The COVID Vaccine – What should you expect?

Audrey Tolouian EdD, MSN, BASW, RN-CNE
Clinical Assistant Professor
ACUE Credentialed Educator
School of Nursing, The University of Texas at El Paso, USA

COVID-19 has now been around for a little over a year, and over the past few months, vaccines have been rolling out. There are several two dose vaccines that have been approved for emergency use for the pandemic, as well as several more that should be approved soon, requiring only a single dose (Pfizer, 2021).

There has been a fair amount of speculation about the vaccine and what happens to the body once one receives it…Chances are that if you are over age 16, the vaccine will be in your near future so, and you may be wondering. So, here is my account from a nursing perspective.

When I arrived at the clinic for my vaccine, they asked me a fair number of screening questions. The typical allergies, name, date of birth etc..- but then they asked more specific questions that I did not expect as part of this screening and feel they are fairly important to pass on:

  1. Any other vaccines in the last two weeks?
  2. Have you had a positive diagnosis of COVID-19 or received monoclonal antibody therapy?
  3. Botox or fillers in the last two weeks? (CDC, 2021,a)

So, why are they asking those questions? I had to find out.

For previous vaccines in the last two weeks- they want to know so that

The current recommendation is that people do not receive the vaccine within two weeks of receiving another type of vaccine. There has not been any research done to identify the outcomes of this. The CDC recommends at this time to avoid. (CDC, 2021,a)

Previous COVID Dx:

Antibodies stay for approximately 90 days, so it is recommended that they delay getting the vaccine, until more doses are available. (National Center for Immunization and Respiratory Diseases, 2021).

Botox/Filler:

“In the Moderna mRNA-1273 trial, three reactions were possibly related to dermal fillers out of 15,184 vaccine recipients. It is unknown how many subjects    in the trial had previous treatment with dermal fillers.” (Avram, et al, 2021)

The first dose of the vaccine was pretty benign. The injection is given in the upper arm- the deltoid muscle. Because the injection needs to be given in the muscle, a fairly large gauge needle is used- typically between a 22 and a 25, with needle sizes the smaller the number the larger the needle bore (Nakajima et al, 2017). Intramuscular injections typically cause a fair amount of pain afterwards- and this one was no different. Similar to a tetanus shot. Due to the type of vaccine, it needs to be delivered into the muscle.

Once the injection is given, they ask for you to wait for 15 minutes for observation period. During this time they are watching you for any type of allergic reaction- trouble breathing, dizziness, itchy tongue etc- this period is extended to 30 minutes if you have had any type of anaphaylaxis in the past (Pfizer, 2021). For me, about 5 minutes after the vaccine I got very anxious- I did some pranayama breathing and it settled down before my 15 minutes was up. Over the next few weeks- I spoke to a dozen or so other people that felt anxious after the vaccine too.

I had typical arm soreness that extended down to my wrist the next day- nothing that acetaminophen did not resolve. I also woke up feeling pretty achy- but this resolves as soon as I went for my morning walk…That was it, no other effects.

The second dose is given a minimum of 21- 28 days after the first dose- but be sure to check what your wait time is as it varies depending on the brand. It is also very important to make sure that you receive the same brand each time as there has not been any research to determine the effects of two different brands of vaccine (Pfizer, 2021). Again it is administered into the deltoid muscle in the upper arm. I used the opposite arm from the last time- and hardly felt it go in. This time my 15 minutes passed very quickly without incident.

Later that evening- about 5 hours after the injection I started to feel a little bit nauseous, but not too bad. That night I had difficulty sleeping, I was very achy, and my fingers swelled enough that I had to remove my wedding rings. The next day I continued to be achy, I was pretty tired, with a mild temperature, and my arm was very sore. All of this was expected after the second dose. After the second dose, they tell you to expect to feel flu-like symptoms (CDC, 2021c), and they were correct. I followed the guidelines and drank plenty of water, ate chicken noodle soup, and stayed on the couch and watched NetFlix- Ok, the last one was not in the guidelines, but it helped me to pass the day, and actually enjoy the break from work! I went to bed early that night and when I woke up the next day, I felt fine. So, a basic timeline, 5 hours after the injection I had nausea, at 10 hours: I started to get achy and my fingers swelled-this continued for about 12 hours, I had a good sleep and felt better.

All in all the experience was not too bad, I would definitely do it again, and I as a nurse, I have no reservations that I took the vaccine. If a day on the couch with mild flu-like symptoms was the worst I felt during the pandemic- I consider myself very lucky. It will be interesting to watch the new trials as more medications and vaccines are created to help stop this pandemic. Here is the website to check them out yourself! www.clinicaltrials.gov.

References:

Avram, M., Bertucci, V., Cox, S., Jones, D., & Mariwalla, K. (2020, December 28).
Guidance 2. Regarding SARS-CoV-2 mRNA Vaccine Side Effects in Dermal   Filler Patients.
https://www.asds.net/Portals/0/PDF/secure/ASDS-SARS-CoV-2-Vaccine-Guidance.pdf

CDC. (2021). Prevaccination checklist for COVID-19 vaccines.

https://www.cdc.gov/vaccines/covid-19/downloads/pre-vaccination-screening-form.pdf

CDC. (2021). Pfizer-BioNTech COVID-19 vaccine standing orders for administering vaccine to persons 16 years of age and older.

https://doh.sd.gov/documents/COVID19/Vaccine/Pfizer_StandingOrders.pdf

CDC. (2021). What to expect after getting a COVID-19 vaccine.

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/pdfs/321466-A_FS_What_Expect_COVID-19_Vax_Final_12.13.20.pdf

Nakajima, Y., Mukai, K., Takaoka, K., Hirose, T., Morishita, K., Yamamoto, T., Yoshida, Y., Urai, T., & Nakatani, T. (2017). Establishing a new appropriate intramuscular injection site in the deltoid muscle. Human vaccines & immunotherapeutics13(9), 2123–2129.

https://doi.org/10.1080/21645515.2017.1334747

National Center for Immunization and Respiratory Diseases. (2021). Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States.

https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html

Pfizer. (2021). Emergency use fact sheet for healthcare providers administering vaccine
(vaccination providers). https://www.fda.gov/media/144413/download

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