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2021 May 18 General comments regarding COVID-19 vaccination for patients with asthma and chronic obstructive airway disease (COPD)

Guidance notes from the Hong Kong Lung Foundation, Hong Kong Thoracic Society and CHEST Delegation Hong Kong and Macau, collated via the Federation of Medical Societies of Hong Kong

(18 May 2021)
General comments regarding COVID-19 vaccination for patients with asthma and chronic obstructive airway disease (COPD)

If I have asthma or COPD, should I receive COVID-19 vaccine?

People with asthma or COPD should have COVID-19 vaccination unless you have the conditions listed below for which you should take precautions and consult a medical professional.1 You should continue your usual inhaled and oral medications for your asthma or COPD when you plan for vaccination. COPD patients are at higher risk of developing severe COVID-19. 2,3

Conditions requiring special precaution for patients with asthma or COPD for COVID-19 vaccine:

1. If you are currently having worsening of asthma or COPD symptoms despite taking the usual medications regularly, you should wait for this worsening to settle before receiving the vaccination. You should consult a medical professional for appropriate treatment and seek advice on when you are ready to receive the vaccine.

2. If you have a fever or any acute illness, delay vaccination until you are fully recovered.

3. If you are currently on biologic therapy for asthma, COVID-19 vaccine and biologic therapy should not be given on the same day so that adverse effects of either can be more easily distinguished.1

4. If you have a history of allergic reaction to prior COVID-19 vaccine or its components, you should not receive the vaccine concerned. Evaluation by a specialist in allergy may help determine if a different COVID-19 vaccine can be administered.4 A history of severe allergic reaction to other medications or foods is not a contraindication for COVID-19 vaccine, but caution should be exercised (particularly for people with previous anaphylaxis to multiple, different drug classes, which evaluation by a specialist in allergy may be considered) and you should be observed for 30 minutes following vaccination.5, 6, 7

5. Other medical conditions that are considered to have contraindications for COVID19 vaccination.

1. GINA guidance about COVID-19 and asthma (Updated 26 April 2021) https://ginasthma.org/wp-content/uploads/2021/04/21_04_26-GINA-COVID-19- and-asthma.pdf
2. Global strategy for the diagnosis, management , and prevention of chronic obstructive pulmonary disease (2021 report) https://goldcopd.org/wpcontent/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf
3. Alqahtani JS, Oyelade T, Aldhahir AM, Alghamdi SM, Almehmadi M, Alqahtani AS, Quaderi S, Mandal S, Hurst JR. Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis. PLoS One. 2020 May 11;15(5):e0233147
4. Consensus statements on the approach to COVID-19 vaccine allergy safety in Hong Kong http://www.allergy.org.hk/doc/HKIA%20- %20Consensus%20Statements.pdf
5. Center of Disease Control and Prevention. Vaccines and Immunisations, PiferBioNTech Vaccine.https://www.cdc.gov/vaccines/covid-19/info-byproduct/pfizer/index.html
6. Coronavac drug insert. https://www.covidvaccine.gov.hk/pdf/CoronaVac_ENG_PI_brief.pdf
7. Public Health England, Department of Health. Immunisation against infectious disease (COVID-19: the green book, chapter 14a) (7 May 2021). https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attac hment_data/file/984310/Greenbook_chapter_14a_7May2021.pdf