Q: I am 53 years old and I have diabetes. I live in California and can get the COVID-19 vaccine soon. What side effects can I expect? There are so many stories floating around and knowing what to think is hard.
A: It is true that there is a lot of confusion and, unfortunately, misinformation about the coronavirus vaccine. We’ve answered specific questions in recent columns, and we’re happy to share the big picture with you and the rest of our readers.
At this time, three vaccines have received emergency authorization from the US Food and Drug Administration. They are manufactured by Pfizer, Moderna and, most recently, Johnson & Johnson. Clinical studies have found that all three vaccines are effective in preventing symptomatic COVID-19. Pfizer and Moderna vaccines require two doses, the second dose being given three or more weeks after the first. The exact range depends on the vaccine you receive; receive instructions on how and when to receive the second dose when you receive the first dose. Johnson & Johnson’s is a single dose vaccine.
The potential 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 track a wide range of vaccine data, we currently see approximately 2.5 episodes of anaphylaxis for every million doses of COVID-19 vaccine given.
The vaccine itself is administered through a very thin needle. Many people say they don’t even feel the injection. Once you have received the vaccine, you will be directed to a designated area to wait during the 15-minute period required by the CDC before leaving the site. People at risk of an allergic reaction, which is determined by a pre-vaccination questionnaire, are asked to wait at least 30 minutes. Each vaccination site should have at hand the medicines, equipment and trained medical staff needed to address potential serious allergic reactions.
Some people have a stronger response to the second blow 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 occur because the vaccine provides a fragment of the coronavirus’s genetic code to stimulate the immune system to recognize it as a foreign invader and respond. You can reduce the potential discomfort at the injection site by exercising your arm before receiving the vaccine and applying a cold, damp cloth to the injection site.
Some people have a stronger response to the second blow of two-dose vaccines. In this case, over-the-counter medications, such as aspirin, acetaminophen, or ibuprofen, can help manage post-vaccination symptoms. But do not take these medicines ahead of time to prevent side effects, as it is not yet known if they affect the effectiveness of the vaccine. If the 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 he uses a prescription antiseptic over the counter, so he will be less likely to spread the coronavirus if he is infected. “I read that killing germs in your nose can reduce your risk of bacterial infections, such as MRSA and staph,” she wrote. “And some experts believe it can help combat COVID-19.”
It is true that some patients use an antiseptic nasal spray to “decolonize” the methicillin-resistant Staphylococcus aureus bacterium, also known as MRSA. However, these nasal sprays target bacteria and not viruses. It is a crucial distinction because COVID-19 is caused by a virus and does not respond to antibacterials. We are not familiar with the data supporting this practice for COVID-19 and would not recommend it to our patients.
• A reader 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 get the vaccine? When will my immunity come out?” At this time, the antibodies are thought to persist for approximately 90 days after COVID-19 infection. The degree of immunity it confers is not yet known, so the only reason to get the test would be out of curiosity. And, yes, we recommend that everyone get the vaccine. This includes those who have tested positive for coronavirus in the past and currently have no COVID-19 symptoms.
• One reader wondered if the anti-inflammatory he was taking for a type of arthritis known as pseudogout had a vaccine problem. “Does it affect the effectiveness of COVID-19?” she asked. “Is one vaccine maker better than another?” We are not aware of data on the low effectiveness of the vaccine in people who use NSAIDs (non-steroidal anti-inflammatory drugs) or steroids. As for vaccines, they are just as effective. We strongly recommend our patients to receive the first available for them.
• I have heard from a number of readers who have asked 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 have convened expert groups to investigate this question. Their conclusion is 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, who was associated with a lower risk of serious disease with COVID-19, wondered about her need for a vaccine. “Do I have to get the vaccine because I have a low risk of taking COVID-19? If so, which is best for me to take?” Yes, we recommend that our patients with type O blood be vaccinated with either the Moderna vaccine or the Pfizer vaccine, whichever is available.
• Many of you are wondering if blood thinners, both prescription and over-the-counter, affect the effectiveness of the coronavirus vaccine and vice versa. It is a question we receive from our patients. The guide at this time is to continue with the blood thinners as prescribed and tell 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].