Here's what adults with comorbidities need to know before getting the COVID-19 vaccine

Metro Manila (CNN Philippines, March 31) — The government has started vaccinating adults with comorbidities against COVID-19. Here are the guidelines you need to note.

The Department of Health said only adults between the ages of 18 and 59 with any controlled comorbidities will be part of Priority Group A3 in the vaccination plan. Vaccinees must register with the local government unit of their current or permanent address or workplace.

Eligibility and requirements

Priority will be given to adults whose comorbidities are among the top causes of COVID-19, national morbidity and mortality. These include chronic respiratory disease, hypertension, cardiovascular disease, chronic kidney disease, cerebrovascular disease, malignancy, diabetes, obesity, chronic liver disease, neurologic disease, and immunodeficiency state.

Eligible adults must provide proof of comorbidity in the form of either a medical certificate from an attending physician, prescription for medicines, hospital records such as the discharge summary and medical abstract, or surgical records and pathology reports, that have been issued within the past 18 months.

For the A3 sub-groups, such as those with autoimmune disease, HIV, cancer or malignancy, and those who are transplant patients, patients undergoing steroid treatment, and patients with poor prognosis or are bed-ridden, they would have to secure a physical or electronic medical clearance from their specialist or attending physician.

They may also get their clearance through teleconsultation, consultation at designated facilities, hubs, rural health units, or other primary care centers designated by the LGU. Patients with comorbidities that are not among those mentioned will not need a medical clearance but they still have to undergo screening on vaccination day at the site for active disease, the DOH said.

Possible deferrals

The DOH said adults with controlled comorbidities will be getting the China-made Sinovac vaccine as it is not recommended for patients who have uncontrolled or poorly controlled comorbidities, and those "in active disease."

Given this rule, patients may get their vaccination deferred if during screening on the vaccination site, they are found to have symptoms of COVID-19 or symptoms of their comorbidity; abnormal vital signs including heart rate, respiratory rate, and blood pressure even after monitoring for 60 minutes, or have had attacks, admissions, or changes in medication for the past three months.

If they have hypertensive emergencies or systolic blood pressure greater than 180 and/or diastolic blood pressure greater than 120, with signs and symptoms of organ damage, their vaccination will be rescheduled.

The DOH said it also allows home-based vaccination in which the LGU must ensure medical clearance for bed-ridden vaccinees prior to the vaccination day, and must schedule on-site vaccination teams. This applies to institutions as well, such as nursing homes or infirmaries.

The LGUs were instructed to ensure that vaccination is scheduled and conducted separately for HIV patients through their treatment hubs to protect their confidentiality, and for tuberculosis patients through the TB-Directly Observed Treatment Strategy (TB-DOTS) centers.