Getting the Covid-19 Vaccine: a firsthand account by Dr. Victoria
Vaccination Selfie!
“Prevention is better than cure”
- Ancient Proverb
Covid-19 has devastated families across the world and in the United States. As of January 20th, 2021 we have had 24,135,690 documented cases and over 400,000 deaths (CDC, 2021).
On January 7th, 2021 I got the first dose of the Moderna Covid-19 Vaccine. Here is my experience.
First, I had to figure out if I was eligible to get the vaccine. As a healthcare worker in Washington state, I qualified for Phase 1A Tier 2. This meant that I was currently eligible. I was excited to learn this, as I believe prevention is better than cure, and vaccinations are an excellent way to work, as a community, to reduce the spread of disease.
Finding out where I could get the vaccine was a bit more difficult. Large hospitals have been pretty good at getting their workers vaccinated, but since they are also the ones on the front lines treating patients with the most severe cases of Covid-19 they lack the extra resources to communicate to those outside their systems. I found out via word of mouth from a friend working a larger clinic.
Thankfully, the state has taken steps to address this issue, and now has the resource FindYourPhaseWA.org. This easy-to-use tool not only screens you to determine your phase eligibility; it also provides information on where to get the vaccine, and offers to contact you once your phase becomes eligible.
I next emailed my vaccine provider. They got back to me within a few hours and confirmed our clinic’s eligibility. From there I got on the phone, and after some wait time got through to a lovely scheduler. Since I wasn’t a patient at this facility they took my insurance information. (Note: the vaccine is free, but insurance is billed when possible.) I was then scheduled for my first and my second shot. This is really important. Unless you are able to make both appointments, you cannot get your first dose. For both the Pfizer and Moderna versions, the vaccine is most effective with 2 shots: an initial dose, and a booster. Pfizer requires the second dose 21 days following the first dose. Moderna requires the second dose 28 days following the first dose. I was offered a wide range of available times, so it was easy to schedule around my work and childcare schedule.
On the morning of the 7th, I got up early and drove to the location. Navigating the hospital was a little tricky, but a friendly helper pointed me in the right direction. Once I arrived at the site I was asked which dose I was there for and sent to the appropriate line. I was given a clipboard with paperwork to fill out and told, in no uncertain terms, not to sign any of the paperwork yet. Most people in line were entertaining themselves with their phones while they waited, and everyone wore a mask. At one point the clinicians went through the line to have everyone with a reusable mask switch to a disposable one, likely to reduce the chance of any pathogens being carried in.
Once it was my turn I was brought into a large room with various stations. The first stations were for checking in: gathering my information, confirming my email address, and making sure I had my second shot scheduled and would be able to make the appointment. The next station was another scheduling station where they confirmed that the second dose appointment was in their system, and made sure a confirmation email had been sent. After another short wait, a woman gathered my remaining paperwork. She went over the vaccine safety screening questions, asking whether I had allergies to any of the ingredients, about my pregnancy and breastfeeding status, the history of any bleeding disorders, etc. They made sure I understood that this vaccine has been approved by the FDA for emergency use authorization order, and that participation is voluntary. After this I signed my consent forms. For me this was an easy decision; I understood that the vaccine had been extensively tested and that severe side effects have been exceedingly rare.
The shot felt no worse than a quick pinch. I was then given a Covid-19 Vaccination Record Card - that pretty little rectangle card everyone is taking selfies with - and told to bring it back for my second dose. I was sent to an observation area where I waited for 15 minutes. Patients with a history of vaccine reactions or severe allergies were asked to wait 30-60 minutes. While I waited in the observation area I was given information about possible symptoms from the vaccine, and told which were normal and which required emergency intervention. I was also provided with contacts in case I had any questions, or wanted to report any of my symptoms. The most concerning symptoms following vaccination are severe allergic reactions. This is extremely rare, but when it happens, it generally occurs quickly following administration. That’s why people are asked to wait in an observation area for a little while after their vaccination. While I was there no one had any obvious reactions and folks were playing on their phones or chatting.
After this I went about my day. I had a sore arm at the injection site, but no other side effects. The soreness lasted about 3 days and I mainly noticed it if I bumped into things or was carrying my toddler for an extended period of time. I didn't notice a huge increase in fatigue. I had a mild headache on the evening of 4th day which resolved with some sleep. I'll be returning for my second dose on February 3rd and am looking forward to more people getting the vaccine and staving off the spread of this awful disease. In the meantime, I’m still wearing my mask, washing my hands frequently, distancing and following all other precautions.
If you aren’t sure when you are eligible for a Covid-19 vaccination, check the Washington State Department of Health screening tool at FindYourPhaseWA.org. Another great way to find out when you should get the vaccine is to talk to your primary care provider. If you don’t have one yet, there are several at Roots for Health who would love to work with you, just call to schedule. For FAQ and more information on the vaccine I have listed some websites below.
