COVID-19 information for the stroke community

The information below is general in nature, guided by the Stroke Foundation Clinical Council. Please talk to your doctor if you are considering getting vaccinated or have concerns about COVID-19.

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It is important even with the vaccine to continue to be COVIDSafe. Everyone still needs to:

• Practise good hygiene.
• Maintain physical distance.
• Wear a mask when needed.
• Stay home if you are sick and get tested.

Why should I get vaccinated?

Having the vaccine means you are much less likely to become seriously ill or die from COVID-19.

It is your choice to have the vaccine. Everyone will have access to the vaccine, and it is free.

Survivors of stroke are more vulnerable to the serious consequences of COVID-19 infection, which is also associated with an increased risk of having a stroke. Vaccinating against it is very important. Talk to your doctor about the vaccine.

Having the vaccine also benefits those around you. Vaccination not only reduces the chance of catching the virus, it also reduces the chance of passing it on.

More people vaccinated reduces the potential for the virus to change and get around the defence of vaccination.

Being vaccinated also reduces the chance of Long COVID, which is when people experience ongoing symptoms after COVID-19 infection. These symptoms may include fatigue, ‘brain fog’, and other effects on thinking and memory, which can also be experienced by survivors of stroke. Long COVID also increases the risk of stroke.

Two doses of vaccine are given initially, followed by boosters for ongoing protection, especially against new variants of the virus. People who are immunocompromised may need to have three doses initially.

Which vaccines are available in Australia?

Four vaccines are currently available: the Pfizer vaccine (also known as Comirnaty), the AstraZeneca vaccine (also known as Vaxzevria), the Moderna vaccine (also known as Spikevax), and the Novavax vaccine (also known as Nuvaxovid).

The TGA is actively monitoring COVID-19 vaccine development both in Australia and around the world, and is also part of a network of international regulators that meet regularly to discuss the development of COVID-19 vaccines.

Australian Government information on the vaccine program.

Is the vaccine safe for people who have had a stroke?

If you have concerns about the vaccine or other medications, please talk to your doctor.

Vaccines are safe for people who have had a stroke.

Following a thorough and independent review, the Therapeutic Goods Administration (TGA) decided that some vaccines meet the high safety, efficacy and quality standards required for use in Australia.

The TGA looks at evidence of safety and effectiveness for a range of different ages, health conditions and lifestyle factors before approving vaccines for use. This includes survivors of stroke and older people. You can read more about the TGA's decision.

In fact, older people and people with an underlying medical condition or disability, including stroke, are among those who will receive the vaccine first because of the risk of death following COVID-19 infection.

Where can I get the vaccine?

Find out where you can book a vaccination with the Australian Government's COVID-19 Vaccine Clinic Finder.

If you need help booking, you can use the Easy Vaccine Access (EVA) service. Text “Hey EVA” to 0481 611 382, and a trained person from the National Coronavirus Helpline will call you back. EVA is available every day from 7 am to 10 pm (AEST), with free interpreting.

Availability can vary depending on the conditions where you are, so also check your state or territory website: ACT, NSW, NT, QLD, SA, TAS, VIC, WA.

Will I need a booster vaccination?

To keep your protection up to date, anyone over 16 years old who had their second COVID-19 vaccine 3 or more months ago is recommended to get a third dose as a booster. You can check when you received your second dose by looking at the date on your vaccination certificate.

The booster dose is particularly important for people who have risk factors for severe disease, such as older people and people with an underlying medical condition or disability, or people in a location or job with high risk of exposure.

People who are at risk of severe COVID-19 illness, including people with stroke, and have had three initial doses will need a fourth dose as a booster. The fourth dose is to be given 4 months after the first booster dose.

If you have had COVID-19, you should wait 3 months after your infection before getting another vaccine.

Read more about booster doses

Are there any side effects to the vaccines?

Please talk to your GP or neurologist if you have any concerns about side effects from the COVID-19 vaccination. 

Like all medicines, vaccines can cause side effects, although many people don’t get any side effects at all.

The vast majority of side effects from a vaccination are mild and short-term. The most common are pain at the injection site, feeling generally unwell, tiredness, headache, muscle pain and joint pain. You can take paracetamol to treat any of these side effects.

Often the side effects are just a sign that the vaccine is doing its job: it can happen with many vaccines that some people might feel slightly unwell because their immune system is responding to the vaccination, but this is not a COVID-19 illness.

The vaccine cannot give you COVID-19.

One of the side effects to all vaccines can be an allergic reaction, the majority of which are mild but can be more severe. You will be asked to wait for 15 minutes after you have had the vaccination to be monitored for any reaction.

