COVID

Should You Get the COVID Vaccine?

With so many unknowns about the vaccine and the COVID virus, it feels overwhelming deciding if you should get the vaccine or not. How effective is the vaccine? Will it protect you against the mutated strands? Will you have bad side effects?

Even though I have years of medical experience working in the Cardiac ICU along with 3 years of doctorate anesthesia training, I am still torn with what is best? It isn’t just me, everyone I know in healthcare is experiencing mixed feelings. Some support, some are against, while others are undecided. This is a tough decision.

In the end, it must be a personal decision. I can not tell you if you should get the vaccine, but I will give you the right questions to ask, equip you with the facts, and identify the “unknowns” to help guide your decision. What is an “unknown”? “Unknowns” are the things we still do not know about the vaccine and the virus.

So let’s give you the facts! Too many opinions and it seems more confusing. What do you need to know to make your decision? Go through the questions below, they will help let you know if you are considered a good vaccine candidate. Follow along the downloadable “COVID vs Vaccination Decision Tree” to help guide your decision

1. Are you at risk for severe vaccine complications?
2. Did you have COVID within the past 90 days? Do you have antibodies?
3. Are you pregnant?
4. Are you at high risk for critical illness with COVID

Who is at HIGH Risk for Vaccine Side Effects?

The same people who are at high risk for poor COVID outcomes are not necessarily the same people who are a high risk for vaccine side effects. For example, a young adult may experience more symptoms after vaccination than an adult advanced in age.

Who Is at Risk for Severe Reactions From the COVID Vaccine

1. Advanced age + critical illness
2. Severe food and drug allergies
3. Had COVID within the past 90 days or strong antibodies remain

Advanced Age Combined with Critical Illness May Lead to Death After Vaccination

On the other hand, elderly patients with critical illnesses may not do well with the vaccine. In this case, it may not be mild side effects, it could be death. Advanced age by itself does not indicate an increased risk. As I mentioned before, someone who is older may experience fewer side effects because their immune system does not go into hyperdrive. Advanced age is not directly leading to vaccine reactions, but when you combine advanced age + critical illness, some are dying. Their body is too weak and can not respond appropriately.

For example, 23 Norweigan nursing home vaccine recipients died within days of receiving the Pfizer vaccine. You must consider, all of these people were over 80 years old AND had underlying critical illnesses. Let me clarify illness, these were not minor illnesses like high cholesterol. So if you are 80+ and already ill, I would put a lot of thought into getting the vaccine. Consult with your primary care physician before making a final decision. They can help you determine if your underlying condition puts you at risk.

Severe Food & Drug Allergies Linked to Severe Reactions After Vaccination

Another thing to consider is severe food & drug allergies. Consider the amount and severity of your allergies. Do you have a mild reaction, or do you need an epi-pen to keep the reaction under control? People with a lot of allergies are more likely to experience mild symptoms (rash, fever, fatigue, etc) after vaccination they manage with over the counter meds (Tylenol, Ibuprofen, etc). Occasionally people require hospitalization, which is linked to people with severe food and drug allergies. If you have an allergy specialist, seek their professional opinion before getting a vaccination. Otherwise, ask your primary care if your allergies increase your risk for vaccine side effects.

Did You Already Have COVID?

Why does it matter if you had COVID? If you get the vaccine too soon after having the virus you increase the risk for a hyperimmune response, increasing your risk for serious side effects and death. If you already have antibodies, your body could have a severe reaction from the vaccine. Your natural antibodies are already doing what the vaccine would do. ??, you are already protected against the virus and do not need the vaccine.

How long after you had COVID should you consider the vaccine? The CDC recommends waiting at least 90 days before getting the vaccine. Get it too soon, and it can cause some nasty side effects. It could actually cause death. This brings up another question, what if you currently have COVID? It is the same, wait at least 90 days. It is very rare for anyone to be reinfected with COVID up to 90 days after having the illness. Use the 90 days as a time to watch vaccination results before you make a final decision.

Should You Get the Vaccine If You are Pregnant?

Are you pregnant? If so, you need to consult with a physician before getting the vaccine. WHO recommends weighing the risks vs benefits in unique circumstances, but does not recommend vaccinating pregnant women. The American College of Obstetrics & Gynecology only recommends the vaccine for pregnant women who are in high-risk groups. Moderna does not recommend pregnant women to get their vaccine. Pfizer is still saying they can not make a recommendation because there is not enough information or studies available. This is a very difficult decision for any pregnant woman to decide.

Who is at Risk for Mild Side Effects

Everyone is at risk for mild side effects after vaccination. Did you ever get a flu shot or any other intramuscular (IM) injection into your glutes? If so, just remember how your arm or wherever you were injected with was sore for a few days afterward.

Who is more likely to experience mild side effects from the vaccine?