FAQ
Why did they ask the screening questions?
Pregnancy and Lactation Status: As of right now they don't have data on the use of the vaccine in pregnant and lactating people because they were excluded from the studies. This is a common practice when developing vaccines. However, now that the vaccine is available the American College of Obstetricians and Gynecologists recommend that pregnant and lactating people be offered the vaccine as it is available for them and that talking to a doctor may be useful for decision making (American College of Obstetricians and Gynecologists’ Immunization et al., 2020). There are no concerns in regards to a person's fertility in relation to getting this vaccine (Brenda Goodman, 2021). Conversely it has been observed that getting the Covid-19 virus could lead to fertility issues related to sperm production (Reuters Staff, 2020).
Bleeding disorders and use of blood thinners: The screening question is due to the fact that this vaccine is given via an intramuscular injection (a needle) and could therefore risk causing bleeding.
Immune compromised status or use of medications that effect the immune system: Similar to pregnancy and lactation, the vaccine was not studied in individuals who are immune compromised or on medications that affect the immune system. So, there is no data. The CDC states that those with weakened immune systems are at higher risk for Covid-19 so even though a compromised immune system may result in a less effective immune response to the vaccination, it may still be helpful (Interim Clinical Considerations for Use of MRNA COVID-19 Vaccine Currently Authorized in the United States | CDC, 2021) It is also strongly recommended that even after receiving the Covid-19 vaccination individuals continue to follow precautions surrounding the spread of Covid-19 like social distancing, wearing a mask, and washing hands often.
Recent vaccination within the last 14 days or plans to receive another vaccine in the next 14 days: Again, there is no data available yet. The Covid-19 vaccines were tested in folks who did not receive other vaccines simultaneously or during the same time period (Interim Clinical Considerations for Use of MRNA COVID-19 Vaccine Currently Authorized in the United States | CDC, 2021). Because of this lack of data they aren’t sure how other vaccines given in the same time period may affect the immune response to the Covid-19 vaccine. If you are trying to figure out when to schedule your flu shot you may want to take this into consideration and schedule at least 14 days before your first Covid-19 dose or at least 14 days after your second dose. Flu shots are widely available at most pharmacies and many healthcare facilities. Talk to your provider if you need help getting one.
Why wasn’t I concerned about this vaccine being available so quickly?
Both the Moderna and Pfizer vaccines are mRNA vaccines. I know mRNA vaccines have been actively researched a long time in humans and that they have been shown to be quite safe. This research was also a big reason the vaccine was able to be developed so quickly. It required only a genetic sequence which was easy to share remotely between scientists, since it was data rather than raw materials. One big reason vaccines take longer to develop most of the time is because they aren't always well funded. In contrast, the Covid-19 vaccine has been extremely well funded due to the urgent need for a way to curb the infection rate during this pandemic. Another reason vaccines tend to take longer to develop is because many of them are for diseases that are severe, but more rare. In order to test a vaccine and show its effectiveness, participants in the study must be exposed to the disease. With rare diseases such as Ebola, exposure itself is less likely, so it is difficult to test effectiveness. During the pandemic chances of exposure to Covid-19 are quite high, so it is much easier to see if the vaccine protects those exposed to the virus from becoming sick. This gave me confidence that despite the vaccine being developed quickly, I did not need to be concerned.
What are the normal symptoms following vaccination and why are they considered normal?
Some symptoms that are considered normal include: pain at the injection site, redness at the injection site, tenderness at the injection site, swelling at the injection site, lymph node swelling in the arm near the injection site, headache, fatigue, muscle pain, joint pain, chills, nausea, vomiting, and fever (Moderna Tx Inc., 2020). I was told that none of these reactions were things to be concerned about and that I could take NSAIDs to alleviate symptoms as needed. As a doctor I was happy to see all of these reactions included in the list of normal, as these reactions all reflect normal immune response to pathogens. That means the immune system is doing its job, which is an example of the healing power of nature, one of our naturopathic principles.
What are severe or concerning symptoms following vaccination and what should I do if I experience them?
Severe and more concerning reactions to the vaccine include: difficulty breathing, swelling of the face and throat, rapid heart rate, severe rash across the whole body, and dizziness or weakness (Moderna Tx Inc., 2020). These reactions are side effects most associated with severe allergic reaction to the vaccine. Thankfully, these severe allergic reactions are rare. However, because we know that severe allergic reactions can be life threatening and tend to happen quickly upon exposure, vaccination sites are taking precautions. One of these is to have the people sit in an observation area following vaccination for a period of time. If you experience these symptoms, please seek emergency care immediately.
Where can I report vaccine reactions?
