COVID‐19 vaccination in patients with heart failure: a position paper of the Heart Failure Association of the European Society of Cardiology

Abstract

Patients with heart failure (HF) who contract SARS‐CoV‐2 infection are at a higher risk of cardiovascular and non‐cardiovascular morbidity and mortality. Regardless of therapeutic attempts in COVID‐19, vaccination remains the most promising global approach at present for controlling this disease. There are several concerns and misconceptions regarding the clinical indications, optimal mode of delivery, safety and efficacy of COVID‐19 vaccines for patients with HF. This document provides guidance to all healthcare professionals regarding the implementation of a COVID‐19 vaccination scheme in patients with HF. COVID‐19 vaccination is indicated in all patients with HF, including those who are immunocompromised (e.g. after heart transplantation receiving immunosuppressive therapy) and with frailty syndrome. It is preferable to vaccinate against COVID‐19 patients with HF in an optimal clinical state, which would include clinical stability, adequate hydration and nutrition, optimized treatment of HF and other comorbidities (including iron deficiency), but corrective measures should not be allowed to delay vaccination. Patients with HF who have been vaccinated against COVID‐19 need to continue precautionary measures, including the use of facemasks, hand hygiene and social distancing. Knowledge on strategies preventing SARS‐CoV‐2 infection (including the COVID‐19 vaccination) should be included in the comprehensive educational programmes delivered to patients with HF.

Association of Reduced Hospitalizations and Mortality Rates Among COVID-19-Vaccinated Patients With Heart Failure

“… 1 , 2 , 3 , 4 While vaccination against COVID-19 has been proven highly effective for preventing adverse outcomes in the general population, concern over potential cardiovascular sequelae may contribute to vaccine hesitancy, particularly amongst patients with pre-existing cardiac disease. 5 , 6 , 7 , 8 , 9 We sought to evaluate the impact of COVID-19 vaccination among patients with HF on all-cause hospitalization and mortality across a large New York City health system.…”

Ofeleein i mi Vlaptin—Volume II: Immunity Following Infection or mRNA Vaccination, Drug Therapies and Non-Pharmacological Management at Post-Two Years SARS-CoV-2 Pandemic

“…All in all, regarding the mRNA vaccinations, it has to be stated that, despite the several aforementioned concerns that have been raised, they still seem to be possibly effective, particularly for high-risk segments of the aged with/or comorbidities population [55][56][57][58].…”

Immune Response to SARS-CoV-2 Vaccine among Heart Transplant Recipients: A Systematic Review

“…At present, vaccination against COVID-19 is the only preventive measure to mitigate the severity of the diseases, reduce hospitalization rate and mortality, and ultimately end the pandemic. 12 - 14 However, due to chronic immunosuppression and existence of multiple comorbidities, production of sufficient anti-SARS-CoV-2 spike immunoglobulin titer or effective neutralizing antibody after vaccination against COVID-19 has been variable among patients with a transplanted solid organ. 15 - 21 …”