COVID-19 vaccine prep is today’s topic. This blog addresses the easy decisions you can make for maximum results and minimum annoyance from your “jab.” (This term used by the Brits is so descriptive!)
You may have a few questions that this blog does not cover:
- Which vaccine should I get? My opinion: the first one that becomes available to you!
- How can I get that vaccine? This is a rapidly moving target. The easiest way I have found to obtain that information is to Google search “covid vaccine locator STATE,” inserting the name of your state.
Therefore, what will we cover here?
- – Vaccine Prep: Before You Go
- – Vaccine Prep: When You Receive the Vaccine
- – and Vaccine Prep: After the Jab
Vaccine Prep: Before You Go
COVID-19 vaccine prep before your appointment is pretty easy. Here are a few words about each of the preparation steps:
– Stop the Painkillers
In an earlier blog we explained why you should stop taking painkillers for one or two days before your vaccine shot, and for 7 days after it. What we have in mind are over-the-counter products such as aspirin, acetaminophen (e.g., Tylenol) and ibuprofen (Advil, Motrin).
This advice does not apply if your doctor directed you to take pain medicines or if you need them to get through daily life. The point is that painkillers may deaden your response to the vaccine; therefore you will derive more benefit from the jab if you pause the painkillers for a few days.
A recent CBS article expands this advice. It suggests avoiding vigorous exercise for two hours before and after the jab, so that your blood flow is normal rather than enhanced. The normal blood flow delivers the vaccine to your body gradually, as occurred in the clinical trials.
How about getting other treatments, such as a flu vaccine shot? CDC advises, until we know that it’s safe, to keep your different vaccine shots at least two weeks apart. But if you don’t happen to follow this advice, consider it OK, you don’t have to re-take either shot. Similarly, don’t get a mammogram for 4 to 6 weeks after the second vaccine shot. Why? Because if the vaccine gave you a swollen lymph node, it might be mistaken as a symptom of breast cancer.
Generally speaking, stay on the safe side: if you know you have another shot or treatment coming, ask your doctor how much space you should allow before or after the coronavirus vaccine shot. Some docs want more space between therapies.
What about drinking alcohol? Moderate drinking is OK: it will not affect your immune system response to the vaccine. (However, if you have aftereffects such as fatigue or a headache, they may be more unpleasant if you also have a hangover!)
– Chill Out
One important part of COVID-19 vaccine prep is mental. Depending on where you get your news, you may have heard doomsday prophecies that discourage you from getting the vaccine, or make you fear its aftereffects.
My advice is: vaccines against measles, polio and other diseases have saved and helped countless people. Vaccines in general are very safe and very desirable, both for the individual and for society. So please don’t be a vax denier. The coronavirus vaccines that have been approved for (emergency) use have passed extensive tests of safety and effectiveness. I, personally, trust the integrity of the testing protocols, and I hope that you will as well.
What about aftereffects? None of them are deadly, and all of them are preferable to getting a COVID-19 infection and rushing to a hospital. We’ll touch on the most common side effects later in this blog.
Therefore, I advise you: chill out. Life is short, and this part of it at least is more good than bad. So go with the flow!
– Wear Short Sleeves or Layers
The healthcare provider who delivers your shot wants to place it in the deltoid muscle of your upper arm. And he or she would like to access the thickest part of the muscle, up near your shoulder. Why? Because the largest part of the muscle is a big target, easy to hit; and because the shot will spread out rapidly and for that reason cause you less pain.
Therefore, part of your COVID-19 vaccine prep is to wear some clothing that will give them easy access to the thickest part of your upper arm. Wear either a short-sleeve or sleeveless shirt. And yes, it’s winter, so you can add a removeable shirt or sweater over it for warmth.
Vaccine Prep: When You Receive the Vaccine
This step deserves some advance thought, but you can change it right up to the last moment. It has to do with choosing the arm that will receive your shot.
– Vaccine Shot Aftereffects
Let me assume that you, like most people, have never had a serious reaction to an injection. In this case, you may expect the following side effects from a coronavirus vaccine injection:
- Most of the time, no reaction at all.
- Sometimes, soreness or inflammation around the injection site, which will go away in a day or two. You can hasten its departure by moving that arm around to enhance its blood flow.
- Sometimes, fever, muscle pain or a swollen lymph node several days after the shot.
- For fewer than 1% of people, a delayed reaction called “Covid vaccine arm” occurring 8 or more days after the shot. You might have redness, swelling or tenderness, symptoms which will go away in 3 to 5 days.
