Ask the Pharmacist

Q. I heard many people are down and out for 2 days after getting the second dose of the COVID vaccines. I am hesitant to go ahead with it as I don’t have time for that. Will we need to go through this each year with booster doses?

A. As more and more people are lining up to get their second doses sooner than later in the hopes of resuming their pre-pandemic lifestyle, many have found themselves needing to take a day or two off to recover. Though this may sound daunting and may lead to hesitancy towards receiving that second shot, remember that two doses are needed to ensure you are fully vaccinated. Recall that the efficacy of two doses is far superior against the infamous Delta variant when compared to one dose.

As well, we are still in a critical, time-sensitive race against the variants which we need to win lest we be plagued by further “waves” and the lockdowns and possible new variants that come along with them.

For those in doubt, consider the case numbers in Timmins, part of the Porcupine Health Unit, and other parts of Grey-Bruce currently. We are all tired of the restrictions forced upon us for so long and are hoping that once the restrictions are fully removed that we will not have to endure yet another lockdown. For that wish to come true, we need to ensure that we get the majority of our population fully vaccinated as quickly as is possible.

The side effects that might come with an injection and may make you hesitant mimic a mild to severe flu-like syndrome such as;

· Fatigue
· Headache
· Muscle aches
· Fever
· Chills
· Nausea
· Sore arm, redness and swelling at the injection site

Not everyone will have the same experience. If you do suffer from some of these side effects, know that it is short-lived (typically 1 to 2 days on average) and understand that it is the vaccine working its magic. Feel free to take what you would normally take for such ailments such as ibuprofen (Advil) or acetaminophen (Tylenol). Not everyone can safely take these medications due to their medical history so if you are unsure, consult your pharmacist. However, do not be alarmed if you get a vaccine and feel perfectly fine afterwards either. Not having much in the way of side-effects does not mean that the vaccine is not working in your body either.

As for booster doses, it is looking more likely that we will be needing to go through another round of vaccinations, particularly in the case of the most vulnerable (elderly, immunocompromised) among us. There is some evidence showing that transplant patients may not have the required antibodies after the typical two-dose series of a COVID vaccine. A study in France using the Pfizer vaccine with 101 transplant recipients showed a third dose greatly improved their immune response.

Another study at John Hopkins University in the States with 30 transplant recipients showed some mixed results. Six of them had mild benefit after two doses and showed increased immunity after the third dose. Some patients were negative after two doses (i.e. they had no immune response) but showed promising results after the third while 16 people were still negative for antibodies, even after three doses. Studies are still ongoing so hopefully we will know more in the near future.

For the non-transplant crowd, studies are also under way to determine how long immunity will last and when a booster dose might be needed. The debate is not if, but when, we may need the third dose. Britain is considering a booster dose starting this September for those over 70 years old, those living in care homes, the immunosuppressed and anyone else considered vulnerable. This is amidst the campaign to get the younger generation their first and second doses yet.

With respect to the mRNA vaccines in the general population, according to the New York Times, it is suggested that the typical immune response from them could last years suggesting that a booster dose is not imminently required. That is great news providing the virus and its variants do not continue to evolve which would then quite possibly affect this decision. This is yet another reason why it is so important that everyone, at least those who can, get vaccinated. Refusing to get a vaccine is a choice that quite possibly affects everyone else around them in a negative way.

For those who are feeling pressure to get vaccinated, that’s a good thing in our opinion. Perhaps that is your conscious nagging away at you. We do not allow second-hand smoke in our restaurants, driving with a blood alcohol of 0.05 or exceeding 50km in a school zone. None of these actions guarantee negative outcomes for our fellow citizens, but they do increase the chances of that occurring. We do not have a “right” to imperil others.

There may come a time soon when we know enough about this disease (and that time is not now) that we may need to risk upsetting those that refuse to do their part by restricting their ability to engage in activities beyond just preventing them from crossing borders. On a less controversial note, this study also showed that individuals who were vaccinated and were previously infected with COVID-19 (thus naturally having some immunity) may not need booster doses.

All in all, the jury is still out with respect to booster doses. It looks like we all need to keep abreast of the information as it continues to unfold. As we learn more, we will try to share that information with you.  For more information on this or any other topic, contact your pharmacist.