COVID-19 vaccines and heart disease

For people with heart disease

This webpage will give you information about:

This webpage is meant to give you general information about what is known about the vaccines right now. Please continue to talk to your health-care team about your heart disease and if the COVID-19 vaccine is right for you.

Last updated: March 4, 2021. The webpage may change as we continue to receive new information.

How do COVID-19 vaccines work?

Vaccines (also called immunizations or vaccinations) are used to help our immune system recognize and protect our body against certain infections.

Health Canada has approved three COVID-19 vaccines:

The Pfizer-BioNTech vaccine is for people 16 years of age and older. It is given in two doses.
The Moderna vaccine is for people 18 years of age or older. It is given in two doses.
The AstraZeneca vaccine is for people 18 years of age or older. It is given in two doses.

The Pfizer and Moderna vaccines have genetic material in them called messenger RNA (mRNA). Cells in our body make mRNA all the time to help build, maintain and repair things in the body. After we get the vaccine, the mRNA tells the cells in our body to make more protein. The protein gets our immune system to start making antibodies (cells that fight infection). These antibodies will help our immune system to detect and destroy the COVID-19 virus before it causes illness.

The AstraZeneca vaccine is a viral vector-based vaccine. These types of vaccines use a harmless virus (in this case, the adenovirus that also causes the common cold) as a delivery system. The vector virus used is not the virus that causes COVID-19. Once injected into the body, the virus contained within the vaccine produces the protein to get our immune system to start making antibodies. This protein doesn't make you sick.

Why is it important to get the COVID-19 vaccine?

People who have a heart condition, vascular disease or risk factors for these conditions (e.g. diabetes, high blood pressure) are at higher risk of complications, including death, if they are infected with COVID-19. For this reason, most people with heart disease should get the COVID-19 vaccine to protect themselves.

Each person’s heart condition is different. Talk to your health-care team about the COVID-19 vaccine and whether it is right for you.

Is the vaccine safe?

How do I know the vaccines are safe?

Health Canada makes sure that vaccines meet very strict safety and efficacy (how well something works) standards before they are approved for our use. The COVID-19 vaccines went through the same amount of safety checks as any other vaccine or medicine.

To read more about how the vaccines were approved for use, go to sunnybrook.ca/vaccine.

Can I get COVID-19 from taking the vaccine?

No, it is not possible to get COVID-19 from taking the vaccine. The Pfizer and Moderna vaccines do not contain the live virus that causes COVID-19. The vector used in the AstraZenca is genetically unable to replicate so no infection is possible.

Can I spread the virus to other people even after I get the vaccine?

Yes. The COVID-19 vaccine will reduce the chance of you getting really sick from the COVID-19. But the vaccine may not protect you from getting infected with the COVID-19 virus. This means that there is still a chance you could get COVID-19 but have no symptoms of the disease.

Is the vaccine safe for people with heart conditions?

Yes. The approved vaccines pose no special problems for patients with heart or vascular disease.

Can people on blood thinners get the vaccine?

Yes. You may get a bigger bruise on your arm, where you got the injection, due to the blood thinner. To help avoid bruising, press firmly on the injection site for a minute or two after the injection. If you notice a large bruise that is painful or continues to enlarge, speak to your health-care team.

Can I still get the COVID-19 vaccine if I already had COVID-19?

Yes. People who have COVID-19 can get the vaccine after they recover from the virus. The vaccine trials included people who had been infected with COVID-19 and the vaccine was found to be safe.

Experts do not know how long antibodies last after someone has had COVID-19. The vaccine may help your body fight a future COVID-19 infection. Talk to your doctor about when it is safe to get the vaccine, after you recover.

Can I get the COVID-19 vaccine if I have symptoms of COVID-19?

If you have any symptoms of COVID-19, wait to get the vaccine. Talk to your health-care team about your symptoms and getting a COVID-19 test. Your health-care team will tell you when it is safe to get the vaccine.

