Vaccine exemption: who can apply for it and who issues it
Unless otherwise specified, the exemptions will be valid until 30 September. “The covid vaccination exemption certificates – reads the circular – may be issued in paper format and may have a maximum validity until 30 September 2021, unless otherwise specified”. The duration of validity, “on the basis of clinical assessments, will be updated when the national system for digital issuance of the same will be launched to allow for digital verification”. Vaccine exclusion certificates already issued by the regional health services are valid temporarily and until 30 September 2021.
Sars-CcV-2 vaccination exemption certifications
Who can apply for vaccine exemption? The certificate can be requested by all those who have had a health problem between the first and second dose, such as a strong allergic reaction to the components of the vaccine or by those who have had a negative opinion from the doctor due to previous diseases, as well as from all “the rare and chronic patients who, due to their pathology, do not have the possibility to access vaccination”. These people did not have the opportunity to apply for the green pass and in a few hours, from Friday 6 August, they would be excluded from various indoor places: swimming pools, gyms, restaurants, bars, theaters, cinemas.
As for the green pass, the exemption can also be in paper or digital format. It will be issued by the vaccinating doctors of the vaccination services of the companies and bodies of the regional health services or the general practitioners or the pediatricians of the patient’s free choice who operate within the national anti Sars-CoV-2 vaccination campaign. The certification must be issued free of charge, taking care to archive the relative clinical documentation, including digitally, through the regional vaccination information services in a manner defined by the individual regions.
For the moment, a thousand volunteers from the Italian Reithera vaccine trial who are not immunized are excluded. For them, the indications of the Ministry of Health are awaited, with another ad hoc provision.
The circular from the Ministry of Health reads:
- Severe allergic reaction after a dose of vaccine or to any vaccine component – A serious allergic reaction after a dose of vaccine or to any component of the vaccine is a contraindication to the administration of further doses of the same vaccine or of products containing the same components. This type of allergic reaction almost always occurs within 30 minutes of vaccination, although cases of anaphylaxis occurring within 24 hours are attributable to the vaccine. In the event of a severe allergic reaction to the first dose of a COVID-19 vaccine, the possibility of using a different type of vaccine to complement immunization may be considered; however, given the possibility of cross-reactions between components of different vaccines, it is advisable to carry out an allergy consultation and an individual risk / benefit assessment.
- Pregnancy – SARS-CoV-2 vaccination is not contraindicated in pregnancy. If, after medical evaluation, it is decided to postpone vaccination, the pregnant woman may be issued a certificate of temporary exemption from vaccination.
- Breastfeeding – Breastfeeding is not a contraindication to Sars-CoV-2 vaccination.
- Guillain-Barré syndrome – Guillain-Barré syndrome has been reported very rarely following vaccination with Vaxzevria. In the event of Guillain-Barré syndrome occurring within 6 weeks of administration of the COVID-19 vaccine, with no other traceable cause, it is prudent not to perform further administration of the same type of vaccine. In such situations, the use of a different type of vaccine should be considered to complement immunization.
- Myocarditis / Pericarditis – Very rare cases of myocarditis and pericarditis have been observed following vaccination with COVID-19 mRNA vaccines (Pfizer and Moderna). The decision to administer the second dose of Pfizer or Moderna vaccine to people who have developed myocarditis / pericarditis after the first dose should take into account the individual’s clinical condition and should be made after cardiology counseling and careful risk / benefit assessment. . In this situation, where it has been considered not to proceed with the second dose of COVID19 mRNA vaccine, the use of a different type of vaccine to complete immunization should be considered.
- Serological tests – It is reiterated that the execution of serological tests, aimed at identifying the antibody response against the virus, is not recommended for the purposes of the vaccination decision-making process; for this reason the presence of an antibody titer cannot in itself be considered, at the moment, an alternative to the completion of the vaccination cycle.