Three contraindications for mRNA vaccines (Comirnaty or Spikevax) against covid 19

Two ribonucleic acid (RNA) vaccines against covid 19 are currently approved by the European Medicines Agency: Comirnaty vaccine from BioNTech-Pfizer and Spikevax vaccine from Moderna.

On Tuesday, July 21, 2021, the Minister of Health, in consultation with the National Agency for the Safety of Medicines and Health Products (ANSM) and the Council on Vaccination Strategy Orientation (COSV), clarified that the medical indications for these vaccines are limited to the following three conditions :

  • History of Pediatric Multisystem Inflammatory Syndrome (PIMS), an extremely rare complication that has affected some children and adolescents following SARS-CoV-2 infection.
  • A history of myocarditis, pericarditis, or severe hepatitis requiring hospitalization after the first injection of the mRNA vaccine.
  • Allergy to one of the components of the vaccine, PEG 2000 or polyethylene glycol, according to the Minister of Health, this situation affects about 10 cases in France.

The minister also clarified that neither pregnancy, nor “a history of allergy to an antibiotic or a bee sting” are contraindications to vaccination.

Indeed, it is necessary to draw up a list of permissible contraindications in order to avoid issuing certificates of convenience. Thus, only medical certificates that indicate these contraindications are recognized. A simple medical or pharmaceutical report with an allergic history will not be enough to confirm a contraindication.

However, for the sake of completeness, it is necessary to add to this list of contraindications an anaphylactic allergy to a vaccine component or an anaphylactic reaction that occurs after the first dose of the vaccine. These contraindications apply to all vaccines.

The Minister of Health did not give specific contraindications to the use of the viral vector anti-vaccine. Vaxzevria (AstraZeneca) vaccine is especially contraindicated in people who have had thrombotic thrombocytopenic syndrome (TTS) after vaccination with Vaxzevria, as well as people who have previously had episodes of capillary leak syndrome. Janssen COVID-19 vaccine is contraindicated in people who have had episodes of capillary leak syndrome.

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