Formulary
COVID-19 vaccine: Indications, Dosing, Side Effects and Interactions
For COVID-19 vaccine COVID-19 vaccines are inactivated vaccines that use the spike protein of the SARS-CoV-2 virus to act as an intracellular antigen and...
MedNext Academy | 3 min read
COVID-19 vaccine: Indications, Dosing, Side Effects and Interactions
For COVID-19 vaccine COVID-19 vaccines are inactivated vaccines that use the spike protein of the SARS-CoV-2 virus to act as an intracellular antigen and...
Drug action
For COVID-19 vaccine COVID-19 vaccines are inactivated vaccines that use the spike protein of the SARS-CoV-2 virus to act as an intracellular antigen and produce an antibody response, thereby protecting against COVID-19 infection. Messenger RNA (mRNA) vaccines, such as Pfizer/BioNTech ( Comirnaty ) and Moderna ( Spikevax ), deliver viral RNA into host cells to enable expression of the spike protein. Other vaccines types include those that contain a recombinant spike protein with an adjuvant to strengthen the immune response, such as Novavax ( Nuvaxovid ).
Indications and dose
**Immunisation against COVID-19**
- **Adult** (By Intramuscular Injection): (consult local protocol).
**Immunisation against COVID-19 for COVID-19 vaccine**
- **Child 6 months-17 years** (By intramuscular injection): (consult local protocol).
Cautions
For all vaccines, general Acute illness; minor illnesses Cautions, further information Illness UKHSA advises vaccination may be postponed if the individual is suffering from an acute illness; however, it is not necessary to postpone immunisation in patients with minor illnesses without fever or systemic upset. Predisposition to neurological problems UKHSA advises: when there is a personal or family history of febrile convulsions, there is an increased risk of these occurring during fever from any cause including immunisation, but this is not a contra-indication to immunisation. In children who have had a seizure associated with fever without neurological deterioration, immunisation is recommended ; advice on the management of fever should be given before immunisation. When a child has had a convulsion not associated with fever, and the neurological condition is not deteriorating, immunisation is recommended ; children with stable neurological disorders (e.g. spina bifida, congenital brain abnormality, and peri-natal hypoxic-ischaemic encephalopathy) should be immunised according to the recommended schedule; when there is a still evolving neurological problem , including poorly controlled epilepsy, immunisation should be deferred and the child referred to a specialist. Immunisation is recommended if a cause for the neurological disorder is identified. If a cause is not identified, immunisation should be deferred until the condition is stable. Impaired immune response and drugs affecting immune response Immune response to vaccines may be reduced in immunosuppressed patients, UKHSA advises consider seeking specialist advice.
Side effects
For all vaccines, general Common or very common Abdominal pain; appetite decreased; arthralgia; diarrhoea; dizziness; fatigue; fever; headache; lymphadenopathy; malaise; myalgia; nausea; skin reactions; vomiting Uncommon Hypersensitivity Side-effects For COVID-19 vaccine Common or very common Chills; lymphatic abnormalities Uncommon Asthenia; insomnia; lethargy; pain in extremity; sweat changes Rare or very rare Angioedema; cardiac inflammation; facial paralysis; sensation abnormal Frequency not known Capillary leak syndrome; extensive swelling of vaccinated limb; menorrhagia
Pregnancy
For COVID-19 vaccine UKHSA advises that COVID-19 vaccines are suitable.
Breast feeding
For COVID-19 vaccine UKHSA advises that COVID-19 vaccines are suitable.
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Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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