January 26, 2021, Submitted by Nandita Scott, MD
Last month, as I walked up the stairs at Massachusetts General Hospital, on my way to receive my first dose of COVID-19 vaccine, I found myself tearing up. The weight of the last year became suddenly apparent. It has been a hard year for everyone, myself, my family, my coworkers and our community. I was amazed at the skill of our teachers rapidly adapting to a new virtual learning curriculum, our restaurants, struggling to reinvent themselves, my colleagues who heroically stepped up as our entire hospital system upended in the face of this pandemic and our children who remarkably adapted to the new tasks we gave them. Though teary, I also felt very hopeful. Thanks to the genius of our scientists, there is light at the end of this long tunnel.
My first dose left me a little tired and achy, the second made my arm red and painful – all for only a day or two, but well worth it. I now feel like a superhuman!
How does the vaccine work? Many of us know by now, that the Pfizer/BioNtech and Moderna vaccines are mRNA vaccines. Once injected, the mRNA gives our body instructions on how to make proteins, in this case, the spike protein that is unique to this coronavirus. This then triggers an immune response, creating antibodies that gets you ready to protect in case of future infection. The Pfizer/BioNTech and Moderna vaccines are 95% and 94.1% effective at preventing COVID-19 infection, respectively, a week (Pfizer/BioNtech) and 2 weeks (Moderna) after the 2nd dose. It is important to know that these vaccines do not contain live virus and therefore you cannot get COVID-19 from a vaccination. The vaccine does not alter your DNA. The vaccine does not make you positive COVID-19.
The vaccine was developed so quickly, is it safe? The rapidity of vaccine development does not reflect cut corners, but the advances that had been made in the field thus far. The work behind the development of an mRNA vaccine has been in development for decades. Once the COVID 19 virus was identified as the cause of the pandemic, its genetic code was released and almost immediately, the scientists began working on the design of these specific vaccines.
What about long-term side effects? Dr. Fauci, now a household name, a world expert in infectious disease, who served on the Trump Administration Coronavirus Task Force and now Chief Medical Advisor to President Biden, reports that when examining the history of all vaccines, 90+% of longer term side effects, occur between 30-45 days after the vaccine trial ends, the FDA therefore waited 60 days before releasing the current COVID 19 vaccines for emergency use.
Is the vaccine safe for pregnant or breastfeeding women? The Pfizer/BioNTech and Moderna vaccines have not been tested in pregnant women, though both companies will be enrolling pregnant women. Data however suggests that pregnant women who develop COVID-19 appear to be at increased risk for severe illness. Similarly, there is no data on breastfeeding women, however mRNA vaccines are not thought to be a risk for breastfeeding infants. The American College of Obstetrician and Gynecologists recommend that the vaccines not be withheld from pregnant women who meet criteria for vaccination and should be offered to breastfeeding women as well. For more information, please visit the MGH FAQ for pregnant and breastfeeding women: https://www.massgeneral.org/obgyn/news/COVID-19-Vaccine-FAQ-for-Pregnant-and-Breastfeeding-People
What about allergic reactions? Data thus far shows that the rate of a severe allergic reaction, anaphylaxis is 2.5 cases per million doses administered for Moderna, and 11.1 cases per million doses administered for the Pfizer/BioNTech vaccine. Most anaphylactic reactions occurred within 15 minutes. NO anaphylactic deaths have been reported. These rates are therefore low. If you have a history of anaphylaxis, you should discuss the vaccine with your physician. You should not receive the vaccine if you are allergic to polyethylene glycol or polysorbate.
Can dermal fillers cause vaccine side effects? Three people, who received the Moderna vaccine developed facial swelling at the filler site, after vaccination. These have been treated with antihistamines and steroids. Thus again, the risk is very low.
What about children? The Pfizer/BioNTech vaccine is approved for those 16 years or older, the Moderna 18 years or older. Both companies are now performing trials in younger children. Children overall are at much lower risk of severe COVID-19 infection.
What is the vaccine schedule? The Pfizer/BioNTech vaccine is two doses, spaced 3 weeks apart, the Moderna is also two doses, spaced 4 weeks apart. These vaccines are not interchangeable. You will be asked to wait 15 minutes after your vaccination to observe for an allergic reaction.
I had COVID 19 – should I get vaccinated? Reinfection is possible post-COVID-19 infection and the duration of immunity is not clear. It is therefore recommended that even though you have had COVID 19 infection, you should still receive the vaccine.
Can I stop wearing a mask after my vaccine? No. The vaccines are extraordinarily effective at preventing serious COVID 19 infection but it is unclear if after vaccination you can still silently shed the virus. We need to continue to wear masks, wash our hands, and physically distance until further notice.
Are there other vaccines? There are several other vaccines in phase 3 clinical trials including the Oxford-AstraZeneca vaccine which has already been approved for emergency use in the UK. The Johnson and Johnson vaccine requires only one dose. These vaccines use double stranded DNA rather than mRNA to promote an immune response. If approved for emergency use in this country, then we will have several other options to battle this virus, increasingly important as we try to meet our vaccination goals and reduce virus spread.
Like the rest of you, I am longing for some normalcy: kids in school full time, eating out with friends and going to TD garden to watch a game. For me, getting vaccinated against COVID 19 is a step towards that normalcy. And, I can’t wait.
If you are looking for more information, please visit the state (https://www.mass.gov/info-details/covid-19-vaccination-program) or CDC (https://www.cdc.gov/vaccines/covid-19/index.html) vaccine websites.
Dr. Scott is a cardiologist at Massachusetts General Hospital, co-director of the Corrigan Women’s Heart Health Program and Director of the Cardiovascular Medicine Section at Massachusetts General Hospital. She is also a Hingham Recreation Commissioner.