January 5, 2021

Life/Science: COVID19 vaccination 1/5/2021

 I work at Department of Medicine, and my worksite is in the middle of the hospital complex in downtown OKC.

 Through worksite, I got invitation to get COVID19 vaccine on 12/26/2020 (which I dismissed) and then on 12/30/2020.  

The vaccine was available earlier than I anticipated. I took the offer and signed up for 1/5/2020 slot. It was free of charge on my side. Like flu vaccine, my worksite group insurance takes care of the cost.


Today I showed up on time for the appointment. There was a long line with about 1 hour waiting time. Injection itself took about 3 minutes, then 15 minutes observation wait afterwards. The first dose is done. So far, so good. Booking for the 2nd dose was smooth as well. 


                                         [1/5/2021 Moderna vaccine 1st dose]


As vaccine is supposed to rev up my immune system, some sore and fatigue are expected. In both Pfizer and Moderna phase 3 clinical trials, pain at injection site, muscle sore, headache and fatigue were most common reactions. I'll see if I get any reaction from this COVID19 vaccine, with Ibuprofen in my hand just in case. 

I happened to have taken Moderna one today. Pfizer one is also available, depending on availability and date. They will clearly state which one you'd get.


The vaccine first arrived at the state of Oklahoma on 12/18-19/2020. The medical system here is being stressed. Currently, regional hospitals are with 20-39% bed occupancy/tier 3, on the verge of close down (tier 4) again. As such, arrival of the vaccine is indeed a good news. Distribution began from frontline healthcare workers (doctors, nurses, hospital site maintenance, and other workers), then nursing home residents and staff, followed by first responders. Soon the invitation should be extended to other groups by age (65+) or by risk, depending on the state/city/community-determined priorities. 


On side effects

Sure, at first I was somewhat concerned about site effects and all. But apparently the reports of site effects are rare, and I have not heard of any frontline healthcare people dropping dead or anything from the COVID19 vaccination. 

Very bad case of acute side effects would be anaphylaxis (severe allergic reaction), which was observed in several among millions (=extremely (negligibly) rare). As the rare site effects surfaced, they addressed it in the procedures. People with previous anaphylaxis history are recommended to take anti-histamine med (Zyrtec etc) beforehand. For all, they set up 15 minutes observation time after vaccination, so that had severe allergic reaction occur, they can take care of it with epi-pen type treatment immediately on site.

As such, acute side effects are of little concern now.


For other "long term effects", comparing "vaccine and its potential side effects" with "no vaccine-no side effects" is poor comparison. In this case, proper comparison is "vaccinated" vs "unvaccinated"; or "possibilities of bad side effects of vaccine, acute and long term" vs "possibilities of bad effects of real thing, SARS-COV2 virus and COVID19, acute and long term".

I'll take vaccine rather than getting real COVID19 any time. As of early Jan 2021, even in this small state of Oklahoma with 4 million population, there are 3000-5000 new diagnosis daily. With this community spread, risk of infection has risen so much. I better get the vaccine as soon as possible. (In other words, places/countries with fewer COVID19 cases may still have some room to be optimistic. Your call.) The merits of vaccine far outweigh demerits here. 


Do the vaccines work?

Number-wise, the phase 3 clinical trial data for Pfizer vaccine is as follows. About 43,500 people signed up. They gave vaccine to a randomized half (18,198) people, and gave placebo to another half (18,325). Vaccine group got 8 people with confirmed COVID19, while placebo group got 162. They calculated it as 95% effective. The numbers for Moderna are not so different.

The numbers look good. Giving vaccine to ~18,200 people led to prevent COVID19 for 154 (162 minus 8) people. In other words, if 1 million people is vaccinated, the number would translate to 8,460 people saved from COVID19 (154 x 1,000,000/18,200). Without vaccine, 8,852 among 1 million may have COVID19 (at the time of the clinical trial. This may change if/when pandemic spread). For preventive medicine, the numbers are quite good. Although some may argue 8,852 among 1 mil is not a big number, note that they are numbers of diagnosed COVID19 that are likely contagious. Reducing the number contributes to end this pandemic.


Timeframe

After vaccination, it would take 10-14 days before the protective effects kick in. They estimate that about 50% protection would be achieved with single inoculation. I am supposed to get another inoculation in 4 weeks (for Moderna vaccine). After that, it would give me about 95% protective effects. 

Then, assuming I'll take another dose as scheduled on early February, by mid-late February I would be getting ready to put this pandemic behind, with biomedical protection the vaccine can provide and with sense of security. No more rolling dices of COVID19. How nice.


There are reports of mutated virus, but current vaccine should work against the mutated virus as well. If other mutated virus strains that evade current vaccines develop, its time for Pfizer, Moderna, and all others to work again. I am not concerned so much at this moment. 


I happened to have gotten a relatively early access to the vaccine via worksite, which is fortunate. It will take some more time for the vaccines to roll out in broader population. In the meantime, I'll wear my mask, wash hands, and keep social distancing.