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what will i feel like after the shot? vaccine answers
what are the side effects? who shouldn't get the vaccine and other questions answered by experts.
dec 16 2020
7 minute read
personal support worker johanne lamesse reacts in anticipation to the needle as she receives the pfizer-biontech covid-19 vaccine at the civic hospital in ottawa, ontario, canada december 15, 2020.
adrian wyld/pool via reuters
the covid-19 vaccine is here. and while many of us are eager to roll up a shirt sleeve to get the shot, there are still some lingering questions about logistics and health effects.
the ontario medical association hosted a panel discussion with doctors specializing in infectious diseases and allergies to tackle some of the concerns canadians have about the science, logistics and impact of the pfizer vaccine, now being distributed across the country.
though the panel emphasized the remarkable scientific breakthrough in creating an effective vaccine for such a new virus, there is a lot about the vaccine that is similar to shots many of us regularly receive.
here’s a look at some common covid-19 vaccine questions:
what will i feel after the vaccine? what are the side effects?
dr. zainab abdurrahman , a pediatric and adult allergist and pediatric immunologist, notes that just like the flu vaccine, some people might feel unwell after getting a covid-19 shot, while others might feel fine.
“as with any vaccine, you’re going to start to experience some symptoms which might make you think about what it’s like to actually have the illness,” she says.
with the injection, “your body thinks it’s getting infected so it makes an immune response, and then makes the memory, so the next time you are exposed to [the virus], you have this ability to generate antibodies to tackle the infection.
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“your body goes through the natural steps it actually goes through when it’s actually fighting infection. so some people might notice elevated temperature — that’s a natural immune response to try and kill viruses. some will notice aches and pains and that’s just generally because you’re feeling under the weather, your body is telling you to tamper down [and] focus our energy on fighting this infection.”
for the covid vaccine, localized pain and swelling is also common, and part of the expected side effects. after reviewing the data from pfizer’s trials, abdurrahman says the side effect profile is very similar to other, current vaccines. “you may notice a bit more pain and tenderness than the influenza shot, but it’s actually less reactive than shingrix, [the shingles vaccine],” she says.
who should not take the vaccine?
abdurrahman points out that both health canada and the fda recommend that the only people who should avoid the vaccine are those who experience anaphylaxis after the first dose, and those who are known to have an allergy to components in the vaccine.
“the canadian society of allergy and clinical immunology is also releasing a statement to that effect, letting patients know that if you have a history of anaphylaxis to foods or venoms or medications like penicillin, you do not have to avoid this medication,” she says.
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one of the components of the vaccine that’s currently in the spotlight is polyethylene glycol. two u.k. health workers who had anaphylactoid reactions from the covid vaccine (and recovered) may have, in fact, had a reaction to polyethylene glycol.
“this is actually a rare allergy,” abdurrahman says. “polyethylene glycol is actually in a lot of medications, which we use routinely, most commonly being tylenol, both the liquid form that we give to young children as well as the tablet forms.”
there’s also the issue of people who are immunocompromised or pregnant. but abdurrahman notes that there’s less concern when it comes to the covid-19 vaccine because it’s an mrna vaccine and not a live vacccine, which can cause a milder form of infection. the decision to take the vaccine, which has not been specifically studied in these groups, should be a matter of informed consent.
“really speak to your doctor in terms of risk,” she says. “make a decision to receive it or perhaps wait for secondary rollouts.”
why do we need two shots of the vaccine? and when can we consider ourselves protected?
health canada has approved the pfizer vaccine, which requires two doses. moderna, expected to be approved relatively soon, also requires two doses. most covid vaccine candidates, save the one currently being developed by johnson & johnson, require multiple doses. experts have previously warned this could be the “achilles heel” of the immunization campaign, given previous research which suggests as many as 70 per cent of adults prescribed a multi-dose vaccine don’t come back after the first jab.
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dr. zain chagla, an infectious diseases physician at st. joseph’s healthcare, says its important to get that second shot of the pfizer vaccine because that was shown to be most effective.
“we do need the two shots because this is still a vaccine that’s built on this two-dose series. when they did the phase 1 trials, they found the best dose optimization to get the best response was those two shots, 21 days apart,” he says.
that doesn’t mean, however, that just because you got your shot you can rip off your face mask and hug all your friends.
dr. vinita dubey, the associate medical officer of health for toronto public health, says that after getting a vaccine, you’ll still have to do what we’ve being all through the pandemic: wear a mask, avoid travel, and maintain a safe physical distance from others.
dubey points to the polio vaccine, which saw massive immunization campaigns across the world in the 1950s, but took some time before the virus was entirely under control.
“it’s not overnight. it still can take months, or even years. i think part of that is because we have to get everyone vaccinated and that’s going to take time as well,” she says.
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generally, people who have received the vaccine started to get protection within the first 10 to 14 days. but dubey cautions that time is what will make the vaccine most successful.
“that doesn’t mean we need one shot. it just means that level of immune response is starting to happen 10 to 14 days after the vaccine and gets better and better with time … knowing the seriousness of the vaccine, knowing what it does for society, knowing that it is going to be used to reduce death and disability and hospitalization due to covid-19, i think we have a due diligence to make sure we do the series correctly and get the optimal amount of immunity in the population, rather than half the series.”
there are also concerns about clinical trials effectively representing those who are getting hit by the virus the hardest. covid-19 in canada and the u.s. has had an outsized impact on black and other racialized communities. however, many vaccine trials are made up of white, college-educated women, who are at less of a risk for exposure to covid-19.
dr. isaac bogoch, an infectious disease consultant and general internist with the university health network, says that the composition of the clinical trial for pfizer has been “reasonable.” he notes that the moderna vaccine, expected to be approved by health canada soon, uses a similar technique to the pfizer vaccine. and there was a concerted effort to ensure a wide range of participants.
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“[moderna] actually slowed down enrolment in their trial so that they could enrol a greater diversity of participants to really ensure it was reflective of the community at large. and that showed very similar results to the pfizer vaccine,” he says.
why are children not eligible for the vaccine?
so far, the pfizer vaccine is only available for those aged 16 and older. however, that may change as pediatric clinical trials are currently under way. it’s not as easy assuming that a vaccine that works fine for an adult will work in the same way for a child.
“as with many vaccines that are developed, the safety is first established in adults. and then we start at looking at pediatric trials,” explains dr. mariam hanna, a pediatric allergist.
“i hate this statement because it’s a cliche, but let’s say it: kids are not little adults,” she says. “truly, their immune system is not that of a little adult. a child’s immune system behaves a little bit differently.”
that said, children are still an important part of the strategy. though children have generally been shown to have less intense covid symptoms, hanna says, “to get full control, we need to have immunity in children. we need to keep our guard up during this transition time. kids are not included in the phase 1 rollout [in ontario]. maybe phase 2, probably phase 3 will include kids.”
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in other words, getting a grip on covid-19 might take some time and we need to continue as we have throughout the pandemic: washing our hands, wearing masks and maintaining physical distancing. but the doctors on the panel did have hope for the efficacy of the vaccine and the future.
“we’ve all suffered. covid has impacted all our lives,” says dubey.
“we have a light at the end of the tunnel. it really is a vaccine that will get us out of this.”
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