Is there a risk of blood clots?

There have been a small number of reports of unusual types of blood clots in people who have had the AstraZeneca COVID-19 vaccine. This condition, called thrombosis with thrombocytopenia syndrome (TTS), is very rare and mostly occurs in younger females.

There is no evidence that people who have had a past history of other types of blood clots have an increased risk of developing TTS, or of becoming more ill from it if it occurs. The Government advises that people with the following conditions can get the AstraZeneca vaccine:

• History of blood clots in typical sites
• Increased clotting tendency that is not immune-mediated
• Family history of blood clots
• History of ischaemic heart disease or stroke
• Current or past thrombocytopenia (low platelet count)
• Those receiving anticoagulation therapy

Therefore, prompt COVID-19 vaccination is still advised for the vast majority of Australian survivors of stroke.

Those with a history of cerebral venous sinus thrombosis (CVST), antiphospholipid syndrome with thrombosis, the immune condition heparin-induced thrombocytopenia (HIT), idiopathic splanchnic venous thrombosis (blood clot in abdominal veins), or other contraindications to the AstraZeneca vaccine, are recommended to have the Pfizer or Moderna vaccines.

Reports of the rare blood clots have happened between day 4 and 42 after vaccination. The main symptoms are severe, persistent headaches that are different to your "usual" pattern and do not settle with paracetamol or other painkillers. Other symptoms may include multiple small bruises, reddish or purplish spots or blood blisters under the skin, swelling of a leg, breathlessness, or pains in the chest or abdomen.

If these symptoms occur, seek medical advice as soon as possible. Anyone attending their GP or a hospital with any concerns should let their treating clinician know the details of the vaccine they received.

Please talk to your GP or neurologist if you have any other concerns about blood clots after COVID-19 vaccination.

Read more about the AstraZeneca COVID-19 vaccine.

Is there a risk of heart inflammation?

In rare cases, COVID-19 vaccines have been linked to side effects of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the tissue around the heart muscle).

These side effects are mostly reported in males under 40 years of age, after the second dose of an mRNA vaccine (Moderna or Pfizer). However, cases do occur in both females and males, at any age, and after any dose, including a third or fourth dose.

Most cases are mild and people recover quickly.

It’s important to remember that myocarditis and pericarditis can have other causes too, and not all cases after vaccination are caused by the vaccine. COVID-19 itself can also cause myocarditis and pericarditis.

People with most kinds of heart condition can still be vaccinated. Those with a history of the following conditions can also be vaccinated, but should talk to a GP, immunisation specialist service or cardiologist first:

• Myocarditis or pericarditis within the last 3 months.
• Acute rheumatic fever or acute rheumatic heart disease (i.e., with evidence of active inflammation)
• Acute decompensated heart failure.

A longer interval between vaccine doses may reduce the risk, and may also improve protection against COVID-19. The recommended interval between 2 doses of Pfizer, Moderna, or Novavax vaccine is 8 weeks. The interval can be shortened in some circumstances (such as for people with increased risk of severe COVID-19) to 3 weeks for Pfizer and Novavax or 4 weeks for Moderna and AstraZeneca.

Symptoms of myocarditis or pericarditis typically appear within 1 to 5 days of vaccination. People who experience any of these symptoms after having an mRNA COVID-19 vaccine should seek prompt medical attention:

• chest pain
• pressure or discomfort in the chest
• irregular, skipped heartbeats or ‘fluttering’
• fainting
• shortness of breath
• pain when breathing.

Read more about COVID-19 vaccines and cardiac inflammation

What should I tell my health professional before having the vaccine?

Tell your doctor, pharmacist or nurse beforehand if any of the below apply you. Your health and wellbeing is their priority. It may mean there are things the health professional needs to check or discuss with you before vaccinating, or it may mean you cannot have the vaccine:

• Your immune system does not work properly (immunodeficiency) or you are taking medicines that weaken the immune system (such as high-dose corticosteroids, immunosuppressants or cancer medicines).
• You have ever had a severe allergic reaction (anaphylaxis) after any other vaccine injection.
• You currently have a severe infection with a high temperature (over 38°C).
• You have a problem with bleeding or bruising, or if you are taking a blood thinning medicine (anticoagulant).

Those with a history of cerebral venous sinus thrombosis (CVST), or the immune condition heparin-induced thrombocytopenia (HIT), are advised to defer vaccination.

What if I am on blood thinners?

Talk to your doctor or health professional before having the vaccine.

Generally, the vaccine is safe for people on warfarin or other anticoagulants, however there is some risk of mild bleeding as with any injection.