People typically have a stronger prompt reaction to the second Covid shot than to the first one. This occurs because the first shot “primes” your body to be more sensitive to the second shot. The opposite is true for the 8-day delayed reaction, which more often occurs after the first dose, not a second dose.
However, things are different if you have had and recovered from coronavirus. In that case you will have the stronger reaction to the first shot, not the second one.
So as you see, the situation is very complicated!
Personal data: My wife Nola and I recently had both Pfizer shots. Her shots were both in the left arm, mine first left and then right. We experienced no pain at the injection site. However, one day after the second shot we each seemed fatigued, which is a possible side effect.
– Which Arm for the Shot?
When you reach the technician, you may choose which arm will receive the shot.
Have you ever had a sore arm or other reaction after receiving a flu shot or other injection? Well, that tells you exactly zero about how a coronavirus shot will affect you. People may have either a greater or lesser reaction to COVID shots, and so far as I know, we can’t predict it.
Are you a side-sleeper, who usually sleeps on your right side? Then you probably want to get the shot in your left arm, so that you aren’t putting your body weight onto an arm that might be sore. And if you’re a lefty, vice-versa.
What if side sleeping is not an issue for you? Then are you concerned about arm pain interfering with your ability to work? Based on the considerations above, here’s my advice:
- If you are receiving a single-shot vaccine (such as Johnson & Johnson’s), choose your non-dominant arm to receive the shot.
- If you are receiving a two-shot vaccine, take both shots in your non-dominant arm.
– Same Arm? Different Arm?
Typical internet advice says that it doesn’t make any difference whether you have both shots in the same arm, or in different arms. But it might make a difference.
I can find only one article that speaks to the question, by Dr Chris Gilbert. She reports that of 12 women who reported “vaccine arm” following both shots, 8 had chosen different arms for the two shots and 4 had chosen the same arm. This tiny bit of data suggests that these stronger side effects might be more common if you switch arms for the second shot.
For this reason, the advice above suggests receiving all shots in the same arm. However, if you arrive for the second shot and your arm is still sore from the first one, your body is telling you something: I personally would give that arm a breather and switch arms for the second shot.
– Do I Really Need That Second Shot?
You might be wondering: do I really need that second shot? After all, some vaccines, including the Johnson & Johnson one, are being offered as a one-shot regimen. What does COVID-19 vaccine prep have to say about that?
There are a couple of excellent articles in MedPageToday that discuss second shots and vaccine effectiveness against mutated virus variants.
Here are some of the key points they make:
- For two currently approved vaccines (Pfizer and Moderna), the antibody protection from a single shot is pretty wimpy. The second dose gives you a 10 times higher level of protective antibodies!
- With two shots, experts believe that you gain significant protection from virus mutations. Although a variant may still infect you, studies show that the infection will be much weaker. Staying out of the hospital is a very worthwhile benefit of having two shots!
- If you receive only a single shot, your body may become an incubating site for new mutated viruses that develop resistance to the vaccine. That is bad not only for you, but for everyone around you.
There is one exception to the advice to get both shots: if you had COVID-19 and recovered, that’s rather like you already had a single shot of vaccine. Therefore, if you get only one vaccine jab, you will have approximately the same high protection that two jabs would give to a never-infected person.
Vaccine Prep: After the Jab
After the shot, your healthcare provider will probably ask you to stay for 15 minutes or more, just to make sure that you don’t have a serious anaphylactic reaction. Anaphylaxis is extremely rare: CDC quotes up to 5 cases per million shots, usually experienced by patients with a history of allergic reactions. If you have such a reaction, the vaccine personnel will have supplies on hand (e.g. epinephrine) to treat you.
If you feel any soreness in the vaccine arm, you can help the soreness go away by moving the arm up and down to stimulate blood flow in that area. That may help dispel vaccine residue that may be causing inflammation inside the muscle.
– A Week and More Later
There is a time delay following the second jab before your vaccine is fully effective. That delay is one week for the Pfizer vaccine and two weeks for the Moderna one.
After you are fully vaccinated, is it safe to re-join normal life? Sorry, not yet! CDC is concerned that even after you are vaccinated, you may be capable of hosting the coronavirus and spreading it to other people. I suggest that you keep an eye on CDC’s advice because they are still collecting data in this area. We can expect them to recommend relaxed rules for vaccinated people, once they are able to measure the risk.
