Ask the Pharmacist

Q. I was in bed for nearly a week after my first COVID vaccine and am reluctant to get a second dose let alone a booster when it does become available for me. Should I forego getting any further doses?

A. As we discussed last week, at this point in time there are only two valid reasons to be exempt from receiving the COVID vaccine (in Ontario that is, it differs elsewhere. For example B.C. does not offer any exemptions at the moment) and not being subject to restrictions in your choice of activities;

1. Having a true allergy to one of the components of the vaccine that has been verified by either an allergist or an immunologist (i.e. your family doctor writing you a note is not good enough).

2. Having experienced myocarditis or pericarditis (conditions associated with inflammation of the heart) with the first dose of an mRNA vaccine.

That being said, some people may experience an adverse reaction (i.e. a side effect) that is not considered to be allergic in nature but can still be very cumbersome and debilitating. There are also some individuals that have found the vaccine may have exacerbated their symptoms of their underlying medical condition such as fibromyalgia or chronic fatigue syndrome to name a couple. There are not many reports or studies confirming or denying if the vaccine does indeed worsen symptoms of some illnesses. However, you know how you felt after your vaccine dose and do not need a study to tell you whether or not it may have aggravated your condition. There is a very good chance (but it is not a certainty) that you will have some kind of reaction with a future dose of the vaccine. It may be similar, more intense or less extreme. There is unfortunately no way to know beforehand.

It is extremely unlikely that it will be severe enough for you to require hospitalization, but these adverse effects, albeit temporary, can still be quite unpleasant. To decide whether or not you should get further COVID vaccine doses will depend entirely on what your life choices will be going forward. Since it is not considered to be one of the valid reasons for being exempt from the vaccine, you will have to decide for yourself whether you wish to complete the series and get your vaccine certificate. Ontario has opted to call it a vaccine certificate but it is in essence the same idea as a passport that some other provinces have elected to call it. This certificate will prove that you are fully vaccinated and thus allowed to enter the following destinations in our province;

· Restaurants and bars (excluding patios which are open to all)
· Nightclubs (including outdoor areas)
· Meeting and event spaces
· Sports and fitness facilities (excluding youth recreation)
· Sporting events
· Casinos, bingo halls
· Concerts, music festivals, theatres
· Strip clubs, bathhouses and sex clubs
· Racing venues

Fully vaccinated definitions vary amongst the provinces and territories but in Ontario, fully vaccinated means 14 days after your second COVID vaccine dose. This all comes into play on September 22nd and you will require either an electronic copy or a paper copy of your vaccination receipts along with photo identification to prove that the vaccination receipt indeed belongs to you. On October 22nd, the Ontario government will require you to update your vaccine verification to one that utilizes a QR code for businesses to scan. This QR code can be printed off to provide you with a hardcopy version or you may opt to have a PDF version that you can screenshot onto your mobile device. The province assures us that a new “app” will be up and functional by this date that can be downloaded onto a smartphone or tablet to be used by both consumers and businesses that will make scanning a QR code simple. Time will tell.

As of now, the following individuals are eligible to receive a booster dose as long as it has been at least eight weeks after their second COVID vaccine;

· Transplant recipients which include solid organ transplant and hematopoietic stem cell transplants
· Individuals receiving treatment with an anti-CD20 agent such as rituximab
· Individuals who are receiving active treatment for malignant hematologic disorders

To receive this booster dose, you must show a referral letter from your health care provider stating one of the above indications. Many local pharmacies are continuing to administer vaccines so if you are eligible, by all means contact one of them to book an injection at a mutually agreeable time.

While we are attempting to get back to our new normal and engage in indoor and/or large group activities, some are now scrambling to get themselves vaccinated with a first dose while others are looking to get their third dose. The individuals under 12 years of age are exempt from the vaccine certificate at this point in time but it is only a matter of time before the vaccine is approved in those aged 5 to 11 years.

For more information about this or any other health related questions, contact your pharmacist.