The first COVID-19 vaccines might be around the corner, but the side effects won’t be a walk in the park, doctors say.
That could be a problem given that both of the first vaccines likely to arrive on the market require doses to be given twice. This isn’t unusual for a vaccine, but it presents a logistical challenge for an inoculation intended to stop a pandemic.
“We really need to make patients aware that this is not going to be a walk in the park,” Dr. Sandra Fryhofer of the American Medical Association said during a virtual meeting with the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices on Nov. 23, according to CNBC.
“They are going to know they had a vaccine. They are probably not going to feel wonderful. But they’ve got to come back for that second dose.”
Both Moderna and Pfizer have reported their vaccines are over 90 percent effective, but that’s if they’re given in two staggered doses. In trials, the doses of Moderna’s vaccine were given four weeks apart, whereas the Pfizer vaccine had two shots three weeks apart.
Some participants in both trials described having serious side effects, with one telling CNBC he had such bad chills he cracked a tooth and another saying he experienced “full-on Covid-like symptoms.”
A North Carolina woman in her 50s who experienced side effects said she didn’t have a fever but ended up with a severe migraine after the second dose. After taking pain relievers and getting sleep, she felt better — but she told CNBC drug companies should warn people they’ll need to take a “day off” after the second shot.
“If this proves to work, people are going to have to toughen up,” she said.
“The first dose is no big deal. And then the second dose will definitely put you down for the day for sure. … You will need to take a day off after the second dose.”
Both Moderna and Pfizer have said vaccine recipients might experience symptoms not unlike a mild case of COVID-19 — including a high fever, muscle chills and a headache. Participants contacted by CNBC said the symptoms didn’t last longer than a day.
Some patients, however, might experience what’s known as “reactogenicity” — transient, severe side effects from the immune reaction the vaccine provokes.
“As long as the side effects of eventual Covid-19 vaccines are transient and not severe, these would not be sources of alarm — in fact, they may be signals of an immune system lurching into gear,” Helen Branswell wrote in Stat. “It’s a simple fact that some vaccines are more unpleasant to take than others. Think about the pain of a tetanus shot, for instance.
“But experts say it makes sense to prepare people now for the possibility that Covid-19 vaccines may be reactogenic.”
Doctors say there needs to be education about side effects if the number of vaccine recipients needed to acquire herd immunity is to be reached. One doctor said companies should use language such as “response” instead of “adverse reaction” when talking about side effects.
“These are immune responses,” Patsy Stinchfield, a nurse practitioner with Children’s Minnesota and a former voting member of the Advisory Committee on Immunization Practices, told CNBC.
“And so if you feel something after vaccination, you should expect to feel that,” she said. “When you do, it’s normal to have some arm soreness or fatigue, some body aches and maybe even a fever. It sounds like in some of these trials, maybe even having to stay home from work.”
While news that the COVID-19 vaccines from Moderna and Pfizer were over 90 percent effective had people excited, there have long been questions regarding just how eagerly any vaccine would be taken up by the public.
A Pew Research poll in September found that only 51 percent would definitely or probably take the vaccine, compared with 49 percent who definitely or probably wouldn’t. In May, those numbers were 72 percent who would definitely or probably take it against 27 percent who wouldn’t.
“There are widespread public concerns about aspects of the vaccine development process. On the heels of a pledge from nine pharmaceutical companies to ensure that a potential vaccine would meet rigorous standards, the Center survey finds three-quarters of Americans (77%) think it’s very or somewhat likely a COVID-19 vaccine will be approved in the United States before its safety and effectiveness are fully understood,” Pew Research said in a September news release.
“And when asked about the pace of the vaccine approval process, 78% say their greater concern is that it will move too fast, without fully establishing safety and effectiveness, compared with just 20% who are more concerned approval will move too slowly, creating unnecessary delays.”
Part of this has likely been the intimation, from both Democrats and the establishment media, that the Trump administration might rush the vaccines through the approval process without doing the appropriate testing.
The evidence for this was mostly specious, but it made for a fun news-cycle talking point.
A Kaiser Family Foundation poll published in early September found that 62 percent of respondents “are worried that the political pressure from the Trump administration will lead the FDA to rush to approve a coronavirus vaccine without making sure that it is safe and effective — including 85% of Democrats and 61% of independents.” Only 35 percent of Republicans expressed concern.
Considering this poisoning of the water, a vaccine might be a difficult sell, particularly if there’s significant reactogenicity.
Whether experts can convince a divided, scared America remains an open question, no matter how effective the vaccines are.
CORRECTION, Nov. 30, 2020: An earlier version of this story gave an incorrect month for publication of the Kaiser Family Foundation poll.
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