Flu, COVID and RSV Vaccines With Congenital Heart Disease | Healos™
Flu, COVID and RSV Season With Congenital Heart Disease: Your Vaccine Checklist
Every fall, the same message goes out: get your flu shot. For adults with congenital heart disease, it's not a generic reminder. A respiratory infection asks a lot of any heart, and a congenital heart that's already working differently often has less reserve to spare.
Here is the short answer. Adults with congenital heart disease are a priority group for fall vaccines. Respiratory infections raise heart strain through fever, faster breathing, dehydration and lower oxygen, and people with more complex physiology tend to have more severe illness. Ask about the flu shot, an updated COVID-19 vaccine, RSV and pneumococcal vaccines, and agree a sick-day plan with your ACHD team.
Infection also stokes the same biology that congenital hearts share with heart attack survivors, inflammation and oxidative stress (see one inflammation, three hearts), which is one more reason prevention is worth the pharmacy visit.
简短的答案： 每年秋天都会听到同一句话：去打流感疫苗。对先心病成人来说，这不是一句普通提醒：呼吸道感染对任何心脏都是考验，而本就以不同方式工作的先天性心脏，往往储备更少。
先心病成人是秋季疫苗的优先人群；呼吸道感染通过发热、呼吸加快、脱水和血氧下降加重心脏负担，生理状况越复杂病情往往越重。请询问流感、更新版新冠、RSV 和肺炎球菌疫苗，并与 ACHD 团队约定生病日计划。
感染也会激起先天性心脏与心梗幸存者共有的炎症和氧化应激，这又多了一个去药房的理由。
Why respiratory infections hit congenital hearts harder
An infection changes the body's demands quickly. Fever raises heart rate and oxygen needs. Faster breathing and poor appetite can lead to dehydration. Lung inflammation can lower oxygen levels. For most people these changes are uncomfortable; for a heart with limited reserve they can be destabilising.
Some groups are more vulnerable than others. In an international study of adults with congenital heart disease who had COVID-19, overall mortality was low, but worse physiological stage, cyanosis and pulmonary hypertension were linked to more severe outcomes (Broberg et al., JACC, 2021). In other words, it isn't only the original diagnosis that matters, but how your heart and lungs are working now.
Infections can also trigger arrhythmias and, in people with a Fontan circulation, upset the delicate balance of fluid and pressure. And in coronary research, heart attack risk rose about six times in the week after confirmed influenza (Kwong et al., NEJM, 2018), a reminder of how directly infection and inflammation affect the cardiovascular system.
为什么呼吸道感染对先天性心脏打击更大： 感染会迅速改变身体的需求：发热提高心率和需氧量，呼吸加快和食欲差可能导致脱水，肺部炎症可能降低血氧。对多数人这只是难受，对储备有限的心脏则可能失衡。
部分人群更脆弱：一项国际研究中，感染新冠的先心病成人总体死亡率低，但生理分期较差、发绀和肺动脉高压与更严重结局相关（JACC 2021）——也就是说，重要的不只是原诊断，还有心肺目前的工作状态。
感染还可能诱发心律失常，并打乱 Fontan 循环中脆弱的液体与压力平衡。冠心病研究中，确诊流感后一周心梗风险约高六倍（NEJM 2018），提醒我们感染和炎症对心血管系统的影响有多直接。
Your fall vaccine checklist
Bring this list to your pharmacist or family doctor. Eligibility varies by age, province and health status, so ask what applies to you:
Influenza vaccine, every fall. Canada's National Advisory Committee on Immunization identifies people with cardiac conditions as a priority group. October or early November is ideal.
Updated COVID-19 vaccine, as recommended for your age and risk group.
RSV vaccine. Now available for older adults and recommended for some higher-risk groups; ask whether your heart condition makes you eligible.
Pneumococcal vaccine, which protects against a common cause of pneumonia and is recommended for many adults with chronic heart disease.
Planning a pregnancy or pregnant? Flu, COVID-19 and maternal RSV vaccination are part of prenatal care; discuss timing with your ACHD and obstetric teams.
Vaccines are safe for people on anticoagulants; press firmly on the injection site for a few minutes to limit bruising. Getting more than one vaccine at the same visit is often possible. Ask your pharmacist.
你的秋季疫苗清单： 把这份清单带给药剂师或家庭医生，资格因年龄、省份和健康状况而异，请询问适用于你的项目：
流感疫苗——每年秋天，加拿大 NACI 将心脏病患者列为优先人群，10 月或 11 月初最理想；
更新版新冠疫苗——按你的年龄和风险组建议；
RSV 疫苗——现已面向老年人并推荐给部分高风险人群，询问你的心脏状况是否符合资格；
肺炎球菌疫苗——预防肺炎的常见病因，推荐给许多慢性心脏病成人；
备孕或怀孕——流感、新冠和孕期 RSV 疫苗是产前保健的一部分，与 ACHD 和产科团队讨论时机。
服用抗凝药也可以接种，注射部位按压几分钟可减少瘀青；同一次就诊接种多种疫苗通常可行，可问药剂师。
Your sick-day plan: fluids, fever and when to call
Vaccines lower risk; they don't remove it. Agree a simple sick-day plan with your ACHD team before you get sick:
Fluids: how much to drink when you have a fever, especially if you have a fluid limit or a Fontan circulation, where both too little and too much can be a problem.
Medications: which ones, such as diuretics, to adjust if you can't eat or drink, and what to do about anticoagulants if you're vomiting.
Oxygen: if you have a home pulse oximeter, what reading should prompt a call.
Fever: which fever reducers are safe for you.
