After vaccination: Arm pain, yes. Headache, maybe.Regret, no

At her home office in Cranston, Rhode Island, 38-year-old Wilson lay her head on a desk with a constitutional emergency doctor she called “horse-like.” Fighting the waves of nausea, she made a loud, unwilling moan in the hallway room that her husband could hear.

“Are you okay, baby?” He called.

“I felt like I was hit,” Wilson recalled in an interview.

It’s not the way most vaccinated people feel later, but Wilson-like reactions were not uncommon in clinical trials of two COVID vaccines currently distributed nationwide. Pfizer, the company that makes what she receives, reported that about 13% of recipients between the ages of 18 and 55 had severe headaches after the first dose. Approximately 16% of people who received other Moderna vaccines in late-stage trials responded so strongly that they interfered with their daily lives.

With tens of millions of Americans waiting for their turn, many are anxious for more details on what to expect. As a result, at the request of friends, colleagues, and reporters, some people, such as Wilson, who was the pioneer of the largest vaccination program in US history, are beginning to offer personal accounts.

The New York Times interviewed dozens of newly vaccinated people in the next few days. Hospital officials in Iowa City, Iowa, said a wide range of reactions, from no response (“not shot”) to symptoms such as uncontrollable tremors and “brain fog.” A nursing assistant in Glendora, California, wondered if the fever he ran was a side effect of the vaccine or a sign that he had infected one of his COVID patients.

And there were various painful arms that were dazzling. Some people likened it to the pain of a flu shot. For others, it was pretty terrible.

Like almost every vaccinated person who spoke to the Times for this article, Wilson emphasized that she has no regrets about being shot, despite a headache that disappeared within 36 hours. .. The Food and Drug Administration has found that vaccines are safe and highly effective. And public health leaders say mass vaccination is the only hope to control the virus, which currently kills nearly 3,000 Americans a day.

However, there is an unavoidable element of suspense in these first weeks of vaccination.

Vaccine recipients will be given information on how to report side effects to the US Centers for Disease Control and Prevention via an app called V-Safe, along with a card that informs them when they need a second dose.

Both the Pfizer-BioNTech vaccine and the Moderna vaccine rely on genetic technology that has never produced a regulatory-approved vaccine. They are only allowed for emergency use. Their safety studies, including the cases of Alaskan health care workers and Boston physicians who experienced a severe allergic reaction after receiving the shot, are still underway.

And when Wilson crawls into bed at 10:30 on weekday mornings, she said she had to be “super-conscious”, saying, “I just got this new vaccine.”

Navigate the brain fog

As the vaccine progressed, experts agreed, the two being distributed now elicit almost more reactions.

At Sandale Nursing Home in Morgantown, West Virginia, Betty Shannon, 81, said some residents had stomach upset after becoming the first elderly person in the country to receive the COVID vaccine.

Lorenzo Alfonso, 34, a California nursing assistant, was unusually tired and in pain.

Delayna Frint, a nurse at Highlands Ranch, Colorado, said her arm hurt after the drip and she had to lower the stand to hang a treatment bag for the drip.

But for infectious disease professionals, a country of post-vaccination malaise will be the best news for a long time. Side effects disappear within a few days, and they are a signal that the vaccine is working, experts say.

“We call them” side effects, “but they’re really just effects,” said Dr. Paul Offit, a vaccinologist at the University of Pennsylvania, a member of the FDA’s Vaccine Advisory Board. It was. “This is what the immune response does when it reacts to an infection.”

Each vaccine works by urging the body to make certain proteins that the coronavirus uses to invade human cells. Neither exposes the recipient to the virus itself. The presence of the protein in the body begins the production of new antibodies that can destroy the protein. This is the key to providing protection against future intrusions of the actual virus. However, this process also releases substances that can cause inflammation, which can cause fever, malaise, headaches, and other symptoms.

Many of the participants in the vaccine trial showed discomfort after the second dose, 3-4 weeks after the first dose. By that time, experts say, the body is already ready to attack proteins.

Most of the reactions experienced by the 1.9 million Americans vaccinated this month have already been seen among the approximately 35,000 people vaccinated in Pfizer and Moderna clinical trials. But experts are hoping for something new. “In the case of one millionth, you need one million to see even one,” said Dr. Peter Doshi, an associate professor of pharmacy at the University of Maryland.

There are also mild allergic reactions, such as “whole body itching” and “mild little urticaria along the forearm” described in a video clip by Dr. Megan Hajjar of Farmington, Connecticut in a Facebook post. Or it can be more severe, as in the few cases of anaphylaxis that the CDC has already identified.

And others may be a more intense version of what the trial called “fatigue.” Alyson MacGregor, an associate professor of emergency medicine at Brown University and a seasoned home chef, said he spent the day after vaccination in a spiritual mist, turning the most basic dietary attempts into inedible masses. Said.

“I can’t believe I messed up ramen,” she told her husband that night.

She said she felt “there is a cloud above me and chasing me.”

Disclosure debate

The first million doses of both vaccines are assigned to healthcare professionals and nursing home residents who are at high risk of dying from COVID-19 if infected.

Public health leaders estimate that more than 200 million Americans need to be vaccinated to effectively prevent the spread of the virus. Polls show that a significant proportion are hesitant to receive COVID vaccination. And some front-line healthcare professionals are wrestling with whether discussing their side effects can discourage vaccinations of others.

“I’m worried — will it encourage someone to rethink?” Said Dr. Matthew Harris, 38, an emergency physician in Great Neck, New York.

After receiving the first shot, Harris had a fever all night and quivered under the blanket. He had joint pain in his wrists and shoulders and continued until the next day.

However, he had already posted a post on Facebook about receiving his shots. Nine months after being hospitalized for severe COVID, it was a particularly moving moment for him to not know if he could survive to see his wife and two young children again.

“Please,” a non-medical friend commented on his preventive contact post. “Tell me what your experience is like !!!”

So the next day he posted about his reaction with the hashtag #stillworthit.

“Everyone read,’This is the light at the end of the tunnel,'” Harris said in an interview. “But after this vaccination, do people have a 100% chance of feeling great? No. If we are not honest with them, how can we expect them to trust us?”

Dr. Sylvia Owusu-Ansah, a Pittsburgh emergency physician, also chose to record the side effects of the vaccine on Facebook. She’s an African-American, and in a live-streaming vaccination earlier this month, she told reporters, “I want to share it with my community that it’s okay.” Due to the history of black abuse by medical institutions, distrust of vaccines is especially high among black Americans.

Owusu-Ansah recorded “mild muscle pain and pain in the left arm” on day 1 and “stuffy nose, mild headache” on days 3-5 in the name of transparency. did.

Another dose

Forty-eight hours after Wilson’s post-vaccination headache sent her to bed, she returned to work in the hospital’s emergency room. Like many hospitals across the country, its intensive care unit was crowded with COVID cases. According to Wilson, in one of the recent shifts, there were 12 patients in the emergency room and only one bed was available in the ICU.

“These are people with strokes and myocardial infarctions that require catheterization,” she recalled. “You have to understand the reality.”

At that time, Wilson said it wasn’t a side effect of the vaccine that made her feel like she was about to throw it out.

She plans to get her second vaccination next month.

© 2020 The New York Times Company