1. Young adults
2. Asthmatics = consider severity?
3. Facial fillers in the past year

Ironically, a younger adult with a strong immune system is more likely to experience rash, fever, fatigue, and other mild side effects after vaccination. Why? Their strong immune system creates a strong response, causing these symptoms. So should young, healthy adults avoid vaccination? No! The mild side effects should be easily managed with over the counter medications (Tylenol for fever, Ibuprofen, Benadryl for rash, Pepcid when the allergic response doesn’t respond, etc)

Someone with asthma has a higher risk for breathing complications after vaccination, but it does not impact their risk for respiratory complications as a result of COVID. I know a few nurses who experienced minor asthma flareups after vaccination. The symptoms were mild enough to manage at home with an albuterol inhaler. Lastly, consider the severity of your asthma before vaccination. If you feel like you could experience more severe complications, ask your primary care before you get the vaccine.

A weird, but minor side effect that people are experiencing after the Moderna vaccine is facial swelling, but this is only with patients with facial fillers. The swelling is easily controlled with over the counter antihistamines (Benadryl, Pepcid), but it is a real consideration if you have facial fillers. Thus far, no one had major complications, but you must consider mild discomfort and swelling if you had fillers within the past year.

Are You at Risk for Critical Illness with COVID

It is challenging to know if you will have a mild illness with COVID. This is very unpredictable. Some young, healthy adults are hospitalized, unexpectantly dying, or experiencing mild-moderate symptoms they manage at home. What we do know, are the common links in patients who are not doing well with COVID. Even though you can not predict if you will have mild symptoms, I hope knowing who is getting critically ill will help guide your decision.

At Risk for Critical Illness From COVID

1. African Americans & Hispanics
2. High Blood Pressure/Hypertension
3. Obesity
4. Diabetics
5. Autoimmune disorders

If you decide to opt for getting COVID naturally, be prepared for long-lasting effects. I am a young, healthy adult and anticipated much milder symptoms. Instead, I had moderate symptoms for almost a month. Now, I am a #COVIDlonghauler because my COVID rash is still lingering after a month. I know other nurses who are dealing with their rash 2-3 months later.

Side Effects From COVID vs the Side Effects From Vaccination

What are the side effects of vaccines? Most people I know had very few or mild side effects after both rounds of the Pfizer or Moderna vaccines. The common reactions were fever, rash, lymph node swelling, mild asthma flareups, and local irritation. At this time, I do not personally know anyone hospitalized due to a vaccine side effect (January 2021).

Most people will only experience side effects for a week or so from the vaccine. As far as the unknown long term side effects associated with getting the vaccine, we do not know. Are they worse than the long-term consequences of COVID? TBD!

What are the side effects of COVID? You can expect to deal with chest burning, shortness of breath, loss of taste & smell, joint pain, subjective fever (you have chills & sweats, but you never have a fever), dry cough, COVID rash, etc. I was able to manage my symptoms at home, but I am not out of the woods yet. You must consider the long-term risk for blood clots & my COVID rash is still there. I know others who are still dealing with the long term effects 2-3 months later. Geez!

Pfizer vs Moderna

If you decide to get the vaccine, they are very similar. For more details, check out my post “Pfizer vs Moderna” for all the info about each. Both vaccines provide ~ 95% protection after a month. Where they differ is in the amount of protection after the initial dose. Pfizer provides ~52% efficacy and Moderna provides 80% protection initially. In the end, they are very similar, so which matches your needs? Read my blog post “Pfizer vs Moderna: What are the Differences” for more information.

Can You Still Get COVID After the Vaccine

Yes, you can still get COVID after getting the vaccine. You are more likely to get COVID after the first vaccine, but it is still possible to get the virus after the second dose. Nothing is 100%. As a personal story, my friends who are healthcare workers as well had to deal with COVID after getting the first Pfizer/Moderna vaccines, and others tested positive after their second dose?. How frustrating! This brings us to the next topic.

Do you still need to wear a mask? Yes, you still need to wear a mask. The vaccine does not guarantee you will not get COVID, it decreases the symptoms and risk for critical illness if you get it.

Will you be protected against the new mutated COVID strands? No one knows this answer yet. It is possible, but not absolute. Moderna is going to offer a booster that will give you coverage for the new strains a year later as a 3rd shot. Again, we will find out when these bad boys roll out if they truly give us protection, and how much.

How long will you be protected after the vaccine? Again, no one knows yet. Research shows most people gain enough antibodies to protect them for a minimum of 3 months, but since we will learn as we follow along with the most recent vaccine recipients.

On the other hand, how long are you protected from COVID after having the virus? Studies show antibodies present at up to 5 months after having the virus. This will be a person-by-person scenario depending on how your body responds to the virus and how many antibodies it produces. For whatever reason, some people produce a lot of antibodies, while others have minimal protection. You can get your antibodies tested, and you most certainly should before getting the vaccine.

Should You Get the COVID Vaccine?

Use the facts, look at your age, consider your health history, then finally weigh the risk vs benefit to make a personal decision. Would I get the vaccine? I am still recovering from COVID and I am on day 20 since my first symptom, and it is late January 2021. I should be protected by natural antibodies and will reevaluate in a minimum of 90 days. Now I have time to learn more about the vaccine while being naturally protected. I know we do not know the long-term side effects associated with the vaccine, but we also do not know the long-term side effects of having the virus.