Are there valid medical reasons why you should steer clear of the Covid vaccine?

There are two small groups of people who should exercise caution but everyone else should be fine, says haematopathologist

09 February 2021 - 15:30 By sanet oberholzer
The Covid-19 vaccine is safe for almost all people - experts say just two small groups need to exercise caution when taking the jab.
The Covid-19 vaccine is safe for almost all people - experts say just two small groups need to exercise caution when taking the jab.
Image: 123RF/Feydzhet Shabanov

Almost a week after SA received its first doses of the AstraZeneca vaccine, trial results made available by researchers from the University of the Witwatersrand on Sunday suggest the vaccine doesn’t offer protection against mild to moderate illness caused by the new Covid-19 variant that has been circulating in SA since the end of last year.

The data, which is yet to be peer-reviewed, did not rely on an extensive research sample and may not be sufficient to draw conclusions. It is also not yet clear that the vaccine will not provide protection against severe illness that may result in death and hospitalisation.

The one million doses of AstraZeneca vaccine that were received on February 1 form part of the first phase of SA’s Covid-19 vaccination strategy which aims to reach 1.23 million health-care workers.

SA initially announced a pause in its rollout of the AstraZeneca vaccine. However, on Monday it said it could still roll it out in a “stepped manner” by distributing 100,000 doses and monitoring it to see if it prevents hospitalisations and deaths.

It will also be making available vaccines developed by Pfizer/BioNTech and Johnson & Johnson to health-care workers in the coming weeks.

But how safe will getting a vaccine be — and is there anyone who should consider not getting the jab once it becomes available to the broader public?


According to Dr Susan Louw, a haematopathologist at SA's National Health Laboratory Service, there are two groups of people who should exercise caution and consider not receiving a Covid-19 vaccine.

“It’s been shown that the people who need to be careful are those who have exhibited severe allergic reactions to previous vaccines of a similar nature,” Louw says.

“We’re not talking about an allergic reaction of having a bit of a sore arm after an injection or a little bit of a red bump on your arm when you’ve had a vaccination. This allergic reaction is an anaphylactic reaction that ends you up in hospital where you need to be admitted and emergency drugs need to be administered and you probably will end up in an ICU situation.”

These situations, Louw adds, are rare but if you are concerned she suggests discussing it with your health-care provider.

People that have exhibited severe allergic reactions to previous vaccines of a similar nature need to be careful
Dr Susan Louw 

The second group of people that vaccinations shouldn’t be administered to is pregnant women.

“You’re just not going to conduct any clinical trials on that very vulnerable group of people,” Louw says. “We haven’t had enough experience in pregnant patients that have taken the vaccine, though anecdotally it doesn’t seem to be causing severe problems if pregnant women in the past have received the vaccine.”

In some parts of Europe, reports have emerged of governments advising against administering the AstraZeneca vaccine to people over 65, citing a lack of evidence to prove that the vaccine will be effective in the age group.

While there are other population groups in which the vaccine may not work as effectively, there are no additional medical reasons why someone should not get the vaccine once it becomes available to them.

“Age, comorbidities, a weakened immune system — none of that is a contraindication to receiving the vaccine,” Louw says. “One thing that we are sure about is that the vaccine is safe and that it has been shown to at least offer some protection, so don’t say no to it — that’s my message to everybody out there.” 

Minister of health Zweli Mkhize hosted a public briefing on February 10 2021 to address the Oxford-AstraZeneca vaccine's lack of effectiveness against the 501Y.V2 strand of Covid-19. The minister also gave a revised plan of the country's vaccine rollout.