COVID-19 Vaccine

If you are like us, you are thrilled the COVID-19 vaccine is here, but you are also a little (or a lot) frustrated that more people do not have access to the vaccine yet.  You are happy that front-line health care workers and those in nursing homes are receiving the vaccine, but you are concerned about a loved one who also needs the vaccine and cannot yet get it.   You are hopeful that this vaccine will put an end to the COVID-19 pandemic, but you are aware that it will be many, many months before that dream may become a reality.   Though the COVID-19 vaccine has every indication to be the blessing we have been looking for, we acknowledge that there are still many questions and concerns, which we will do our best to answer below.

How does the vaccine work?

If you have not watched it yet, Dr. Mirrop created a great video on this exact topic.  Watch it here:  Dr. Mirrop discusses the COVID vaccine.  As always, his explanation is thorough and easily understandable. Our favorite key take home messages are that the vaccine is safe, and that it cannot give a person COVID-19.   This is great news for 2021! 

This vaccine was created very quickly!  Should I be worried about its safety?

“The COVID vaccine is safe. Pfizer’s vaccine was the first to be authorized for emergency use by the FDA it was tested on 44,000 people... and, Moderna’s vaccine, which is also authorized for emergency use, was tested on 30,000 people.”  These vaccines are 94-95% effective at preventing COVID-19 illness, including serious disease.  For many years scientists have been working on vaccines for other related SARS viruses, so they have been able to quickly adapt ongoing research to focus on the COVID vaccine during this crisis, enabling a more rapid turnaround for this vaccine in particular. The Centers for Disease Control and Prevention said it had administered 20,537,990 doses of COVID-19 vaccines in the country as of January 23, 2021. The vaccine has been very well tolerated and the side effects reported have been mostly some fever and body aches that resolved within 1 to 2 days.

Who can get it?

As of this post date, the vaccine is being offered for the following risk groups: 

1. Phase 1A - Front-line health care workers AND residents of long-term care facilities
2. Phase 1B - Individuals at risk of more severe disease due to age, chronic illness, or both, and includes: those 65+ AND 16+ with a chronic medical condition (such as asthma, cancer, chronic kidney disease, chronic obstructive pulmonary disease, heart conditions including heart failure, coronary artery disease or cardiomyopathies, solid organ transplantation, obesity, pregnancy, sickle cell disease, and diabetes mellitus).

“The Pfizer/BioNTech vaccine is authorized for patients ≥16 years and the Moderna vaccine for ≥18 years.”

So, what about those who do not fit in these categories?

1. Children <16 years: Because the vaccine has not yet been rigorously studied in this age group, it is likely that children may not be eligible for the vaccine for many months or even a year.  The American Academy of Pediatrics supports prompt efforts to begin including children in clinical vaccine trials, and these are in early stages as of this post. Although we are eager for children to have prompt vaccine coverage, it is overall reassuring that from what we have seen thus far, children seem to contract the virus less often than adults, experience milder symptoms, and may be less likely to transmit the virus than adults.
2. Children > 16 without a chronic illness: Texas Department of State Health Services says, “The best estimate of when vaccines will become available to the general public is springtime. But that could change. The state’s Expert Vaccine Allocation Panel (EVAP) is considering what criteria should be used for later stages of vaccine distribution.”  “This webpage will be updated when those decisions are completed: COVID-19 Vaccine Information”
3. Adults <65 without a chronic illness: Texas Department of State Health Services says, “The best estimate of when vaccines will become available to the general public is springtime. But that could change.” “This webpage will be updated when those decisions are completed: COVID-19 Vaccine Information”
4. Pregnant and breastfeeding mothers: “Although pregnant and breastfeeding women were not enrolled in the Covid-19 vaccine trials and as a result there are limited data about safety, the CDC advises that pregnant and lactating women should be offered the vaccine and may choose to be vaccinated. This view is shared by the American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine. There is no theoretical reason why mRNA vaccines would be harmful to the mother during pregnancy, to a developing fetus, or to a breastfeeding infant. Also reassuring is that gestating rats receiving the Moderna vaccine did not demonstrate any safety concerns related to fetal or embryonal development.” We recommend discussing with your OB/GYN whether or not the vaccine is right for you.

What if I’ve already had COVID-19 illness; when I qualify, should I get the vaccine?

“Since re-infection after recovery from Covid-19 is rare in the first 90 days, some people may wish to defer immunization for this long — however, if they wish to be immunized sooner, there is no contraindication. Patients who were treated with monoclonal antibodies or convalescent plasma should wait this long, however. These treatments might inactivate the vaccines, making them less effective. Deferral of immunization for 90 days after treatment with monoclonal antibodies or convalescent plasma is recommended.”

