As you probably know, the vaccination program for COVID-19 has begun. While it is not the role of an environmental center to tell you whether or not to get the vaccine, we believe it is our job to provide information on this topic as a member of your community and an education center.
I am going to switch to first person here and give you a little background on my credentials and let you know my own plan for the COVID-19 vaccine. My name is Dr. Kristen Lycett and I am a staff member at the Phillips Wharf Environmental Center. While my doctoral degree is in Marine Estuarine Environmental Science, I spent 5 ½ years in a molecular biology lab, working with microorganisms, DNA, and RNA. And while I plan to get vaccinated when I am eligible, I fully support your decision not to get vaccinated or to wait.
I want Phillips Wharf to be a supportive member of our community, so my goal in sharing this information is to allow you to make your own decision and learn when and where you can sign up to get vaccinated if that is what you choose to do. Many people have questions about the safety of the vaccine and when they may be eligible to receive it. There is a lot of information out there on this topic right now and it can be hard to actually find what you need.
Is the vaccine safe?
First, it is up to you to decide if the vaccine is safe. Many people do experience side effects including; injection site pain, fatigue, headache, muscle pain, chills, joint pain, and fever. Side effects such as these are common with any vaccination, not just the COVID-19 vaccine, and are signs that your immune system is doing its job. In the case of the COVID-19 vaccine, it means your body is creating antibodies to the protein blueprint contained in the vaccine. What is different about the new COVID-19 vaccines is that they do not contain any living or dead viral cells; they only contain the messenger RNA (mRNA) that encodes for a single protein on the outside of the virus. Your body reads the mRNA and produces just the protein, then identifies it as foreign and attacks it. This is what generates an immune response and creates the antibodies that will provide you with future immunity. It’s also important to note that mRNA is very short lived so it does not stick around inside your body for long, nor will it alter your genetic information in any way.
In rare cases, some people experience a severe allergic reaction after receiving a COVID-19 vaccine. Because of this, the Centers for Disease Control (CDC) recommends that if you have ever had an allergic reaction to a vaccine or if you are allergic to any ingredient in the vaccine, you should speak with your doctor about whether or not you should get vaccinated. It may be that you need additional attention after being vaccinated to monitor for an allergic reaction, which can then be treated. For a list of ingredients in both vaccines, see the very end of this article.
You should also be aware that some news outlets are reporting a lower rate of side effects in the Pfizer vaccine as compared to the Moderna vaccine, but that may change as more people are vaccinated. Others report that side effects are more intense after the second shot, compared to the first for both vaccines. Regardless, it is recommended that you do not get vaccinated and then go to work - get your shot at the end of the day or on a day when you are off. This way, you can rest, get lots of fluids, and allow your body to focus on generating antibodies. I personally, will do the same things I do when I feel like I am getting sick, in advance of getting vaccinated. This means getting plenty of fluids and rest, avoiding alcohol and increasing my vitamin C intake. I can't say for sure that this will reduce potential side-effects but my hope is that it will help my body produce antibodies more efficiently.
A very small number of people in both the Pfizer and Moderna trials experienced Bell’s Palsy after receiving the COVID-19 vaccine. The cause of this is unknown, but involves swelling of a facial nerve that results in weakness of facial muscles. This makes one side of the face appear to droop, such as is seen in some stroke victims. However, in the case of Bell’s Palsy, this weakness is usually temporary, though it may take several weeks for a full recovery (source).
Now how likely you are to experience this side effect? Pfizer had 10,841 participants receive the vaccine, with 4 experiencing Bell’s Palsy. Moderna had 14,134 participants receive the vaccine, with 3 experiencing Bell’s Palsy. This means that the odds of experiencing Bell's Palsy from the COVID-19 vaccine is roughly 7 in 24,975, which is a less than 0.03% chance. It’s also important to note that in the US, you have a 0.023% chance of developing Bell’s Palsy without getting vaccinated, so the chances of this side effect occurring after vaccination are only slightly higher than your chances of getting it naturally. Regardless, this is a potential side effect that you may experience so you should be aware of that chance.
Deaths due to the vaccine
Ok, now let's talk about deaths associated with the COVID-19 vaccine. In the United States, over 17.4 million people have received the initial dose of the vaccine as of January 23rd (source). So far, there has been a single reported death that has not yet been confirmed to be connected to the COVID-19 vaccine. A 56 year old doctor in Florida died several weeks after receiving his first dose. Reportedly, he was admitted to the ER three days after receiving the shot due to internal bleeding and was suffering from a condition known as thrombocytopenia (source). While this condition has been linked to the measles, mumps, and rubella (MMR) vaccine in children, it is also linked to other underlying conditions such as heavy drinking, anemia, exposure to some toxins, viruses, and cancer. To date, no other cases of thrombocytopenia have been linked to the COVID-19 vaccine, nor have there been any other US deaths reported.
However, Norway has reported multiple deaths after vaccination. To date, 33 deaths have occurred in people who were recently vaccinated (source). The difference in Norway's vaccination plan is that they are focused on the elderly first. All of these deaths appear to be in adults over the age of 75, especially those over the age of 80, many of whom likely had underlying conditions and were already in poor health. What this suggests is that if you are sick, you may want to wait until you are in better health before receiving the vaccine. If you are sick, the common side effects (such as fever) may become severe and possibly life-threatening and any existing conditions may become worse.