When to call the clinic and when to go to emergency: breathlessness that's worse than usual, chest pain, fainting, a racing or irregular heartbeat, bluer lips or fingers, confusion or being unable to keep fluids down. Call 911 if symptoms are severe.
生病日计划：液体、发热与何时求助： 疫苗降低风险，但不能消除风险。请在生病之前与 ACHD 团队约定一份简单的生病日计划：
液体——发热时喝多少，尤其有液体限制或 Fontan 循环者，太少太多都可能出问题；
药物——吃不下喝不下时哪些药（如利尿剂）要调整，呕吐时抗凝药怎么办；
血氧——如果家里有指夹血氧仪，读数低到多少要打电话；
发热——哪些退烧药对你安全；
何时打电话给门诊、何时去急诊——比平时更严重的气短、胸痛、晕厥、心跳快或不规则、嘴唇手指更发紫、意识混乱或无法保住液体；症状严重请拨打 911。
ACHD special considerations
Many adults with a Fontan circulation or heart failure have a fluid limit, which matters more than ever during an infection. Many take anticoagulants, and illness can affect INR, so ask whether you need an extra check. Endocarditis can mimic flu with fever and fatigue; if a fever persists or you feel unusually unwell, tell your team rather than assuming it's a virus. Cyanosis and pulmonary hypertension raise the stakes of any lung infection. Your ACHD team's guidance overrides any general advice, including ours.
ACHD 特别注意： 很多 Fontan 循环或心衰患者需要限制液体，感染期间这一点比任何时候都重要；很多人服用抗凝药，生病可能影响 INR，可询问是否需要加测；心内膜炎可能以发热和疲劳表现、与流感相似，如果发热持续或感觉异常不适，请告诉团队，不要认定只是病毒感染；发绀和肺动脉高压会让任何肺部感染的风险更高。你的 ACHD 团队的指导高于任何通用建议，包括我们的。
How Healos™ supports adults with congenital heart disease
Healos™ nutrition plans don't prevent or treat infections and never replace vaccination. What they offer is steady support for the shared root through the season when hearts are under the most pressure. The 91-Day Protocol moves through Clear, Replenish and Repair, providing complementary cellular nutrition and lifestyle support, with check-ins at days 30, 60 and 91. Sovereign Monthly · Protect continues that support month to month and can be cancelled any time.
Healos™ 如何支持先心病成人： Healos™ 营养方案不预防或治疗感染，也绝不替代疫苗；它在心脏压力最大的季节，为共同根源提供稳定的支持。91 天方案依次经过减负、补给、修复，提供辅助的细胞级营养与生活方式支持，并在第 30、60、91 天评估；Sovereign Monthly · Protect 按月延续支持，可随时取消。
The bottom line
For a congenital heart, fall vaccines are part of heart care. Ask about flu, COVID-19, RSV and pneumococcal vaccines this month, plan for pregnancy if it applies, and agree a sick-day plan with your ACHD team before you need it. Ten minutes at the pharmacy can protect a whole winter.
结论： 对先天性心脏来说，秋季疫苗是心脏照护的一部分。这个月就询问流感、新冠、RSV 和肺炎球菌疫苗，涉及妊娠时提前规划，并在需要之前与 ACHD 团队约定生病日计划。在药房的十分钟，可以守护整个冬天。
Frequently asked questions
Should adults with congenital heart disease get the flu shot? Yes, for most people. Canada's National Advisory Committee on Immunization identifies people with cardiac conditions as a priority group for influenza vaccination, ideally in October or early November.
Is COVID-19 more dangerous with congenital heart disease? Overall risk of death was low in an international ACHD study, but worse physiological stage, cyanosis and pulmonary hypertension were linked to more severe illness, so staying up to date with recommended COVID-19 vaccines matters.
Can I get the RSV vaccine if I have a heart condition? RSV vaccines are available for older adults and recommended for some higher-risk groups. Eligibility for younger adults with heart conditions varies by province, so ask your pharmacist or doctor.
Are vaccines safe if I take blood thinners? Yes. People on anticoagulants can be vaccinated; pressing firmly on the injection site for a few minutes reduces bruising.
What should I do if I get the flu with a Fontan circulation? Follow the sick-day plan agreed with your ACHD team for fluids, medications and fever, and call promptly for worsening breathlessness, fainting, palpitations, bluer lips or being unable to keep fluids down.
常见问题：
先心病成人要打流感疫苗吗？多数人应该打，NACI 将心脏病患者列为优先人群，10 月或 11 月初最好。
新冠对先心病更危险吗？国际研究中总体死亡率低，但生理分期差、发绀和肺高压者更重，应按建议接种。
有心脏病能打 RSV 疫苗吗？面向老年人并推荐给部分高风险人群，年轻成人资格因省而异，请问药剂师。
吃抗凝药能打吗？可以，按压注射部位几分钟。
Fontan 患者得流感怎么办？按与 ACHD 团队约定的生病日计划处理液体、药物和发热，气短加重、晕厥、心悸、发紫或无法保住液体请及时联系。
References
Broberg CS, et al. COVID-19 in adults with congenital heart disease. Journal of the American College of Cardiology. 2021;77(13):1644–1655.
Kwong JC, et al. Acute myocardial infarction after laboratory-confirmed influenza infection. New England Journal of Medicine. 2018;378:345–353.
Fröbert O, et al. Influenza vaccination after myocardial infarction (IAMI). Circulation. 2021;144(18):1476–1484.
National Advisory Committee on Immunization (NACI). Statement on Seasonal Influenza Vaccine; RSV and pneumococcal vaccine statements (current). Public Health Agency of Canada.
