Coronavirus Immunization Counseling
The most common reported side effects of the vaccines are lymphadenopathy (swelling of lymph nodes), pain/redness/swelling at injection site, fatigue, and headache. We recommend all patients receive their vaccine when they are able to. Studies show minimal side effects as listed above from the vaccine and allergic reactions are rare. The Pfizer and Moderna vaccines are 94% effective against COVID-19 in the general population and significantly reduce symptom severity if you are to acquire the virus. The vaccines cannot give you COVID-19 and they do not alter your DNA. Please see this website for further FAQs.
https://files.ontario.ca/moh-covid-19-vaccines-fact-sheet-en-2021-02-05.pdf
Although many people who have had COVID-19 have no symptoms or mild to moderate symptoms. There are many patients of all ages who have required hospitalization, ICU admissions, and intubation. The COVID-19 virus can lead to respiratory failure and death in some patients. In addition, for those who recover from the virus regardless of the severity of the initial illness there are reports of significantly prolonged recovery times.
Based on the current research, the small risk of adverse reactions from immunization are outweighed by the benefits in terms of protection against acquiring the COVID-19 virus which has a potentially severe initial course of illness, prolonged recovery time and unknown long-term consequences on patients’ chronic health.
Please see below for advice regarding COVID immunization and specific medical conditions/medications you may be on:
Allergic reactions to a COVID vaccine or its ingredients
Severe allergic reaction reactions to the COVID vaccines are rare (~11 cases per million doses administered for Pfizer), but if you experienced an anaphylactic reaction (breathing difficulties requiring epipen) to your first dose, it is NOT advised that you receive a second dose.
If you had an allergic reaction such as hives or swelling within 4 hours of receiving your COVID vaccine (~40-50 cases per million doses for Pfizer), consultation with an allergist/immunologist is required prior to your second dose. Please contact our office to arrange a referral. You will need to provide documentation from an allergist at your appointment for your second dose.
If you are allergic to polyethylene glycol (polysorbates), you should NOT receive the Pfizer or Moderna vaccines
Allergic reactions to any vaccine or injectable therapy
If you have had any form of allergic reaction to any vaccine or injectable therapy you will need to provide documentation that you have discussed the risks and benefits with your healthcare provider prior to being given the COVID vaccine. The risk of an anaphylactic reaction with the Pfizer vaccine is approximately 11 cases per million doses administered and with Moderna vaccine is approximately 2.5 cases per million doses administered. In the studies, patients with an anaphylactic reaction to one of the COVID immunizations often had had a previous anaphylactic reaction to some other allergen. No deaths occurred as a result of anaphylactic reactions to the COVID immunization. The benefits of receiving the COVID vaccine include effective protection against the coronavirus infection and reduction in symptom severity if you are to acquire the virus. If have a history of anaphylactic reactions, it is advised that you bring your EpiPen with you to your immunization appointment. All vaccination clinics are also stocked to manage anaphylactic reactions should they arise. If you experience hives, skin rash, itching, or other symptoms of minor allergic reactions, you may use allergy medications purchased over the counter as required to alleviate your symptoms.
If you have had an allergic reaction to any vaccine or injectable therapy, please call the office and we will be able to provide documentation of the risks and benefits for you to bring to your vaccination appointment
If you have had an anaphylactic reaction to foods, animals, venoms, environment, latex, etc. Your observation period will be extended from 15 minutes to 30 minutes after you receive your immunization. You are still able to receive the vaccine.
Pregnancy and Breastfeeding
If you are pregnant or may be pregnant at the time you are offered the COVID immunization, it is the Society of Obstetricians and Gynecologists of Canada’s (SOGC) consensus that for patients who are at high risk of infection and/or morbidity from COVID-19 that the documented risks of not getting the vaccine outweigh the theorized and undescribed risk of being vaccinated during pregnancy. Most patients with a COVID-19 infection will have mild to moderate symptoms; however, 8-11% of pregnant women require hospitalization and 2-4% ICU admission. Intubation and ventilation rates are also higher in this population. The perinatal morbidity associated with COVID-19 infection also includes higher rates of preterm (early) delivery and C-section. There are some reports of higher rates of stillbirth in women infected with COVID-19 who have severe infection. The Pfizer and Moderna vaccines are mRNA vaccines which do not enter the human nucleus or alter human DNA. They are transported by liposomes which do not cross the placenta. The vaccines have shown great efficacy in preventing symptomatic cases of COVID-19. Pregnant patients were excluded from the vaccination studies, however 12 women who were in the Pfizer trials have since become pregnant and are being monitored.
If you are breastfeeding this is NOT a contraindication to getting the vaccine. You are still able to receive the vaccine while breastfeeding. Women who were breastfeeding were not included in the initial immunization trials. As above the risks of acquiring COVID-19 outweigh the theoretical risks of vaccination while breastfeeding.
If you are pregnant or breastfeeding, you do NOT need to provide documentation of a discussion with your healthcare provider prior to getting your vaccine
Autoimmune conditions
If you have an autoimmune condition but are not currently on medication for it you will need to verbally attest that you have discussed the risks and benefits with your healthcare provider. You do not need to provide written proof. The effectiveness of any vaccine in patients with autoimmune conditions may be less effective than the general public but this does not prevent these patients from receiving the COVID vaccine as some protection is better than 0% protection. Patients with autoimmune conditions were not included in the initial vaccination trials and therefore the exact % effectiveness in this population is unknown. The risks and benefits of the vaccine are otherwise discussed above.
Patients with stable HIV infections are considered immunocompetent.
Medications which may affect the immune system (steroids, chemotherapy, etc.)
Most treatments for autoimmune conditions do not blunt the benefit of the vaccines. If you are on immunosuppresive therapy, you may have a lesser response to immunization which could lead to a lower efficacy in terms of protection against COVID-19 but as mentioned above this efficacy would still be higher than the 0% protection not receiving the vaccine would provide. If you have an autoimmune condition and are on medication managed by a rheumatologist, we would advise you contact their office if you wish to discuss timing of your vaccination between your medication doses or temporarily stopping your medication in order to increase the effectiveness of your vaccination.
There is a possibility of an inflammatory response from immunization, particularly with the mRNA vaccines (Pfizer, Moderna). As such there is a possibility of a short term flare to your autoimmune condition after receiving the vaccine. It is best to be vaccinated when your condition is well controlled.
You will need to verbally attest that you have discussed the risks and benefits of vaccination with your healthcare provider at your appointment. This may serve as this discussion if you are comfortable with the above information.
Bleeding Disorders or Blood Thinners
If you have a bleeding disorder that is well managed you may receive the COVID 19 vaccine. If you are on a blood thinner you may receive the COVID vaccine. We will hold pressure on the injection site for a longer period of time to help the blood clot
Dr Archibald & Dr Priestner