These deaths may also mean that adults over 80 (or even 75) should not be vaccinated if they have severe underlying conditions. As additional vaccines are approved and the US rollout of the vaccination program is expanded to include older adults, we will likely see additional recommendations for this age group, so if you or your loved ones fall into this category, you may want to wait to get vaccinated. Your doctor or healthcare provider is a good person to discuss your concerns with as they should be familiar with any underlying conditions you may have.
Johnson & Johnson is developing a COVID vaccine that is not an mRNA vaccine. So far, the early trials suggest fewer side effects from this vaccine. However, it does contain modified form of a live adenovirus. This is also a fairly new vaccine technology, which uses a weakened form of the adenovirus virus to bring a small piece of coronavirus DNA into your body to generate an immune response and antibodies. One of the good things about this version of the vaccine is that because the genetic information is in the form of DNA, it is more stable than the mRNA vaccines. This means it can be stored at a less extreme temperature and for longer periods of time, meaning it can be distributed in less developed countries that don't have access to low temperature freezers.
The new Johnson & Johnson vaccine is also being tested using both a single dose and an initial dose with a follow up booster shot. Depending on the results of the phase 3 trials that are currently underway, a single dose of the vaccine may provide immunity, instead of the two doses currently required for both the Moderna and Pfizer vaccines (source). The results of the Phase 3 trials should be published in the next few weeks and may result in Emergency Use Authorization by the US government. If given, this authorization will allow for distribution of this vaccine to begin, possibly as early as February 2021. Depending upon the results of the Phase 3 trial, it may be better to get this vaccine if you are worried about side effects, especially for older folks with severe underlying conditions.
If I want the vaccine, how do I get it?
Ok, so if you have decided to get the vaccine, when and where can you do it? Every state has a different plan for rolling out the vaccine, but since Phillips Wharf is in Maryland, that’s the state I will be focusing on here. If you’d like information on a different state, check out your state health department website.
In Maryland, we have a tiered system. As of January 18th, we have entered phase 1B, which includes those who live in assisted living facilities, adults 75 and older, educators and some government officials. Already completed in phase 1A were healthcare workers and emergency management service personnel. Individual counties may be on different phases based on their population size and the number of individuals in particular groups, such as health care workers.
Here in Talbot county, if you are in a group because of your employment status, the county should be working with your employer to schedule vaccines, as was done for healthcare workers. For those that were missed, a form was created by the county for individuals to self-identify and get on the vaccination list. This may be the continued format as we move into additional phases.
If you are in a group based on age, you must go to the Talbot County Health Department website to pre-register. Currently, only adults 75 and older and adults 65 to 74 are able to pre-register. The forms to pre-register are available here and new forms will likely be added as we move into phase 1C, which includes essential workers. What will likely happen is that, based on the information provided in these forms, you will be contacted to schedule your vaccination appointment. Those with pre-existing conditions will likely be contacted first, so be sure to include that information when you fill out the pre-registration survey. Pre-existing conditions include cancer, type 1 and 2 diabetes, kidney disease, and heart conditions. For a full list according to the CDC, click here.
Many counties in Maryland have their own websites devoted to COVID-19 information, so if you reside in another county and want to learn more about vaccination, be sure to check there. Many of these county programs also have Facebook pages where COVID information is shared daily, so following these pages and liking their posts will allow you to get timely updates on vaccination information. I personally follow the COVID pages for Talbot County, Dorchester County, and Wicomico County so that I can keep an eye on new infections in my county and those around me.
Keep up your safety protocols
The final thing to remember is that even if you get vaccinated, you may still be able to transmit COVID-19 to others. This is especially important for those who work or live with others that may be in a later vaccination group. Social distancing, masks, and good personal hygiene such as hand washing are still important steps to protect the people around you. I believe this is very important for families with children to remember, as the current vaccines were not tested on children younger than 16. Trials for children under 16 are currently underway but large scale vaccination of this age group will likely not occur until summer 2021 or even later.
I plan to get vaccinated as soon as I am able but it is understandable if you are still hesitant about these vaccines. I hope that this information helps you better understand the risks associated with these vaccines so that you can talk to your doctor and your family and determine what is the best course of action for you.
Dr. Kristen Lycett
Vaccine Ingredients - if you know what these are, you probably have a degree in biochemistry!
Moderna ingredients: messenger ribonucleic acid (mRNA), lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]), tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose (source).
Pfizer ingredients: lipids (0.43 mg), 4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate), 0.05 mg 2[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide, 0.09 mg 1,2-distearoyl-sn-glycero-3-phosphocholine, and 0.2 mg cholesterol), 0.01 mg potassium chloride, 0.01 mg monobasic potassium phosphate, 0.36 mg sodium chloride, 0.07 mg dibasic sodium phosphate dihydrate, and 6 mg sucrose. The diluent (0.9% Sodium Chloride Injection, USP) contributes an additional 2.16 mg sodium chloride per dose (source).