Are Heart Valve Patients in “Phase 1c” for COVID-19 Vaccination?

Since posting our “Doctor Q&A” about the safety of COVID-19 vaccines for heart valve surgery patients, we received several important questions about whether-or-not heart valve patients are in “Phase 1c” of the COVID-19 vaccination roll-out.

As you may already know… The Centers for Disease Control and Prevention (CDC) has made the following recommendations for vaccine allocation distribution (although the specific timeline for each phase will vary upon each states eligibility guidelines and community needs):

• Phase 1a – Healthcare workers and long-term care facility residents
• Phase 1b – Frontline essential workers and people over the age of 75
• Phase 1c – People ages 65-74 and people ages 16-64 with high risk medical conditions
• Phase 2 – People 16 years and older

As I reviewed the CDC recommendations and other materials across the web, I looked to see if heart valve disease qualified as a a specific “high-risk” condition for Phase 1c.  If so, heart valve patients would be considered high risk and therefore be considered part of Phase 1c.  Unfortunately, I struggled to find a specific high risk definition that included or excluded heart valve disease specific to Phase 1c.

What Do Experts Think About COVID-19 Vaccination “Phase 1c” for Heart Valve Patients?

To learn more, I contacted several heart valve experts to see what they thought… Are pre- and post-operative heart valve patients considered part of the “Phase 1c” guidelines for COVID-19 immunization.

Dr. Marc Gerdisch

In response to this important question, Dr. Marc Gerdisch, Chief of Cardiac Surgery at Franciscan Health in Indianapolis, Indiana, stated, “It’s hard to make a blanket statement about risk for people with a history of valve disease. But, I would say that, in general, heart valve patients are at increased risk and would often fall into the category of Phase 1c (less than 65 years old but with increased risk). COVID-19 is associated with a prothrombotic state that could have real consequence for anyone with a prosthetic valve, either mechanical or bioprosthetic.”

Dr. Joanna Chikwe

Dr. Joanna Chikwe, Chair of Cardiac Surgery at Cedars-Sinai Medical Center in Los Angeles, California, shared with me, “Pre-op and some post-op cardiac surgery patients could be considered part of phase 1c.  Patients aged 65-75 years are included in phase 1c (patients >75 were included in phase 1b).  As of January 19, 2021, the CDC also includes patients aged 16-65 years with “medical conditions that increase the risk for severe COVID-19” as provided for in its “Evidence Table for COVID-19 Vaccines Allocation in Phases 1b and 1c of the Vaccination Program”.

Dr. Chikwe then addressed the cardiac conditions that are at increased risk for COVID-19. Dr. Chikwe shared, “As of January 19, 2021, the cardiovascular conditions listed by the CDC as being associated with increased risk of severe illness from COVID-19 at any age are (and some of which may be present after surgery in some patients):

• Heart failure
• Coronary artery disease
• Cardiomyopathies
• Pulmonary hypertension
• Having other cardiovascular or cerebrovascular disease, such as hypertension (high blood pressure) or stroke, might increase your risk of severe illness from COVID-19.

Dr. Ram Dandillaya

Dr. Ram Dandillaya, Clinical Chief, Division of Cardiology, at Cedars-Sinai Medical Center, shared with me, “From a review of the CDC website, I think Phase 1c would include heart valve patients.”

As the clinician statements above suggest that pre- and post-operative heart valve patients could be considered part of Phase 1c, we will continue to monitor this topic as the COVID-19 vaccinations roll out.

Currently, we are seeing several states (Ohio, Delaware, Pennsylvania) just beginning the roll-out of Phase 1b COVID-19 immunizations – which has a focus of persons 65 and up.

That said, it could be a little while before Phase 1c has an opportunity to get vaccinated from the novel coronavirus.

Keep Learning About COVID-19 & Heart Valve Disease

• Doctor Q&A: COVID-19 Vaccine Safety for Heart Valve Patients
• New Free eBook!  Advances in COVID-19 & Heart Valve Therapy!
• Video: Is Heart Surgery an “Elective” Procedure During COVID-19 Crisis?
• In Difficult Times… John & Larry Inspire Us
• TeleHealth & Cardiac Care During COVID-19
• A Safe “New Normal” for Cardiac Surgery Appointments
• Patient Alert! Is Heart Valve Surgery Safe During COVID?
• Doctor Q&A: What Should You Know About the COVID-19 Blood Shortage?