Q: I am 53 years old and have diabetes. I live in California and can get the COVID-19 vaccine right away. What side effects are you expecting? There are so many stories that it’s hard to know what to believe.
A: Yes, there is a lot of confusion about the coronavirus vaccine, and sadly there is misinformation. I’ve answered certain questions in a recent column. We are happy to share the big picture with you and other readers.
Currently, three vaccines are urgently licensed by the US Food and Drug Administration. They are manufactured by Pfizer, Moderna, and more recently Johnson & Johnson. Clinical trials have shown that all three vaccines are effective in preventing symptomatological COVID-19. The Pfizer and modelna vaccines need to be given twice, the second at least 3 weeks after the first vaccine. The exact interval depends on the vaccine you receive. You will be instructed when and how to take the second dose when you take the first dose. Johnson & Johnson’s is a single dose vaccine.
The potential side effects of coronavirus vaccines range from mild to severe. Anaphylaxis, a life-threatening allergic reaction, is attracting attention. However, this reaction to the vaccine is very rare. According to the latest figures from the US Centers for Disease Control and Prevention, which tracks a wide range of vaccine-related data, there are currently about 2.5 episodes of anaphylaxis for every 1 million doses of the COVID-19 vaccine.
The vaccine itself is delivered with a very fine needle. Many say they don’t even feel an injection. After receiving the vaccine, you will be directed to a designated location, wait 15 minutes as required by the CDC, and then leave the site. People at risk of an allergic reaction, as determined by the pre-vaccination questionnaire, are asked to wait at least 30 minutes. Each vaccination site requires the necessary medications, equipment, and trained healthcare professionals to address potential serious allergic reactions.
Some people have shown a stronger response to the second dose of the double dose vaccine.
The most common side effects of the vaccine are temporary pain and swelling at the injection site. This can be started anywhere from minutes to hours after the injection. Additional reactions include fever, chills, headache, muscle aches, nausea, and malaise. These occur because the vaccine delivers a fragment of the genetic code of the coronavirus that stimulates the immune system, recognizing it as a foreign invader and initiating a response. You can reduce the potential discomfort at the injection site by moving your arm and applying a cold, damp cloth to the injection site before vaccination.
Some people respond more strongly to a second dose of a double dose vaccine. In that case, over-the-counter medications such as aspirin, acetaminophen, and ibuprofen can help manage symptoms after vaccination. However, it is not yet known whether these drugs affect the effectiveness of the vaccine, so do not take these drugs in advance to prevent side effects. If your symptoms persist or worsen after a few days, be sure to consult your healthcare provider.
Other COVID Questions: One reader shared that she was using over-the-counter nasal disinfectants to reduce the chance of the coronavirus spreading if she became infected. “I read that killing bacteria in the nose can reduce the risk of bacterial infections such as MRSA and staphylococci,” she writes. “And some experts believe it can help fight COVID-19.”
Indeed, some patients use nasal sprays as a disinfectant to “eradicate” methicillin-resistant Staphylococcus aureus, also known as MRSA. However, these nasal sprays target bacteria, not viruses. This is an important difference because COVID-19 is caused by the virus and does not respond to antibacterial agents. We are not familiar with the data supporting this practice of COVID-19 and do not recommend it to patients.
• Readers who tested positive for COVID-19 in August asked about antibodies and immunity. “Do I need to be tested for antibody levels?” She wrote. “Should I be vaccinated? When will my immunity be weakened?” At this time, the antibody is thought to last about 90 days after COVID-19 infection. The only reason to take the test is curiosity, as the degree of immunity they give is not yet known. And yes, we recommend that everyone be vaccinated. This includes people who have tested positive for coronavirus in the past and are currently asymptomatic for COVID-19.
• One reader wondered if the anti-inflammatory drug she was taking for a type of arthritis known as pseudogout poses a problem with the vaccine. “Does it affect the efficacy of the COVID-19 vaccine?” She asked. “Is one vaccine maker better than another?” There are no data on reduced vaccine efficacy in individuals using either NSAIDs (nonsteroidal anti-inflammatory drugs) or steroids. When it comes to vaccines, they are equally effective. We strongly recommend that patients have access to the first one.
• We’ve heard from many readers asking if the vaccine is safe for people with disabilities such as multiple sclerosis and Parkinson’s disease. Both the Parkinson’s Foundation and the National Multiple Sclerosis Foundation have convened a panel of experts to study this question. Their conclusion is, yes, people with these illnesses should be vaccinated. It is important to note that these recommendations apply only to Pfizer and Moderna mRNA vaccines.
• Readers of type O blood associated with COVID-19’s reduced risk of serious illness wondered about the need for vaccines. “Do I need to be vaccinated because I have a low risk of getting COVID-19? If so, which one is best?” Yes, for patients with type O blood, the Moderna vaccine or Pfizer We recommend that you inoculate one of the available vaccines.
• Many wonder if both prescription and over-the-counter anticoagulants affect the effectiveness of coronavirus vaccines and vice versa. That is the question we are getting from our own patients. The current guidance is to continue with the prescribed anticoagulant and tell the person receiving the vaccine that they are using the anticoagulant.
• Dr. EveGlazier is a physician and associate professor at UCLA Health. Dr. Elizabeth Ko is a physician and associate professor at UCLA Health. Please send your question to [email protected]