Everyone is waiting for the arrival of the Covid-19 vaccines as they are considered the light at the end of the tunnel. Some feel that through vaccination, we have a fighting chance against the Covid-19 virus. There are those, however, who are not so confident while other openly declared that they will not allow themselves to be vaccinated.
The question, though, is—if people should be vaccinated to protect themselves from the virus, are there people who should not get the vaccine as well? Are these the older members of society, the immunocompromised or those with known allergic reactions to vaccines? Many know that even a simple flu vaccine can cause reactions, what more a new and still largely untested, one?
Are the vaccines really necessary?
Dr. Regina Pascua-Berba, Associate Professor, UP College of Medicine and Head of Hospital Infection Control at UP-PGH, and Chief, Division of Adult Medicine, Department of Medicine of UP-PGH, said yes and that the best way to stop the virus is to build enough Covid-19 specific immunity.
She said no virus has ever eliminated itself by inducing natural immunity and only “herd immunity” or protection induced by vaccination can eliminate viruses.
“We need to trust the system that our vaccines are safe even if they were developed quickly. They underwent trials that were large enough to detect any major safety concerns, and were scrutinized not only by stringent global bodies but also independent scientists and experts. And there are ongoing monitoring of adverse events. Even as people are being vaccinated, they are being watched as well. So we need to trust what the government is providing us,” she said.
The basic premise is that these vaccines were tested safe by the Food and Drug Administration (FDA) before they are issued an Emergency Use Authorization (EUA).
What allergic reactions will make someone fit to receive the vaccine?
According to the Philippine Society of Allergy, Asthma, and Immunology, the only current contra-indication for COVID-19 vaccination is if one had an allergy to a previous dose of Covid-19 vaccine or any of its components. For those who received the first dose and developed a rash or severe anaphylactic shock should not get the second dose. Additionally, those who developed allergic reactions to other vaccines like flu shots, should be further evaluated or should consult first with an immunologist.
Meanwhile, persons with allergic reactions to certain food, inhalants/environmental allergens and those not related to vaccines can still get the vaccine. Those with autoimmune or immune-deficiencies can also get the vaccine, provided they are informed that there is not enough data yet to establish vaccine efficacy and safety in these conditions. Those with controlled asthma and on inhaled corticosteroids, those with allergic rhinitis, can receive the vaccine.
On Antibody-dependent enhancement (ADE), the Covid-19 vaccines are also not expected and are not seen to be producing an ADE response.
What are the side effects?
As the body creates an immune response, there may be side effects, which may occur on the first week after vaccination, or most likely one to two days after. There will be more frequent side effects on the second dose and it is more likely to happen in younger recipients. The most common adverse events are headaches, dizziness, nausea, even chills and pain on the injection site. These are not uncommon but they usually go away within 24 to 48 hours.
When there are side effects, take paracetamol, cold compress and the health-care facility should be fully equipped with emergency medications. Most mild reactions can be resolved by antihistamines, and the facility should be ready to respond in case of anaphylaxis.
But what if there are no side effects?
Many people will get the vaccine and experience no side effects but this does not mean the vaccine did not work. “On the contrary, in many of the clinical trials, about 80 percent did not experience side effects but we know there is efficacy in more than 90 out of 100 people.”
For those who previously received a vaccine like anti-pneumonia, the US Centers for Disease Control and Prevention (US CDC) recommends a 14-day wait between receipt of a Covid-19 vaccine and non-Covid-19 vaccine, regardless of the order in which they were received.
If one has received a vaccine, is it a risk to the unvaccinated household?
No. The vaccine is not composed of live viruses so there is no infectious virus to spread from the vaccinated person to the unvaccinated ones. However, if families don’t get vaccinated at the same time, those vaccinated should continue to practice the same health protocols. And even if the whole family is vaccinated, it is still best to practice same health protocols since the vaccine may not work 100 percent for everyone.
Can pregnant women get the vaccine?
There is no data included for pregnant women in the early trials but once data became available, there were no major safety concerns noted in this small group of women. Of course, there is still a need for additional data on this. But overall, pregnant women can receive the vaccine. “It is best to consult the obstetrician and discuss the pros and cons, and should still follow health protocols whether vaccinated or not.”
How about the immunocompromised?
They can still get the vaccine, provided they do not have allergies to vaccine components, history of severe allergy to vaccines or injectable medications. For those with immunocompromised states, it is better to discuss with a doctor. “But in general, the immunocompromised ones are those we really want to be protected against the severe effects of Covid-19.”
What about those with active Covid-19 infection?
They should wait until they are fully recovered, while those who participated in clinical trials or received convalescent plasma, they should wait for three months before getting the vaccine. But people who had Covid-19 in the past or tested positive can still benefit from the vaccination.