In addition to the counseling regarding vaccine reactions I was also provided with resources for documenting my reactions, including the option to enroll in V-safe, an app for smartphones which checks in with people every day to track symptoms following vaccination for a week, and VAERS (FDA/CDC Vaccine Adverse Event Reporting System) which is used by the government to track vaccine reactions.
Once I have the vaccine will I get to start doing normal things again?
The short answer is no, not yet. You should continue to follow all precautions regarding the Covid-19 spread until Public Health sends out further guidance. Why? At this time even though we know that the vaccine provides great protection for those who have received it, we don’t know for sure whether those vaccinated can still transmit the disease. To clarify, the vaccine in and of itself will not make you infectious. So you won’t be putting your family at risk by getting the vaccine, you can breathe easy. However, there isn’t enough data to show whether someone with the vaccine who is exposed to the virus, can pass it on or not. We know that one of the ways the virus has spread so well is through people who were asymptomatic carriers. Their bodies did a really good job at protecting themselves, but were also really good at passing on the disease. Proven ways to reduce spread, even from an asymptomatic carrier, are wearing masks, social distancing, staying 6 feet apart, frequent hand washing, avoiding touching mucous membranes (nose, eyes, mouth, etc.), and sanitizing commonly touched surfaces.
I want the vaccine, but how do I get it?
If you aren’t sure about when you are eligible for a Covid-19 vaccination, use the Washington State Department of Health screening tool available at FindYourPhaseWA.org, which offers to contact you when it’s your turn. Another great way to make sure you get the vaccine as soon as possible is to talk to your primary care provider. One of the jobs of a primary care provider is to help patients with preventative health care, including keeping up on vaccinations. Don’t have a primary care provider yet? We have several at Roots for Health who would be happy to work with you. Call us today to schedule.
OK, this was helpful but I still want more information. Got any resources I can check out?
Below I have listed some websites I found useful regarding the Covid-19 Vaccine, hopefully you find them useful too.
Resources
King County Public Health's Page on the Covid-19 Vaccine: https://kingcounty.gov/depts/health/covid-19/vaccine.aspx
Washington State Department of Health's Page on the Covid-19 Vaccine: CovidVaccineWa.org
A helpful screening app from the Washington State Department of Health which determines your phase for the vaccine: FindYourPhaseWa.org
Moderna Covid 19 Vaccine Fact Sheet: https://www.modernatx.com/covid19vaccine-eua/
Pfizer Covid 19 Vaccine Fact Sheet: https://www.fda.gov/media/144414/download
CDC Fact Sheet regarding the development of Covid-19 Vaccines: https://www.cdc.gov/vaccines/covid-19/downloads/journey-of-covid-19-vaccine-508.pdf
CDC's Page on Covid-19 Vaccination: https://www.cdc.gov/vaccines/covid-19/index.html
CDC/FDA Vaccine Adverse Event Reporting System: https://vaers.hhs.gov/
V-Safe: https://vsafe.cdc.gov/
CHI Franciscan Covid-19 Vaccine FAQ Page: https://www.chifranciscan.org/patients-and-visitors/covid-19/vaccine-information.html
University of Washington Covid-19 Vaccine FAQ Page: https://www.uwmedicine.org/coronavirus/vaccine
Washington Department of Health Infographic with breakdown of Initial Covid-19 Vaccination Phases: https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/VaccinationPhasesInfographic.pdf
CDC Data and Statistics on Covid-19: https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days
References
American College of Obstetricians and Gynecologists’ Immunization, I. D., Laura E. Riley, M., Richard Beigi, M., Denise J. Jamieson, M., Brenna L. Hughes, M., Geeta Swamy, M., Linda O’Neal Eckert, M., Cynthia Gyamfi-Bannerman, M., Mark Turrentine, M., & Sarah Carroll, M. (2020, December 21). Vaccinating Pregnant and Lactating Patients Against COVID-19. ACOG. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/vaccinating-pregnant-and-lactating-patients-against-covid-19
Brenda Goodman. (2021, January 13). Why COVID Vaccines Are Falsely Linked to Infertility. Medscape. https://www.medscape.com/viewarticle/944011#vp_2
CDC. (2021, January 13). CDC COVID Data Tracker. CDC. https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days
Interim Clinical Considerations for Use of mRNA COVID-19 Vaccine Currently Authorized in the United States | CDC. (2021, January 6). CDC. https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html
Moderna Tx Inc. (2020). FACT SHEET FOR RECIPIENTS AND CAREGIVERS EMERGENCY USE AUTHORIZATION (EUA) OF. www.modernatx.com/covid19vaccine-eua.
Reuters Staff. (2020, November 30). COVID-19 May Hurt Male Fertility. Medscape. https://www.medscape.com/viewarticle/941650
