Is it safe for my father to get the COVID vaccine while on Eliquis and Coumadin?

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A vaccine can be given even if you are taking Warfarin (Coumadin derivative) provided INR is lower than the upper limit of the therapeutic range, i.e., less than three in case of atrial fibrillation. A fine needle (23 or 25 gauge) should be used for the vaccination, followed by firm pressure applied to the injection site without rubbing for at least two minutes. The same applies to Eliquis, except there is no need for INR monitoring. There is a slight risk of hematoma formation inside the muscle.

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Anticoagulant is used to prevent stroke in atrial fibrillation and not to cure atrial fibrillation. Currently, there is no evidence that the COVID-19 vaccine triggers atrial fibrillation in those who do not have pre-existing atrial fibrillation or in those who have paroxysmal atrial fibrillation. Side effects of the vaccine include slight flu-like symptoms, fever, pain, and a generalized feeling of being unwell for a few days.

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If this could have caused atrial fibrillation, the vaccine must have come with a black box warning. COVID-19 vaccine and atrial fibrillation may be a coincidence. Yes, COVID-19 infection itself can cause atrial fibrillation as this is an inflammatory condition, but still, this is just an assumption and 100% theoretical. Atrial fibrillation itself is not life-threatening. Atrial fibrillation is an abnormal rhythm of the upper chamber of the heart called the atrium. This can cause a blood clot to form inside the heart, which can dislodge and lodge in arteries of the brain, blocking blood flow and causing a stroke. To prevent blood clot formation in the heart, blood thinners are used, such as Warfarin or Apixaban, Rivaroxaban, etc., and thus stroke risk is reduced. Regarding can atrial fibrillation be remedied, yes, it can only in the initial days or months of onset that too not in all cases. So, only heart rate is controlled to relieve symptoms, and anticoagulation is given to prevent stroke. Fibrillatory rhythm is left as such because, in many cases, it returns. In paroxysmal atrial fibrillation, a catheter ablation procedure is done to stop this rhythm in a limited number of cases. Any drug or vaccine is brought into the general population market only after many trials to ensure efficacy and safety. If during trials safety is not ensured, drug or vaccine is withdrawn. The same is the case with the COVID-19 vaccine. The vaccine is approved for the general population after phase1, phase2, and phase3 trials. Since how long your father has atrial fibrillation? Is he on rate control only, or rhythm is also controlled? Apart from anticoagulant, what other medicines he is taking for atrial fibrillation? An electrophysiologic study or ablation procedure is done or not?

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Flecainide is used to control the rhythm. So, he should be in sinus rhythm (the normal rhythm of the heart). He have an ECG to confirm. Flecainide is contraindicated in structural heart disease such as heart failure, enlarged left atrium or ventricle, heart attack history, heart blocks, etc. Take an echocardiography to look for the structure of the heart. Regarding interactions of COVID-19 vaccine with other drugs. Currently, there is no data on this as no such studies are done so far. The data of observed adverse reactions in participants of trials 16 years of age and older were pain at the injection site (> 80%), fatigue (> 60%), headache (> 50%), myalgia (> 30%), chills (> 30%), arthralgia (> 20%) and pyrexia (> 10%) and were usually mild or moderate in intensity and resolved within a few days after vaccination.