Collect Your Covid Cliff Notes
Holy cow! This newsletter was born a year ago tomorrow. It has grown—much like my children and my collection of hand sanitizer—beyond my wildest dreams. So when I celebrate tomorrow night, watching TV in my PJs with my drink and my husband beside me, I will undoubtedly toast you, my dear readers, for sticking with me a whole 365 days.
Onward!
Now that more people are getting vaccinated, I’m getting a TON of great questions about what to expect from the shot, how to manage side effects, and what the variants mean for all of us.
As always, let's start with the facts:
The three currently available vaccines (Pfizer, Moderna, and Johnson & Johnson) are phenomenally effective, essentially taking death, hospitalization, and severe disease from COVID-19 off the table and turning coronavirus into its wimpy cousin: the common “cold.”
The real-world vaccine efficacy data is even better than the clinical trial data, demonstrating the extraordinary ability of the vaccines to cut rates of death, hospitalization, and overall cases.
The vaccines work well against the current variants. Yesterday’s report that the Moderna vaccine has reduced efficacy against the South African variant does not mean that your immunity from getting Moderna’s shot is moot; it simply means that more of your newly-created antibodies would be required to fight the South African variant should you encounter it. And you have plenty of them.
In other words, the variants have not outsmarted the immune protection from vaccination. Will they? And will we need boosters?? It depends on how fast we can vaccinate wide swaths of the population and deprive the virus of the chance to mutate further. For now, the existence of more contagious variants—and the current spread of B117 as states hastily lift mask mandates—means this: masking and distancing remain critical for unvaccinated people and for vaccinated people in public and around groups of unvaccinated people. Indeed, we are far from done, but we are getting there, fast.
There is no evidence that mRNA vaccines cause infertility. We of course need to follow long-term safety data on the vaccines, but there is no biologically plausible reason for the vaccines to promote infertility. Sadly, this myth is holding some women back from getting vaccinated.
The J & J vaccine is not inferior. It's the Java Chip ice cream cake on a dessert menu alongside Pastry Puff Pfizer and Chocolate Mousse Moderna. Rejoice in it!
Facts about getting vaccinated:
There are two types of expected side effects from the vaccines:
pain, redness, and swelling at the vaccination site, and
nonspecific flu-like symptoms (body aches, fever, chills, fatigue) and/or other symptoms like mouth sores, rashes, itchiness, and jitteriness that I’m commonly seeing in my patients. None of these is worrisome; they indicate the immune system at work. (Of course you should always check with your doctor for any specific concerns and/or if your post-vaccine symptoms are not improving after 72 hours.)
Unless you have any particular medical reason not to, it is perfectly fine to take Ibuprofen, Tylenol, and/or Benadryl in the case of any vaccine side effects (which, by the way, are not inevitable). The rumor that Ibuprofen blunts the immune response to the vaccine is just that: a rumor.
It's not recommended—nor is it necessary—to take medication before getting the vaccine. Aside from attempting to calm anticipatory anxiety, I can’t think of any reason to pre-medicate.
Some people experience side effects within the first 48 hours of getting the vaccine; others have side effects a week later.
People who do NOT experience vaccine side effects still mount a robust antibody response to the vaccine. I am living proof. I had zero side effects and have a beautifully high post-vaccine antibody level. (Plus killer T-cells doing the bulk of the work.)
It’s okay if you don’t get your second dose exactly 21 days after the first Pfizer or exactly 28 days after the first dose of Moderna. Your immune system doesn’t have a stopwatch.
People who have had COVID-19 should get the vaccine. Why? Even more data out just yesterday reveals that immunity from the vaccine is stronger than immunity from natural infection. If you’ve recovered from COVID-19, there is no reason to wait (beyond, of course, the 10 days of isolation i.e. the natural arc of coronavirus infection). That said, there is no reason to rush to get it, either; people who have recovered from COVID-19 have natural immunity for at least 6 months and probably a lot longer.
The real world data on 50 thousand vaccinated pregnant women shows what we suspected: the vaccine is safe. Pregnancy is a risk factor for poorer outcomes from COVID, so pregnant women should be offered the vaccine after discussing it with their doctor. Fun fact this week: babies born to vaccinated women are arriving into the world with a nice set of COVID-crushing antibodies!
Breastfeeding women also should strongly consider vaccination. Remember that the main reason we breastfeed is to confer antibodies to our newborn baby!
Next week, I will cover more about what you can and cannot do after vaccination—from testing to kissing to traveling and canoodling. Until then, be well.
P.S. Like my T-shirt? Two friends started a non-profit called GotPoked.org to promote vaccination, fight misinformation, and give back to others. They were kind enough to send me their prototype. Thank you, Rebecca and Rebekah!