Reasons why Covid vaccination medical exemptions can be given by GPs

GPs are being pushed daily for medical exemptions for Covid vaccines as new freedoms for the fully vaccinated loom, but experts say there are very, very few actual reasons to qualify.

Doctors are reporting increasing rates of patients demanding a medical exemption from the Covid vaccine — but experts warn there are very few conditions that genuinely qualify.

Sydney University immunisation expert Professor Robert Booy said while the AstraZeneca vaccine may not be advisable for several rare conditions, you can always get a different type.

“There are no conditions really, in fact it’s the opposite — if you have chronic medical condition you are at much higher risk of getting severe Covid consequences,” Prof Booy said.

The listed contraindications for AstraZeneca include a past history of cerebral venous sinus thrombosis, Heparin-induced thrombocytopenia, Splanchnic vein thrombosis and Antiphospholipid syndrome with thrombosis.

This can mean a higher risk of the very rare clotting complication TTS but, for anyone with those conditions, Pfizer or Moderna are recommended.

“Those four or five, all rare thrombotic syndromes, they account, together, for one in 10,000-50,000 people, so there is no reason why you can’t get one of the other vaccines,” Prof Booy said.

Professor Robert Booy. Picture: NCA NewsWire / Gary Ramage

Dr Karen Price says there are few reasons to be exempt from having the vaccine.

President of the Royal Australian College of General Practice Dr Karen Price said anaphylaxis after a previous dose of Covid-19 vaccine was another medical reason.

“Well, anaphylaxis to particular ingredients like Polyethylene glycol or polysorbate 80, particular ingredients in the vaccines,” Dr Price said.

“If you have had a TTS with AstraZeneca, obviously we don’t recommend another one.

“Other people may have to delay or consider the timing of the dose if having advanced chemotherapy or bone marrow transplants, such as the very unwell. But that is all about timing, not a contraindication. There are very, very few conditions (that require an exemption).

“My son has anaphylaxis to peanuts and he had a Pfizer. We watched for 30 minutes but he had no reaction, so anaphylaxis in general is not a contraindication.”

GPs have reported increasing pressure from those demanding medical exemptions based on self-diagnosed issues.

“They are giving a variety of reasons — high blood pressure, COPD, diabetes or they had cancer 10 years ago and it’s puzzling because they are the people we really do want to vaccinate as they are most in need,” Dr Price said.

There are only a few medical reasons why people can be medically exempt from having the Covid vaccine. Picture: NCA NewsWire/Dan Peled

“Those with auto-immune should definitely have a vaccination.

“There is a cohort of conscientious objectors who see that vaccine passports may be coming and they believe a medical exemption may get them out of being banned from certain places.

“These conversations can go poorly when they overrule medical experts, but the problem is those who may react angrily to what they are being told.

“Doctors are happy to help anyone who has misinformation who is willing to go through a conversation but obviously people who are unable to listen, or conscientious objectors or anti-vaxxers, we have better things to do.”

The Pfizer jab has been linked to a rare side effect of pericarditis, or swelling around the heart.

Previous myocarditis and pericarditis is a contraindication but only within the last six months Prof Booy said.

“If you have had something in the last six months you need to see a cardiologist and you will have a delayed vaccination, but if you have had a cardiac issue more than six months ago, most are fine to be vaccinated,” he said.

“If you have a stable cardiac condition you can be vaccinated.”

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Originally published as Reasons why Covid vaccination medical exemptions can be given by GPs