January 15, 2021: Citing precautions and contraindications for COVID-19 vaccination ahead of massive immunisation scheduled on January 16, the Union Health Ministry has said that interchangeability of vaccine is not permitted while pregnant and lactating mothers should not receive COVID-19 vaccine at this time.

In a letter to the States/Union Territories, the health ministry has shared the competitive factsheet for both the vaccines (Covishield and Covaxin). They contain information on vaccine platform, physical specifications,

dosage, cold storage requirements, contraindications and minor AEFIs.

The health ministry has directed the States/UTs to disseminate information to program managers across all levels and through them to call chain handlers and vaccinators for ready reference.

Mentioning precautions and contraindications for COVID-19 vaccination, the letter noted: "Under the emergency use authorisation, COVID-19 vaccination is indicated only for 18 years and above. Interchangeability of COVID-19 vaccine is not permitted. The second dose should also be of the same COVID-19 vaccine which was administered as the first dose."

In case of co-administration of vaccines: if required, COVID-19 vaccine and other vaccines should be separated by an interval of at least 14 days, the ministry said.

Explaining contraindication, the letter said, "A person with a history of an anaphylactic or allergic reaction to a previous dose of COVID-19 vaccine. Immediate or delayed onset anaphylaxis or allergic reaction to vaccine or injection able therapies, pharmaceutical products, food items etc."

"Pregnancy and lactation: pregnant and lactating women have not been part of any COVID-19 vaccine clinical trial so far. Therefore, women who are pregnant or not sure of the pregnancy, and lactating women should not receive COVID-19 vaccine at this time," the government said.

Provisional and temporary contraindications: in these conditions, COVID-19 vaccination is to be deferred for 4 to 8 weeks after recovery.

"Persons having active symptoms of SARS-CoV2 to infection. SARS-CoV2 patients who have been given anti-SARS-CoV2 monoclonal antibodies on convalescent plasma. Acutely unwell and hospitalized patients (with or without intensive care) patients due to any illness.

Special precautions: vaccine should be administered with caution in persons with a history of any bleeding or coagulation disorder, for example, clotting factor deficiency, coagulopathy or platelet disorder.

Following conditions are not contraindicated for COVID-19 vaccines: a person with a past history of SARS-CoV2 infection or and or RTPCR positive illness. History of chronic diseases and comorbidities (cardiac, neurological, pulmonary, metabolic, renal, malignancies).

Immuno-deficiency, HIV, patients on immunosuppression due to any condition (response to the Covid vaccine may be less in these individuals. Other important issues to consider are that vaccine-specific contraindications may apply as the new information becomes available.

India has got two Covid-19 vaccines--Covishield and Covaxin Emergency Use Authorisation after meeting going through established safety and immunogenicity through a well prescribed regulatory process.

This vaccine may cost in the range of Rs 200 to 295 in India. Earlier in the day, the health ministry said that full initial procurement amount of 1.65 crore doses of COVISHIELD and COVAXIN vaccines have been allocated to all states and Union Territories in the proportion of Health Care Workers database.