Like most vaccines, the coronavirus vaccine is injected into the muscle of your upper arm. Injections into your muscle may bleed a little more than injections that are given under the skin, but less than those that are given into a vein.

If you are taking a blood thinner, the bleeding may take a little longer to stop and you may get more bruising on your upper arm.

The vaccine is also safe for people taking clopidogrel and other antiplatelet medications. You may experience a little more bruising around the injection site.

Will I be able to catch and pass on the virus if I’ve had the vaccine?

If you are unlucky enough to be infected after being vaccinated, you can still get COVID-19, but you are much less likely to be severely ill or need to go to hospital.

With only mild symptoms, it is likely that you have a lower risk of passing it on, but it is not eliminated completely.

So, even if you’ve been vaccinated, it’s really important to continue to be COVID-19 safe. This means continuing to:

• Practise good hygiene.
• Maintain physical distance.
• Wear a mask when needed.
• Stay home if you are sick and get tested.

How can I get tested if I have symptoms?

You can do your own test at home using a rapid antigen testing (RAT) kit.

Rapid antigen testing uses a nasal swab (a small cotton bud) that is placed in a chemical solution to detect signs that your immune system has been exposed to the coronavirus. It gives results in 15 to 20 minutes. Read more about rapid antigen testing.

You can also get a polymerase chain reaction (PCR, or RT-PCR) test, which is a laboratory test that looks for traces of the coronavirus.

PCR test locations depend on where you live, and include pop-up testing centres, GP offices, respiratory clinics, and drive-through testing sites.

Find a testing location near you.

I’ve caught COVID-19, what happens now?

Everyone is different, but most people with COVID-19 will experience mild illness and recover within a few days. Your recovery will depend on your age, general health and how severe your symptoms are.

For tips on what recovery means, when to seek medical help, and what to do when you’re better, see HealthDirect.

Can I get antiviral treatments?

People who are at high risk of severe COVID-19 illness are eligible for the oral antiviral treatments Lagevrio® (molnupiravir) and Paxlovid® (nirmatrelvir and ritonavir).

These are capsules or tablets that need to be taken as soon as possible after COVID-19 symptoms begin, to help stop the infection from becoming severe.

You may be eligible for antiviral treatments if test positive for COVID-19 and you are:

• 70 years of age or older, regardless of risk factors and with or without symptoms
• 50 years of age or older with 2 additional risk factors
• Aboriginal or Torres Strait Islander, 30 years of age or older and with 1 additional risk factors
• Moderately to severely immunocompromised.

Risk factors include living with stroke.

If you test positive, you should contact your doctor first to find out if you’re eligible and get a prescription.

Your doctor can send your prescription electronically to a pharmacist, so the medications can be either collected by a friend or family member or delivered to your home.

Find out more about oral antiviral treatments.

If I've had COVID-19, do I still need to get vaccinated?

Yes, it’s really important to get the vaccine, even if you’ve already had COVID-19. You may have some level of immunity if you’ve had the disease, but this varies and may not last long.

Do I have to pay for the vaccine?

The COVID-19 vaccine is free.

Which vaccine will I get?

The vaccine you get will depend on your age, your priority group and which vaccines are available in your area.

All vaccines made available through the Australian Government’s immunisation program are safe and effective.

How does the vaccine work?

Vaccines are a safe way of producing an immune response in the body without causing illness. They strengthen your immune system by training it to recognise and fight against specific germs (bacteria and viruses) that can cause serious illness.

Vaccines contain either killed or weakened versions of the virus that causes the disease, or a small part of it, such as a protein or nucleic acid. When you get a vaccine, your immune system recognises these as foreign. It responds by creating memory cells and antibodies that protect you against future infection.

Do I still need to have a flu vaccine?

Flu is caused by a different virus to the virus which causes COVID-19. It is important to have both vaccines if you are offered them.

Importantly, There must be a 14-day gap between having a COVID-19 vaccine and the flu vaccine.

Talk to your doctor or healthcare professional about the timing of the vaccinations.

How quickly does the vaccine work?

Protection from the virus starts after 12–14 days. This is because your immune system needs to generate a response, and people’s immune systems can vary.

Disclaimer

This information provided by the Stroke Foundation Clinical Council is general in nature. For individualised advice please talk to your doctor or health professional.

Latest information about the Australian Government’s coronavirus (COVID-19) vaccine program

National coronavirus and COVID-19 vaccine helpline 1800 020 080.

Latest on the COVID-19 health alert.

For information and advice on stroke prevention, treatment and recovery contact StrokeLine 1800 787 653.