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Vaccine Considerations

Everyone who is eligible can be safely vaccinated against COVID-19, although a very small number of people may need to delay vaccination if they have severe allergies to parts of the vaccine.
Last updated: December 28, 2023

Very rarely a person may need to delay vaccination because of severe allergies, illness or severe reaction after the first dose. If you have concerns, discuss with your health care provider about how you can safely receive the vaccines. 

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Timing with other vaccines

COVID-19 vaccines can be safely given at the same time or any time before or after any other live or inactivated vaccine. This includes the Influenza vaccine. 

If you are getting a COVID-19 vaccine you do not need to delay getting an influenza vaccine. 

It’s especially important to protect yourself against respiratory viruses during cold and flu season. If you get any two vaccines at the same time or close together the healthcare provider will usually administer the vaccines in different arms/limbs.

Pregnancy or breastfeeding

COVID-19 vaccines are recommended for everyone 6 months of age and older, including people who are pregnant, breastfeeding or who may become pregnant.

Planning for your COVID-19 vaccine if pregnant, breastfeeding or thinking about getting pregnant

OpenPlanning for your COVID-19 vaccine if pregnant, breastfeeding or thinking about getting pregnant

Pregnant people are at increased risk of serious illness and
complications from COVID-19 infection. Vaccines can drastically reduce this risk and can be given safely at any time while trying to conceive, during pregnancy or while breastfeeding.

Evidence from around the world continues to grow and has not found any safety concerns for pregnant or breastfeeding people who were vaccinated or for their babies. Studies have shown that pregnant people who get a COVID-19 vaccine receive the same levels of protection that non-pregnant people do, and that this protection can be passed on to your baby.

There are currently no known serious risks (such as an increased risk of miscarriage or possible birth defects) when getting a COVID-19 vaccine while pregnant or breastfeeding (or providing expressed human milk) to either the person being vaccinated or the child. There is no need to change your breastfeeding routine or plan if you get a COVID-19 vaccine.


There are many benefits to getting a COVID-19 vaccine while you are pregnant or breastfeeding


Currently available COVID-19 vaccines are very effective in preventing people from severe COVID-19 disease.


  • Being vaccinated can help protect you from severe COVID-19 disease and reduce the risk of spreading it to others.
  • The vaccine helps your body produce antibodies that will protect you from severe COVID-19 disease if you are exposed to COVID-19. These protective antibodies pass into your milk and may also protect your baby from infection.
  • Other vaccines are safely given in pregnancy or during breastfeeding, including tetanus-diphtheria-pertussis and influenza vaccines.
  • The COVID-19 vaccines are safe, have no live virus and cannot cause COVID-19.
  • Pregnant people who have had two or more COVID-19 vaccines are at much lower risk of hospital or ICU admission, preterm birth, and infant NICU admission for COVID-19 compared to those who have not been vaccinated.
  • If you are pregnant and you have diabetes, asthma, high blood pressure, kidney, liver, lung or heart disease, are very overweight or are a smoker, you are even more likely to develop serious illness from COVID-19.

There are no known risks to getting a COVID-19 vaccine while you are pregnant or breastfeeding


The US Center for Disease Control shared evidence from studies on the safety of receiving an mRNA COVID-19 vaccine during pregnancy. They did not find any safety concerns for pregnant people who were vaccinated or their babies.

Another report looked at pregnant people enrolled in a study who were vaccinated before 20 weeks of pregnancy. There was no increased risk for miscarriage among people who received an mRNA COVID-19 vaccine during pregnancy.

Mild to moderate side effects are common after receiving a COVID-19 vaccine and include:
  • Pain, redness or swelling at the injection site
  • Fatigue
  • Headache
  • Fever, which in pregnancy or when breastfeeding can be managed safely by taking acetaminophen(e.g., Tylenol®)

Not everyone uses the term breastfeeding to describe their feeding

experience and may prefer to use other terms such as nursing or chestfeeding. You can use whichever terms you’re most comfortable with, and you can ask that your friends, family and health-care providers use them, too.
The BC Centre for Disease Control recommends vaccination for pregnant people because it provides protection against severe COVID-19 disease during pregnancy. Vaccination protects you, your baby and those around you.

The Society of Obstetricians and Gynecologists of Canada (SOGC) recommends that pregnant or breastfeeding people should be offered the COVID-19 vaccine at any time if they have no symptoms or medical conditions preventing them from getting immunized.

The SOGC also says that a vaccination decision should be based on an individual’s personal values and their understanding of the risks and benefits of getting or not getting the vaccine while pregnant or breastfeeding.

Canada’s National Advisory Committee on Immunization (NACI) recommends that a complete series of COVID-19 vaccine be offered to pregnant and breastfeeding people.
  1. Get the COVID-19 vaccine as soon as you can through a public health clinic, pharmacy or other medical clinic offering the vaccine, as available. Make sure you are registered with the Get Vaccinated system to keep up to date with your vaccinations.

  2. Follow prevention measures like staying home when sick and cleaning your hands often.
 
 

There is misinformation circulating about COVID-19 vaccines and infertility. COVID-19 vaccines do not cause infertility and there is no scientific reason or biological way they would impact fertility.

 

Some people have reported changes to their menstrual cycle following vaccination. However, it is important to know that a number of factors can impact the menstrual cycle, including sleep, stress, infection, diet and exercise. In fact, getting COVID-19 itself may impact the menstrual cycle, as more than 35% of individuals noted changes in their menstrual cycle after COVID-19 infection. 


While studies are taking place to understand this potential impact, we know that other vaccines have not impacted the menstrual cycle. Read more from the Society of Obstetricians and Gynecologists of Canada.


