. Conditions of this kind, we recall, are however extremely rare, and have so far only been associated with the formulations of Janssen and AstraZeneca.

5. Pregnancy, breastfeeding and fertility

That of vaccinations for women it is perhaps the area most of all characterized by fake news and bad information. There is no contraindication, nor from the available data is there any scientific evidence that points in this sense, for vaccination during pregnancy, and even less during the breastfeeding period. Although the scientific investigations are partly still in progress, there are also data on animal models that confirm the absence of contraindications, and for breastfeeding the contraindication does not even have a "biological plausibility", to put it in the words of the Aifa.

At the most, for the period of pregnancy only, on medical advice it can be evaluated to postpone vaccination until delivery, thus obtaining a temporary exemption but with a very specific deadline. However, it must be said that pregnancy, especially when combined with other conditions such as diabetes and obesity, represents an additional risk factor for complications from Covid-19, and in this sense vaccinating pregnant women is even more important. Finally, on the basis of the scientific evidence collected, the anti Covid-19 vaccines have nothing to do with the loss of fertility or with infertility, as we have already told here on Wired in a dedicated study.

6. Post vaccine Guillain-Barré syndrome

This peripheral nerve disorder, resulting in acute inflammatory poly-neuropathy with muscle weakness, has been observed in a very small number of people as an adverse effect to vaccination with the formulations of AstraZeneca and Janssen, which appeared in the first 40 days after administration.

As in the case of other adverse reactions at the first dose, in these situations there is no general contraindication to continue with the vaccination, but considers it appropriate (or, to use Simg's words, “prudent”) to use a different formulation - ie a messenger, given the current vaccination offer - for the continuation of vaccination.

7. My post vaccine carditis and pericarditis

Same issue as in the previous case also for these two disorders of the cardiovascular system. Here too we are dealing with an extremely rare case series, and all the cases reported so far have involved administrations with messenger rna vaccines, that is Pfizer or Moderna.

With respect to the Guillain-Barré syndrome, we are therefore at the indication symmetrical: instead of switching from a viral vector vaccine to an mRna one, it is suggested to suspend the administration of mRna vaccines and switch to viral vector vaccines such as Janssen and AstraZeneca. Before proceeding with the vaccination, however, it is important to evaluate the overall clinical picture by contacting a specialist in cardiology, since in some specific cases it may be sensible to suspend - completely or temporarily - the vaccination.

8. Pre-vaccine facial paralysis

The thesis according to which those suffering from facial nerve palsy (the so-called Bell's palsy) cannot be vaccinated is a widespread but utter hoax. It is often boasted as a valid reason for exemption, but it is not for any vaccine. In fact, those suffering from this disorder can receive any of the commercially available and approved anti Covid-19 vaccines.

In some very rare cases (including one recently documented by the British Medical Journal) it has actually been established a likely cause-and-effect relationship between vaccine administration and temporary Bell's palsy, but no reason has been identified why pre-existing Bell's palsy should be a contraindication to vaccination.

9 Autoimmune and autoinflammatory diseases

There are many people in Italy who suffer from one of these conditions, it is estimated at least one and a half million. For these cases, the task force of the Italian Society of Allergy, Asthma and Clinical Immunology (Siaaic) has also recently expressed its opinion, which reiterated how vaccination - net of some precautions - is by no means contraindicated in these patients. Moreover, as frail patients, people with autoimmune and autoinflammatory diseases are among those who can derive the greatest benefit from vaccination.

The only two elements that must be taken into account, in order to evaluate a possible postponement of administration, is that the clinical stage of the disease has been stable for at least a month, and that some specific therapies may need to be temporarily suspended or modified ad hoc to allow the vaccine to perform its action in the best possible way. In other words, it makes sense to postpone vaccination in those cases in which the patient is in an acute and unstabilized condition, also because one cannot afford to alter the therapies to allow vaccination. In general, however, it is irrelevant that the pathology one suffers from involves a reduction in platelets or an alteration in blood coagulation.

10. Oncological and immunocompromised patients

Similarly to the case previous, even for these categories of patients there are no contraindications to vaccination, and indeed they are people who can greatly benefit from the protection generated by the vaccine. Even those currently undergoing chemotherapy can normally be vaccinated, although it is possible that the protective efficacy is partially reduced.

Bonus: Presence of antibodies in the blood

Verification, for for example through a serological test or a blood test, to already possess a certain concentration of antibodies against Sars-Cov-2 is irrelevant from a bureaucratic point of view (it is not included among the enabling conditions for obtaining the green pass), and from a scientific point of view it does not constitute a contraindication reason for receiving the vaccine. Although some voices in the scientific community believe that it may be a justification for postponing the administration, all agree that those who possess the antibodies can normally get vaccinated, without additional risks or specific contraindications.


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