A shot at understanding COVID-19 vaccine effects

Since the beginning of the COVID-19 pandemic, Dr. Hai Shao, board certified infectious disease specialist has been involved in all aspects of the management of COVID-19. Shao practices at both Sharp Chula Vista Medical Center and Scripps Mercy Hospital Chula Vista.

He is a medical director for both hospitals in infection control and hospital epidemiology and the Antibiotic Stewardship Program. He said his work has ranged from infection control, PPE, treatment, diagnosis, testing and vaccinations. Shao sits on multi committees laying out and implementing polices. Shao said it is extremely important to get vaccinated as COVID-19 is an extremely serious illness.

“Many people thought this was just another form of an influenza and I would beg to differ on my own clinical experience and knowledge about this virus,” said Shao. “This virus kills people 10 times higher than influenza. I have been through so many flu seasons in hospital ICUs seeing people struggle, but I have never, ever in my career seen such a bad virus causing so much death and co-morbidities in my life.”

Shao said people should not be complacent, get vaccinated with herd immunity being the ultimate goal.

“As more people get vaccinated and protected, the more difficult it is for the virus to spread and transmit within a community and making people sick,” he said. “We can save a tremendous number of resources in our healthcare industry and obviously, improve the quality of life for everyone that do not have to be home sheltered and businesses closed.”

Both the Pfizer and Moderna vaccines are extremely safe and highly effective on all the data collected so far, said Shao. Both vaccines use the messenger RNA that introduces messenger technology so the body will automatically make a protein from the template. He said this protein develops to a part of the viral particle that the immune systems recognizes that it is a foreign protein and develops antibodies and immune responses.

Shao said symptoms that people experience after the inoculations can all be found at the Center for Disease Control and Prevention website. The CDC encourage people to use their smartphone to tell CDC about any side effects that they experience getting the COVID-19 vaccines. By Jan. 27, when it published the initial safety data, more than 22 million people had gotten either the Pfizer or Moderna vaccine and reported their symptoms. Visit www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafe.

Shao said if you look at symptoms from people that received their second shot, there is a significant difference from the first dose.

“Usually, the symptoms are very mild with both vaccines with the first shot,” said Shao. “Largely muscle aches from the injection site for about 24 hours that will disappear. People will typically report more symptoms after their second shot. The most common symptom, pain or body aches were reported by 70% of people that got the vaccine. Fatigue is at about 33%, headache 29%, muscle ache 23%, chills and/or fever 11% and joint pains at about 10%.”

Shao said the good news is symptoms after the vaccinations are seldomly related to the respirator track and secondly, the symptoms are short lived.

“Usually less than 24-48 hours and can be relieved by over the counter medications such as Tylenol or ibuprofen. Most people tolerate both shots very well,” he said.

Shao said there is a rare incidence of anaphylactic shock among people that were vaccinated. For Pfizer, only five out of one million people experienced this, usually women which had a history of anaphylactic reactions before. For Moderna, it is lower. It is about 2.8 out of one million people. “The good news is that so far, no one had died from side affects or reactions to either vaccine,” he said. “The vaccines are extremely safe and based on trial data, they are highly effective in preventing infection from COVID-19. Most symptoms are a result of the immune system responding.”

Shao said many companies are working on other forms of vaccinations and their research has come to a point where they have conducted enough research and advocacy and waiting for the FDA to approve. The frontrunners are Johnson & Johnson which uses an adenovirus mechanism, which means you only need one shot.

“The protection is not as high as Pfizer or Moderna, but it is decent, easy to give, easy to manufacture. AstroZeneca was currently approved by the British government,” he said. “So far, the data suggests that they are both very safe and highly effective.”

The CDC reports there are variants of the virus that causes COVID-19 now circulating globally:

The United Kingdom identified a variant with many mutations in the fall of 2020. This variant spreads more easily and quickly than other variants. This variant was first detected in the US at the end of December 2020. In South Africa, another variant emerged independently, originally detected in early October 2020. Cases caused by this variant have been reported in the US at the end of January 2021.The CDC reported in Brazil, a variant emerged in early January. This variant contains a set of additional mutations that may affect its ability to be recognized by antibodies. This variant was first detected in the US at the end of January 2021.

“These variants seem to spread more easily and quickly than other variants, which may lead to more cases of COVID-19. An increase in the number of cases will put more strain on health care resources, lead to more hospitalizations, and potentially more deaths. So far, studies suggest that antibodies generated through vaccination with currently authorized vaccines recognize these variants. CDC reports this is being thoroughly investigated and more studies are underway.”