The COVID vaccine is not a magic bullet

By Jane M. Orient, M.D.

Vaccines are being distributed by the millions, but can and should you get one, and where?

Moderna is confident that it can produce 500 million doses of COVID-19 vaccine in 2021 – enough to give two doses to 75% of the U.S. population. But obviously, not everyone can be vaccinated at once. The first doses are being allocated to health care workers, other essential workers and high-risk persons such as elderly. Some people feel aggrieved that others are in line before them – unfairly.

The safest place to get a vaccine or other treatment is in a place where the atmosphere is calm, your medical record is accessible, and equipment and trained personnel are immediately available. At least one clinic, with a very large patient base, bought a new freezer … but hasn’t been able to get vaccine.

An unexpected COVID-19 danger you might face currently is at a mass vaccination site. When people are frightened and angry, the last place you want to be is in a crowd or a traffic jam. In Florida, police and National Guard were at one vaccination site. Tempers were frayed. Many had been lined up in their cars for hours and were furious when turned away for lack of an appointment.

People were instructed to wait afterward in the parking lot and sound their horn if they were having a reaction. Apparently, the site was prepared to treat anaphylactic shock, but problems can recur after an initial response. Is there a safe exit path to an emergency room? Are emergency rooms ready?

Questions are swirling around on the internet. Can the time guidelines for the second dose – 21 days for Pfizer, 28 days for Moderna – be relaxed so that more people can get partial protection from the first dose, as the British government proposed? Can you get the second dose with a different vaccine based on availability? The FDA says stick with the schedule that has been tested. If you are a little late for the second shot, officials say get it as soon as you can.

Hundreds of people are showing up at emergency rooms with vaccine reactions, including high fever and severe headache. It can look just like COVID. The vaccine contains no virus, so it can’t infect you, but it takes a week or two for the protection to start, and you might have been infected before you got vaccinated. Most reactions are expected to resolve in a day or two, but if there is a physical injury it would be covered under the Countermeasures Injury Compensation Program (CICP).

There have been a few post-vaccine deaths, e.g., a healthy Miami physician, but Pfizer says they are unrelated. Doctors are urged to counter “bad reaction anecdotes” with “good reaction” stories.

The virus is reportedly mutating, and the mutant might not be affected by the new monoclonal antibody treatments. Will the vaccine still be effective?

The vaccine is not a magic bullet. Look into immunity-boosting measures and early treatment options that you may need whether you eventually get a vaccine or not. See:

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