How do we sign up to receive the COVID-19 vaccine?

Unfortunately, due to many logistical considerations including vaccine availability and the extreme temperatures required to store certain vaccine brands, it is unlikely that we will be able to offer this vaccine at PAA. Currently the only sites offering vaccine pre-registration for the COVID-19 vaccine are for individuals in the Phase 1A and 1B groups listed above.

1. For individuals in the Phase 1A and 1B groups you can go online to pre-register for the vaccine at: COVID-19 Vaccines Pre-Registration . You can also call vaccine providers listed on this Texas DHSH website to check vaccine availability:

https://tdem.maps.arcgis.com/apps/webappviewer/index.html?id=3700a84845c5470cb0dc3ddace5c376b

2. For those in all other groups, our best advice is to check this site often for updates: COVID-19 Vaccine Information
3. As we become aware of vaccine locations and opportunities, we will share this information in a newsletter and on social media. We too are ready for all members of the population to receive the vaccine!

What are the vaccine side effects?

Per the information available online from the vaccine manufactures, the most common reported side effects are very short lived and include muscle soreness and/or swelling at the vaccine site, low-grade fever, chills, fatigue, and headache.  These side effects are small in comparison to the potential symptoms associated with contracting COVID-19 and show that the immune system is hard at work creating antibodies to the virus.  Our office staffs’ personal experiences have been similar to those reported above and side effects did not appear to vary dramatically between the Pfizer and Moderna groups.  We are thankful to report that almost our entire patient-care staff has received both doses of the COVID-19 vaccine!

What about taking pain medication such as Tylenol (acetaminophen) or Advil (Ibuprofen) for side effects?

It is not advised to take these medications before getting the vaccine to preemptively help with anticipated side effects; “theoretically they could also blunt immune response and make the

vaccines less effective… They are useful, however, in diminishing side effects once they occur. Acetaminophen is preferred for pregnant women.”  In general, medical experts support these medications on an as-needed basis for side effects after the vaccine has been administered.

How many doses and how long until it works?

To receive full protection against COVID-19, 2 doses are required for the currently available vaccines.  The Pfizer doses are spaced about 21 days apart and the Moderna doses are spaced 28 days apart.  The second dose can be given later than these intervals, but no earlier.  Both doses must be by the same manufacturer and “it could take your body a few weeks to build up immunity after the second dose of a vaccine.”  We anticipate that this vaccine may be needed yearly, like a flu shot, to offer future protection.  Other vaccine manufacturers are working on vaccines that may be effective with just one dose, but these are still in various stages of clinical trials and not yet approved for emergency use by the FDA.

Once we have the vaccine, life can go back to normal, right?

Unfortunately, not yet.  “While the Pfizer and Moderna vaccines are effective at preventing symptoms of COVID-19, it’s not yet clear whether someone who’s been vaccinated can still catch the virus and transmit it to others. The vaccine is just one tool that can help slow the spread of the coronavirus.  The CDC says it could take months for the population to build up immunity and continues to recommend preventive measures such as face masks and social distancing.” Though the vaccine can and will help, “we can’t really breathe a collective sigh of relief until 70 to 80% of the population has an immunity” by receiving the vaccine. “That means that everyone who can, should take the vaccine…that includes people who have already had COVID.” 

Although we are not at the finish line yet, we are making great strides along the way, and the end is in sight (even if it’s just a glimpse).  Let’s go forward into 2021 with patience and hope.  The vaccine roll out processes are seemingly cumbersome and slower than we would like, but we look to a better future for ourselves, our families, and our community, as the pandemic gradually moves closer to and end.  Please understand that we are working tirelessly to give your children the best care possible while maintaining a safe environment during these challenging times.  Thank you for your patience and kindness as we continue to navigate a “new normal.”  We are here for you, and we are going to get through this together!

 If you still have questions about the COVID-19 vaccine, The New England Journal of Medicine extensively addresses many more questions here: Covid-19 Vaccine —Frequently Asked Questions.   

 References:

https://states.aarp.org/texas/covid-19-vaccine-distribution

https://www.dshs.state.tx.us/coronavirus/immunize/vaccine.aspx

http://www.austintexas.gov/covid19-vaccines

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html

https://www.happiestbaby.com/blogs/parents/covid-vaccine

https://www.nejm.org/covid-vaccine/faq