Previous diagnosis of COVID-19

People who have had COVID-19 should still be immunized with COVID-19 vaccines as not everyone develops a strong immune response after having COVID-19. Vaccine is the best way to help develop immunity. 

If you've recently had a positive COVID-19 test result, you can wait up to 3 to 6 months for a booster dose. 

Both vaccination and COVID-19 infection provide immunity. Vaccination is a safer because it is not associated with the serious illness that COVID-19 can cause. Vaccines have been shown to be highly effective in preventing serious illness and death, even after you have had a COVID-19 infection. If you are due for a COVID-19 vaccine booster dose and recently had a positive COVID-19 test result, you can either: 

  • Defer your booster dose for 3 to 6 months, as the likelihood of a COVID-19 reinfection during this period of time is small because having COVID-19 boosts your immunity. Waiting at least three months is preferable as immunizing shortly after infection may interfere with development of immunity resulting from that infection. 

  • Get your booster dose at any time after your symptoms have passed and you have fully recovered or within a few months of infection. This may interfere with infection induced immunity but you may have other reasons why you feel you need a booster dose earlier. 

Vaccination after COVID-19 - select image link to see full PDF


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Allergies

If you have an allergy to an ingredient of one type of COVID-19 vaccine, you are still able to receive the other type. Speak with your care provider if you have questions.

You should not get an mRNA COVID-19 vaccine (Moderna/ Pfizer-BioNTech) if you have had a serious allergic reaction (anaphylaxis) to:

  • Polyethylene glycol (PEG), an ingredient in both the Moderna and Pfizer-BioNTech COVID-19 vaccines. PEG can be found in some cosmetics, skincare products, laxatives, cough syrups, and bowel preparation products for colonoscopy. PEG can be an additive in some processed foods and drinks, but no cases of anaphylaxis to PEG in foods and drinks have been reported.
  • Any component (part) of either the Moderna or Pfizer-BioNTech COVID-19 vaccine
  • People who experienced a severe immediate allergic reaction after the first dose of an mRNA COVID-19 vaccine can safely receive future doses of the same or another mRNA COVID-19 vaccine.
  • Consult with an allergist or ask your primary care provider to explore options.
  • You will be asked to stay in the clinic for 30 minutes after getting the vaccine so you can be monitored. By staying in the clinic, a health care provider can respond in the event you experience a reaction. Tell a health care provider if you feel unwell after your vaccine.

Previous reactions to non-COVID-19 vaccines do not mean that you should not get a COVID-19 vaccine. Ask your health care provider whether there are any similar ingredients in the vaccine that you had a reaction to and COVID-19 vaccines. If there are none, it is safe to get the COVID-19 vaccines.

If you have a history of any of the following it is still safe to get the COVID-19 vaccines:

  • X-ray dye allergy
  • Bee and wasp stings allergy
  • Food allergies
  • Environmental allergies such as to pollen or dust mites
  • Recurring anaphylaxis of unknown origin (idiopathic anaphylaxis)
  • Systemic Mastocytosis
  • Chronic hives
  • Guillain-Barré Syndrome (GBS)
  • Contact allergy to propylene glycol (PG)

For more information on allergies and COVID-19 vaccination check the FAQs from the Canadian Society of Allergy and Clinical Immunology.

Health conditions and other considerations

People who have medical conditions are still able to receive the COVID-19 vaccines. The health conditions below are NOT contraindications for COVID-19 vaccines. You should still get vaccinated if any of these apply to you.

If you are currently taking medication or undergoing treatment it is still safe to get the COVID-19 vaccines. If the medication you are taking suppresses your immune system, check with your healthcare provider about the best time to get the COVID-19 vaccine to ensure an optimal immune response.

 

Anyone with the following is able to get mRNA COVID-19 vaccines:

  • History of thrombosis following a previous dose of an adenovirus vector COVID-19 vaccine-like AstraZeneca/COVISHIELD
  • History of capillary leak syndrome
  • History of cerebral venous sinus thrombosis (CVST) or heparin-induced thrombocytopenia (HIT)

If you have an autoimmune disease, you should get the COVID-19 vaccine.  Speak to your healthcare provider or medical specialist if you have specific questions.
Please refer to the information for people with health conditions who are clinically extremely vulnerable for further information about specific autoimmune conditions.

Children and young people

Vaccine considerations for children are similar to adults. The vaccine can be given to children who take medications regularly, including youth with conditions that make them clinically extremely vulnerable.

 

Vaccination should be delayed for 90 days following MIS-C (the rare multi-system inflammatory syndrome in children).

Learn more about COVID-19 vaccinations and children. 

People who have had COVID-19 should be immunized with COVID-19 vaccines. You should wait until you have recovered to get immunized.‎

Resources for clinically extremely vulnerable groups

Some people with specific health conditions or taking specific treatments are considered clinically extremely vulnerable. Here you will find information and resources about getting the COVID-19 vaccine if you are part of this group. 

A third dose of COVID-19 vaccine is recommended for some people who are moderately to severely immunocompromised. Booster doses are recommended for everyone 12 years and older.

Information for health professionals can be found in the COVID-19 vaccine resources for health professionals.

A third dose of COVID-19 vaccine is recommended for some people who are moderately to severely immunocompromised.


COVID-19 vaccines are not live vaccines, and there are no significant concerns about safety for those with weakened immune systems. It is possible that the vaccine may not work as expected in people who have a weakened immune system.


If you have questions and have a weakened immune system, speak to your healthcare provider about the COVID-19 vaccine.


A third dose of COVID-19 vaccine is recommended for some people who are moderately to severely immunocompromised.


Learn more about who is eligible to receive a third dose and how to get your third dose of vaccine.


SOURCE: Vaccine Considerations ( )
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