In POTS, response to position changes is exaggerated

Dear Dr. Roach: I have postural orthostatic tachycardia syndrome. Is it safe to get the COVID-19 vaccine? — K.K.

Dear K.K.: The body goes through a complex set of changes to adapt to an upright posture. The heart and blood vessels must react quickly in order to keep the blood supply to the brain constant. For most people, the systems work well, and we can change positions frequently and quickly without symptoms. However, most people have had the experience of getting a lightheaded when they rise too quickly.

One of the ways the body adapts is to increase the heart rate. This reflex normally is not pronounced. In people with POTS, the increase is exaggerated. This may lead to symptoms of palpitations and anxiety. Other people with this condition will have more severe lightheadedness, weakness, vision changes and fatigue upon standing.

I get multiple questions from people wanting to know if it is safe to get the COVID19 vaccine with their individual medical condition. The vaccine is incredibly safe, and there are very few people who cannot get it. In the case of POTS, the risks are negligible, and POTS is not a reason to deny yourself.

The benefit of the vaccine outweighs the risks in most cases, but only that person’s medical provider can properly weigh those risks and benefits alongside a knowledge of the person’s medical condition. Given the enormous burden of COVID-19 throughout the country and the world, the terrible loss of life, and the serious and often underappreciated long-term complications among survivors, a person is almost always far better off taking the vaccine.

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