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Tue, Apr

The COVID-19 Vaccines Work. The Best Side Effect: Surviving the Pandemic!

LOS ANGELES

THE DOCTOR IS IN--I just got my second Moderna vaccination shot yesterday (2/6/2020), and frankly I couldn't wait to get it fast enough.

These vaccines have taken by far too long to get to health care workers, let alone those over 65. There are definite side effects, but they are far worth the inconvenience to survive this terrible COVID-19 pandemic. 

There are up to 25% or more health care workers who don't want the vaccinations, but some hospitals and medical groups will mandate them to stay employed there. Within the first month of the vaccines showing up, less than 40% got the vaccines. 

Of course, the "newness" of the vaccines scare many people, and there are many reading this who refuse vaccines of any sort. They certainly do have side effects, but they are temporary. You will get muscle soreness at the location of the shot, you will feel tired, and you might get a sore throat. 

File this under "who cares", please! If you have a good workout at the gym, your muscles will feel sore but they will also grow. Ditto for the vaccine side effects. Just give yourself 2-3 days to get over them (the same after you get a good workout, right?). I did each of mine during a Saturday morning, and by Monday morning I was and will be good to go. 

Now some Frequently Asked Questions: 

1) Are some vaccines better than others? 

Our three vaccines (there are the two-shot Moderna and Pfizer vaccines, and the new single shot Johnson and Johnson (J & J) vaccine) appear to work very well. The first two vaccines are the earliest, and did not get studied against the newer, more aggressive COVID-19 variants in South Africa and South America. The J & J, however, did. They will each be approximately 85% against severe cases of all virus variants, and 70% is considered to be pretty darned good. 

2) Is the vaccine free? 

Yes! Your insurance information might be asked for, but even with no insurance you will pay nothing. 

3) Can I choose which vaccine I will get? 

Probably not. The availability of each vaccine, and the ability to refrigerate or freeze a given vaccine makes them unable to allow us a "choice". Furthermore, right now the national and local health officials conducting our vaccination program want as many individuals vaccinated as possible, and as fast as possible. The J & J vaccine allows a new wave of vaccines to get into Americans' arms. 

And remember: if you need two doses (Pfizer and Moderna), there will be that second dose stored and waiting for you after your first vaccination. Other nations are playing around with delaying or splitting doses to get more citizens vaccinated, but the United States is not. 

Three weeks between doses are needed for the Pfizer vaccine, and four weeks for the Moderna vaccine, and the J & J vaccine needs only one dose. Approximately two weeks after each vaccine, you should be protected. 

4) Can't I just get COVID-19 "naturally" to get immunized the old-fashioned way, and just get through it because so very few die? 

You certainly can, but you are playing Russian Roulette! Some people get just a cold, some people get a two-week flu-like syndrome, many people become permanently disabled with long-lasting lung and vascular damage, and some just die (even if they're healthy). Furthermore, "natural" exposure and vaccination both lasts only 5-6 months and does not always allow you protection against newer variants.  

On the other hand, the vaccinations appear to give you protection for at least a year. So, get vaccinated! If you get COVID-19 between the two doses, you have to wait 3 months before you get that second shot...but get it! 

By the way, ongoing evidence suggest that the deep cleaning of doorknobs and surfaces is being overplayed when that might not be needed. 

5) Where can I get vaccinated? 

Do it through a hospital you're affiliated with, a medical group you're affiliated with, or a public location (like Dodger Stadium). Go online. Those over 65 get first dibs, because they're more at risk. But let's make something clear: people in their 30's, 40's, and 50's have also died. We cannot get vaccinated fast enough, and only when there's about 75% of our total population or more immunized can we all throw away our masks. 

6) Wait a minute--even after I get vaccinated, I still have to wear a mask and do the social distancing thing? 