Yet to come in your future: we know that coronavirus mutates, although not nearly as rapidly as influenza virus. To counter new variations, pharmaceutical companies are developing booster shots which may become available late in 2021. FDA promises to grant these boosters rapid approval after positive test results are available. The booster may be a simple as giving you a shot of a different vaccine than the one you already received. Or, the booster may be one of the better, broader vaccines we previously discussed.
I hope this summary has helped you toward successful COVID-19 vaccine prep. Take care, be positive and stay healthy!
Image Credits: All images in the public domain, from CDC
Thanks Art. Very valuable information and well researched. As an RN I really appreciate your sensible and scientific advice. We need your positive attitude also.
Thank you Marci! We can all be thankful that the positive news is outnumbering the negative recently. – Art
After getting my 1st Moderna shot this morning, I came home to find CNN running a story that Moderna had developed a variation of their vaccine that will protect from the South Africa strain, and that they were beginning to ship it. I have a month before I go back for my 2nd shot, which makes me wonder whether (1) it could be used as the 2nd shot and give some extra immunity, and (2) whether they would just use that new variation of the vaccine or whether they would be constrained to give me the standard Moderna shot in a month whether or not the variation that protects against the South African strain was available.
Charles, that’s a great question! You are in an excellent position, with many options. First, for the benefit of other readers, the CNN story is here: https://www.cnn.com/2021/02/25/health/moderna-pfizer-vaccine-boosters-variants/index.html. It goes into detail on Moderna’s and Pfizer’s plans. Moderna in particular is testing every combination you might want, including three-dose vaccines, revised vaccines, and separate boosters.
Here are your choices as I see them:
(1) Stick with the schedule and get your second Moderna dose in 4 weeks. You’re less likely to upset the applecart and miss altogether, you’ll have excellent immunity, and you will be protected from serious disease even from the variants (it is believed). Your immunity will probably last 1 to 2 years and you can add the new booster this fall.
(2) Try to sign up for a Moderna clinical trial (put this search into Google: moderna site:clinicaltrials.gov). At present they seem to be recruiting teens for Covid vax tests but per CNN there will be other trials coming. CNN says that the trials for the modified vaccines will take several months, so getting into a trial might delay your second dose. Unless you can get on a trial in which boosters are tested for people who have had two Moderna doses, in which case you would be a good candidate after your second shot.
(3) Sign up for e-newsletters at medpagetoday.com. They are running a series where they interview pharms, govt people and researchers in depth about COVID-19 vaccines, and they often get that news ahead of other media.
(4) Contact Moderna directly and ask to participate in a US-based trial against the variants. I would search their website and newsletter (modernatx.com). A google search targeting their site might help find the info faster.
(5) Another possibility: review status reports on the already-ongoing clinical trials at Moderna and contact the principal investigator (at clinicaltrials.gov), asking to participate in the next relevant trial that he or she manages.
A rich catalog of possibilities for you to consider…
Best wishes –
Nice info Art! I had two Pfizer jabs. Twelve hours after the second injection I had mild symptoms. Aches, chills, and fatigue. Nothing I found difficult. It was a nice opportunity to rest for a whole day. A few months ago I had a Shingrix Vaccine and the side effect was so terrible I thought I had Covid! I’ve had every conceivable vaccine including yellow fever and rabies (due to Peace Corps and extensive travel). I will live with side effects. Vaccines are so important!
Hi Karen! I’m so sorry to hear that you had such intense side effects from Shingrix. And it surprises me that your reaction to Covid vax was mild by comparison. But you are 100% correct, the side effects will pass, and they are modest compared to what you are protecting yourself from. I believe with your travel to all the ends of the earth, you must have had every jab available by now. Thank goodness most of them last for a good length of time before they need a booster. Best wishes and stay healthy! – Art
Thanks Art! I had the second jab of the Moderna vaccine yesterday.
Today the injection site on the arm is sore — but more important I am feeling some “flu-like” symptoms. (Chilly, tired, soreness at the injection site)
Be well, and many thanks for your excellent summary.
Excellent, Dick. Moderna is the one our family members in Brooklyn are getting, so far only the first shot. Glad that NJ is able to deliver the goods for you. Stay healthy! – Art
Well, that was good timing … I managed to (finally) snag an appointment last night and will be getting the first “jab” this morning. Thanks for the update.
Congratulations, Charles! I understand from other friends in California that it requires real persistence, I’m glad you were able to succeed. – Art