Q: I am 53 years old and I have diabetes. I live in California and I can get the COVID-19 vaccine soon. What side effects can I expect? There are so many stories floating around, and knowing what to believe is hard.
A: It is true that there is a lot of confusion and, unfortunately, misinformation about the coronavirus vaccine. We’ve been answering specific questions in the last few columns and we’re happy to share the overview with you and the rest of our readers.
At this time, three vaccines have received emergency authorization from the U.S. Food and Drug Administration. They are manufactured by Pfizer, Modern and, more recently, Johnson & Johnson. Clinical trials found that all three vaccines were effective in preventing symptomatic COVID-19. Pfizer and Moderna vaccines require two doses, with the second dose administered three or more weeks after the first. The exact interval depends on the vaccine you receive; get instructions on how and when to get your second dose at the time of receiving the first dose. Johnson & Johnson’s is a single dose vaccine.
Possible side effects of the coronavirus vaccine can range from mild to severe. Anaphylaxis, which is a life-threatening allergic reaction, has received a lot of attention. However, this response to the vaccine is extremely rare. According to the latest figures from the Centers for Disease Control and Prevention, which monitor a wide range of vaccine-related data, we are currently seeing about 2.5 episodes of anaphylaxis for every million doses of COVID-19 vaccine. administered.
The vaccine itself is made using a very fine needle. A lot of people say they don’t even feel the injection. After receiving the vaccine, you will be directed to a designated area to wait for the 15-minute period required by CDC before you leave the site. People at risk for an allergic reaction, which is determined by a pre-vaccination questionnaire, are asked to wait at least 30 minutes. Each vaccine site should have on hand the medication, equipment, and trained medical personnel needed to address possible serious allergic reactions.
Some people have a stronger response to the second shot of two-dose vaccines.
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The most common side effect of the vaccine is temporary pain and swelling at the injection site. This can start from a few minutes to a few hours after the injection. Additional reactions may include fever, chills, headache, muscle aches, nausea, and fatigue. These arise because the vaccine provides a fragment of the coronavirus genetic code to stimulate the immune system to recognize it as a foreign invader and respond. You can reduce potential discomfort at the injection site by exercising your arm before getting the vaccine and applying a damp, cool cloth to the injection site.
Some people have a stronger response to the second shot of two-dose vaccines. If this is the case, over-the-counter medications, such as aspirin, acetaminophen, or ibuprofen, can help control post-vaccination symptoms. But do not take these medications in advance to prevent side effects, as it is not yet known if they affect the effectiveness of the vaccine. If symptoms do not go away after a few days or if they get worse, be sure to consult your doctor.
More COVID questions:
One reader said she uses an over-the-counter nasal antiseptic so she will be less likely to get the coronavirus if she becomes infected. “I read that killing germs in the nose can reduce the risk of bacterial infections such as MRSA and staph,” he wrote. “And some experts believe it may help combat COVID-19.”
It is true that some patients use an antiseptic nasal spray to “decolonize” the methicillin-resistant bacterium Staphylococcus aureus, also known as MRSA. However, these nasal sprays are aimed at bacteria and not viruses. It is a crucial distinction, as COVID-19 is caused by a virus and does not respond to antibacterials. We do not know the data that support this practice for COVID-19 and we would not recommend it to our patients.
• A reader who tested positive for COVID-19 in August asked about antibodies and immunity. “Do I have to test my antibody levels?” she wrote. “Should I get the vaccine? When will my immunity be depleted?” At this time, antibodies are thought to persist for about 90 days after COVID-19 infection. The degree of immunity they confer is not yet known, so the only reason to get the test would be out of curiosity. And, yes, we recommend that everyone get vaccinated. This includes those who have tested positive for coronavirus in the past and currently have no symptoms of COVID-19.
• One reader wondered if the anti-inflammatory he is taking for a type of arthritis known as pseudogout has a vaccine-related problem. “Does it affect the effectiveness of the COVID-19 vaccine?” she asked. “Is one vaccine maker better than another?” We do not know any data on the decreased efficacy of the vaccine in people using NSAIDs (nonsteroidal anti-inflammatory drugs) or steroids. As for vaccines, they are equally effective. It is recommended that our patients have the first one available.
• We have heard several readers ask if the vaccine is safe for people with disorders such as multiple sclerosis and Parkinson’s disease. Both the Parkinson’s Foundation and the National MS Foundation convened expert panels to investigate this issue. His conclusions are that, yes, people with these diseases should be vaccinated. It is important to note that these recommendations only apply to Pfizer and Moderna mRNA vaccines.
• A reader with type O blood, related to a lower risk of serious illness with COVID-19, was asked about her need for a vaccine. “Do I need to get the vaccine because I have a low risk of getting COVID-19? If so, which is best for me?” Yes, we recommend that our patients with type O blood be vaccinated with the Moderna or Pfizer vaccine, whichever is available.
• Many of you are wondering if prescription and over-the-counter anticoagulants affect the effectiveness of the coronavirus vaccine and vice versa. It is a question we receive from our own patients. At this point, the guidance is to continue with the anticoagulants as prescribed and inform the person administering the vaccine that you are using them.
• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to [email protected].