Possible side effects from the vaccine

As with other vaccines, some people may get mild side effects in the days after. Most side effects will go away on their own.

Learn more about the possible side effects

The most common side effects from the mRNA vaccines are:

Fatigue (tiredness)
Headache
Muscle aches
Pain where you got the shot (on your upper arm)
Redness and swelling where you go the shot (on your upper arm)
Joint pain
Mild fever
Swollen glands (this happens less often)

Serious side effects from the vaccine are rare. If you get any of these side effects within three days of getting the vaccine, call your health-care team right away or go to your nearest emergency department. These serious side effects include:

Hives
Swelling of the face or mouth
Trouble breathing
Very pale colour in your face or serious drowsiness (feeling very sleepy)
Fever over 40 degrees Celsius or 104 degrees Fahrenheit
Convulsions (muscle movement you cannot control) or seizures
Numbness

If you have serious allergies or have had a serious allergic reaction to other vaccines, drugs or food, talk to your cancer doctor before you get the COVID-19 vaccine.

How well will the COVID-19 vaccine work?

All three approved vaccines are highly effective in preventing COVID-19 infection with over 80 per cent efficacy. Patients should not delay getting vaccinated given the ongoing risk of COVID-19 in the community and emergence of variants of the virus that are more transmissible. The best vaccine to receive is the one that is available to you.

How long will protection from the vaccine last?

At this time, we do not know how long the vaccine protection will last, but it is a minimum of three-months and likely longer. Since this is a new vaccine, more research over the next year will help to answer this question more specifically.

How will I get the vaccine?

COVID-19 mRNA vaccines are given in the upper arm muscle just like a flu shot.

How many shots of the vaccine do I need?

All three available vaccines in Canada involve two shots but we know that even one dose is quite protective.

How soon does the vaccine start to work?

Within two weeks, there is some protection from these vaccines and by three-to-four weeks the protection is quite significant. By the time a patient is ready to receive their second dose, they already have over 80 per cent protection. The second dose offers even greater protection (85-95 per cent) and may increase the duration of the protection.

If the vaccine is safe for me, when will I get the COVID-19 vaccine?

We are following the directions of the Ministry of Health for the rollout of the vaccine. For the most up-to-date information, please go to sunnybrook.ca/vaccine.

Does my heart disease qualify as an underlying medical condition, moving me ahead of the general public in terms of getting the vaccine?

The Government of Ontario recommends that, due to the risk of severe or critical COVID-19, patients with heart disease receive their vaccination sooner than the general population. You fall under phase 2 in Ontario. If you are aged 80 years or older you fall under phase 1.

Do I still have to wear a mask and practice physical distancing after I get the vaccine?

Yes. You still need to wear masks and practice physical distancing until a large number of people get the vaccine. In Ontario, the vaccinations will happen over the next few months.

Other vaccine information

Can I still get a flu shot if I have not had one yet?

Yes. The flu and the COVID-19 virus are not the same thing. For people with heart disease, the flu can be serious and sometimes life-threatening (cause death).

People with heart disease should get a flu shot that has an inactive (dead) flu virus. Most flu shots do not contain the live virus.
Do not get the flu vaccine through the nose as nasal spray. These nasal sprays contain live flu virus. People with heart disease and those in the same household should not get the nasal spray flu vaccine.

Your health-care team will tell you when to get the flu shot depending on your condition.

Can I still get a flu shot if I have COVID-19?

If you have COVID-19 or think you may have the virus, wait to get your flu shot. This keeps other people safe from being exposed to COVID-19.

Can I get other vaccines at the same time I get the COVID-19 vaccine?

No. You should not get other vaccines at the same time you get the COVID-19 vaccine. Do not get other vaccines until at least 28 days after you get the second dose of the COVID-19 vaccine.

If you get a vaccine before the COVID-19 vaccine, wait 14 days before you get the COVID-19 vaccine.

For more information

Talk to your health care team for more information about the COVID-19 vaccines. We also have resources for you at sunnybrook.ca/vaccine.