Sadly, yes. The vaccines prevent the virus from overwhelming you if you're exposed, but even if you never know if or when you might be exposed, you can still pass it to others. It's the same thing with the measles, the influenza virus, or Hepatitis B. The vaccinations won't work in a society to provide "herd immunity" unless the overwhelming majority of that society gets immunized.  

And the concerns about newer, aggressive mutations are admittedly and honestly adding to our collective exhaustion that this viral pandemic and its societal effects aren't going to end soon. 

But increasing evidence shows that our schools need to open, and our teachers should be prioritized for vaccination to allow students to go back to school. We need to prioritize our children, who are suffering horribly from the psychologic effects of the longstanding lockdown. 

And both the American Academy of Pediatrics and the CDC are in agreement that schools can open right NOW without immunizing teachers although pragmatically the teachers should be vaccinated to allay their personal fears. 

7) Shouldn't I stop any immunosuppressive medicines for rheumatologic, dermatologic, GI, or autoimmune diseases during this virus? 

Don't...you...dare!!! It is not the virus that disables or kills you, but rather your own immune response that disables or even kills you. For example, why do we feel so awful during the common cold? The sniffling might be the virus finding a way to spread it from person to person, but the fevers and chills we get are due to our own body creating substances (such as cytokines and interferon) to stop the virus from replicating throughout your body. 

Therefore, you should remember that Methotrexate, Humira, Cosentyx, Enbrel, Taltz and other medications can even save your life by preventing your own host response from hurting you. The big exception is Prednisone (or other steroids), yet that's what we give people who actually get serious COVID-19 syndromes. Talk to your doctor or other provider, and make darned sure they know about this phenomenon, because many do not. 

Remember that it's not the virus that kills or disables a person, it's your own immune system, which is why you should not be afraid of the side effects of the vaccines. 

8) So, wait a minute...how long will the vaccines protect me? What about new strains of the virus, if it mutates? 

Sadly, it's not like the polio virus that has only three types, and which can therefore be "cured" for your life with the trivalent vaccine we've all gotten as kids. It's not like the two-shot shingles vaccine (90 days apart) which is pretty darned long-lasting (Shingrix) and recommended for everyone over 50 years of age. The Shingrix shots hurt more than the flu vaccine, but a whole lot less than shingles! 

Both the influenza (flu) and COVID-19 virus mutates enough so that a good likelihood of annual boosters and altered proteins/mRNA will be needed for indefinite future. Maybe it will be less than every year for COVID-19, but there is definitely a need for an annual flu shot...but if the world gets immunized to the flu, most of our society survives what used to be devastating annual bursts of hospitalizations and deaths. Ditto for the COVID-19 and related variants. 

Count this as an unfortunate side effect of living in a world that's got a lot smaller, and one that allows travel and commerce to other nations throughout the planet. 

9) What if we get enough of our population vaccinated? 

Good news: if enough of us get vaccinated, the virus has nowhere to go and new cases will plummet. The smaller nation of Israel has had many vaccinated, and of those who got two shots of the Pfizer vaccine, only 0.04% caught COVID-19. 

But we're also smart enough to vaccinate our nation and world. I am on my way to being at least 85% protected from COVID-19. Please do what it takes to be in that happy place, and if enough of us do this, we can throw away our unpleasant masks, hug each other, and go back to our jobs and the vacations we not so long ago took for granted!

 

(Kenneth S. Alpern, M.D, is a dermatologist who has served in clinics in Los Angeles, Orange, and Riverside Counties, and is a proud husband and father to two cherished children and a wonderful wife. He was termed out of the Mar Vista Community Council (MVCC) twice after two stints as a Board member for 8-9 years and is also a Board member of the Westside Village Homeowners Association. He previously co-chaired the MVCC Outreach, Planning, and Transportation/Infrastructure Committees. He was previously co-chair of the CD11 Transportation Advisory Committee, the grassroots Friends of the Green Line (which focused on a Green Line/LAX connection), and the nonprofit Transit Coalition, and can be reached at [email protected]. The views expressed in this article are solely those of Dr. Alpern.)

-cw