| In this week's edition of the Covid Q&A, we look at who shouldn't take the vaccine. In hopes of making this very confusing time just a little less so, each week Bloomberg Prognosis is picking one question sent in by readers and putting it to an expert in the field. We've gotten lots of questions about whether other health conditions make getting a Covid-19 vaccine too risky. One reader, for example, was concerned that kidney disease and arthritis medications might make a vaccine unsafe. Another had her gall bladder, pancreas and spleen recently removed. One reader worried about the safety of vaccines for her son with an autoimmune disease, while another expressed concern about a child with severe allergies. So this week we asked an expert about the quandary. Who shouldn't take the vaccine? First off, let's get a disclaimer out of the way: This newsletter doesn't provide medical advice. As always, the best person to weigh in on your individual medical situation is your personal physician. Getting back to this week's question, we need as many people as possible to get inoculated against Covid to ensure that the vaccines work. But for some people, any medical intervention can be risky.
"The only reason not to get the vaccine is if you are allergic to one of the ingredients in the vaccine itself," says Purvi Parikh, an allergist and immunologist with both NYU Langone Health and the Allergy and Asthma Network.
People with other allergies — such as to penicillin or other foods or drugs — should be fine to receive the vaccine, she says.
"You also should receive the vaccine if you have a chronic illness and you are at higher risk for Covid-19," she says. "That includes transplant recipients, those with autoimmune diseases or other forms of immune compromise."
Whether people who are immune-compromised should be vaccinated is a bit confusing. People with weakened immune systems are often cautioned not to receive vaccines that contain either weakened or inactivated viruses, like the one for polio. But that's not how the Pfizer and Moderna vaccines work. They instead use a technology called mRNA to teach the body's immune system what to do if it encounters the coronavirus. That technology makes the safety profile a bit different.  Vaccines made by Pfizer and Moderna don't rely on live virus. Instead, they use a technology called mRNA to teach the body's immune system what to do if it encounters the coronavirus. Photographer: Nathalia Angarita/Bloomberg "The vaccine helps produce both antibodies and T-cell responses, so one shouldn't worry they may not respond to it if they are immune- compromised or without a spleen," says Parikh.
The only contraindications the CDC lists are for people who have either had a severe allergic reaction to a vaccine ingredient or polysorbate, a type of emulsifier. And of course, people who had a severe allergic reaction to a first dose shouldn't get a second shot. If you have gotten sick with the virus and received a monoclonal antibody treatment, Parikh says you should wait 90 days but still get vaccinated. People who have had the virus but didn't receive a monoclonal antibody treatment can get vaccinated as soon as they feel normal, she says. (For more on vaccination for people who have had Covid, see last week's newsletter).
The CDC notes that vaccine safety data for people with some illnesses, such as those with autoimmune conditions, is limited, but so far nothing suggests vaccination would be harmful. More study will clear a lot of that up. But, as we said at the top, if you have questions, the best course of action is to reach out to your doctor.
Thanks to all of you for writing in this week! Next Sunday, we'll be answering the best question we receive again. So if you have any, we want to hear from you. Write to us at CovidQs@bloomberg.net — Kristen V. Brown | 
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