Getting the Covid-19 Vaccine: Dose 2
“Prevention is better than cure” – Ancient Proverb
Covid-19 has devastated families across the world and in the United States. As of February 18th, 2021 the US has had 27,669,556 documented cases and 489,067 deaths. There have also been 57.7 million vaccines administered - we are getting closer to herd immunity (CDC, 2021).
On February 3, 2021 I got the second dose of the Moderna Covid-19 Vaccine. Here is my experience:
Vaccines are one of the best ways we as a community can help fight this pandemic. So I was very excited to be getting my second vaccine and I thankful the process was simpler than with the first dose. (That story is here.) All I had to do was show up to my appointment on time. I received reminders prior to my appointment from the vaccination facility and the V-Safe App, a CDC tool for tracking Covid-19 vaccine reactions. It is important to get both doses so the vaccine is effective. Many vaccination sites schedule you for both doses at once and send you appointment reminders. The second Moderna dose is 4 weeks after the first, and for Pfizer it happens 3 weeks after the first dose. To find when and where to schedule your vaccination, check out the Washington State Department of Health tool FindYourPhaseWA.org. This tool contacts you when you’re eligible and provides information on vaccination locations.
On February 3rd, I made my way to the vaccination facility. There was a desk set up just inside the entrance with an attendant directing patients. She provided me with a disposable mask to either be worn over or instead of my current mask and she confirmed my appointment as they were not doing walk-ins at this location. Next, I was sent to a room with registration desks and another person confirmed my information and had me sign in. I received a sheet of stickers with my information and was sent down the hall to another staff member, who confirmed which dose I was receiving and that the stickers I had gotten from registration had the correct information. I was then told to fill out the highlighted areas of some paperwork including basic information: name, date of birth, place of employment (this is so they know if you are an employee of theirs). The paperwork included a consent form with an overview of the vaccination like my first dose and was to be signed at the time of my vaccine. I was then sent to the waiting area. Since this time there was no wait, the nurses said I could go to the main room as soon as I finished my paperwork.
There, a nurse was ready with a vaccine dose. She had me get out my vaccination card so she could add the second dose to it. I was asked if I had any questions about the vaccine or the consent forms. She confirmed that I did not have any severe reactions during my previous dose or allergies to any of the ingredients. I signed the consent forms, gave her my paperwork, and got my shot. The shot itself was no worse than a pinch. I was given back my vaccination card and a sticky note indicating when my post-vaccine observation time would be complete. Since I didn’t have severe reactions to the previous dose or history of severe vaccine reaction I was told to wait 15 minutes. Those with a history of severe reactions are monitored longer.
The observation area had several socially distanced chairs set up on color-coded dots. Another nurse told me where to sit and checked in with me to see if I had any questions and knew about V-safe. Since it was my second dose I didn’t receive any new information. She checked the time on the sticky note and let me know that if I wasn’t having any reaction to the vaccine I was ok to leave at the time listed. While I was waiting neither I nor anyone else around had any reactions to the vaccine. This time most of the people were seniors getting their first shot some. I chatted a bit with the nurses and when my time was up, I left. I was in and out within 25 minutes.
After this I went about my day. I noticed worse symptoms following the second dose than with the first dose; however, my symptoms were never bad enough for me to change my routine. For most people, myself included, the symptoms tend to be worse during the first few days following the vaccine. I lessened my symptoms by staying well hydrated, eating nutrient-rich foods, and getting plenty of sleep. I also took Epsom salts baths which helped my aches.
This is what I experienced:
Day 1/Day of the shot symptoms: I felt sleepy, and like I wanted a nap. I could still do all of my daily tasks, I was just tired. My arm was sore at the site of the injection but I only noticed it when my husband gave me a tight hug and managed to squeeze that part of my arm.
Day 2: I felt muscle soreness and mild joint pain. I felt a bit under the weather and achy. I was still able to do all my daily activities but I was a bit uncomfortable and tired. My arm was still sore to the touch. A bath with Epsom salts relieved some of my achiness.
Day 3: I felt much better. I was still a bit more tired than usual, but markedly less than the previous 2 days. The achiness and muscle soreness were gone. My arm was still sore to the touch.
Day 4: My arm was only mildly sore, I was no longer tired.
Day 5: All of my symptoms had resolved.
*Symptoms vary from person to person. Refer to the FAQ below for a thorough list of possible symptoms.
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 a doctor yet, there are several at Roots for Health. Further FAQ and verified websites on the vaccine are listed below.
FAQ
Why do they ask certain 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 as these 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 recommends 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: This vaccine is given via an intramuscular injection (a needle) and therefore bleeding is a risk.
Immune compromised status or use of medications that affect the immune system: Similar to pregnancy and lactation, 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 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). If you are trying to figure out when to schedule your flu shot you may want to schedule at least 14 days before your first Covid-19 dose or 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 most vaccines take longer to develop their lack of funding. The Covid-19 vaccine, in contrast, 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 responses are side effects most associated with severe allergic reactions to the vaccine. Thankfully, these 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, like keeping people under observation for a period for a period of time after vaccination. 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.
Will the vaccine protect me from the new variants the news keeps talking about?
The short answer is yes, the vaccine is still the best protection against the new variants. Research is showing that it has been effective against newer strains, however drug companies are working on creating boosters to make them even more effective against the new strains(Moderna COVID-19 Vaccine Retains Neutralizing Activity Against Emerging Variants First Identified in the U.K. and the Republic of South Africa | Moderna, Inc., n.d.). In the mean time experts recommend getting the vaccine as soon as it’s available to you and continuing to follow safety guidelines(COVID-19 Variants :: Washington State Department of Health, n.d.; New Variants of the Virus That Causes COVID-19 | CDC, n.d.). In Washington State we also have a phone app called WA Notify which will notify you if you come into contact with anyone at risk.
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 at 206-588-1061 to schedule.
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
Washington Exposure Notifications App also referred to as WA Notify: https://www.doh.wa.gov/Emergencies/COVID19/WANotify
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, February 11). CDC COVID Data Tracker. CDC. https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days
COVID-19 Variants :: Washington State Department of Health. (n.d.). Retrieved February 10, 2021, from https://www.doh.wa.gov/Emergencies/COVID19/Variants
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.
Moderna COVID-19 Vaccine Retains Neutralizing Activity Against Emerging Variants First Identified in the U.K. and the Republic of South Africa | Moderna, Inc. (n.d.). Retrieved February 10, 2021, from https://investors.modernatx.com/news-releases/news-release-details/moderna-covid-19-vaccine-retains-neutralizing-activity-against
New Variants of the Virus that Causes COVID-19 | CDC. (n.d.). Retrieved February 10, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/transmission/variant.html
Reuters Staff. (2020, November 30). COVID-19 May Hurt Male Fertility. Medscape. https://www.medscape.com/viewarticle/941650
