Is the Second Dose Bad? If I Feel OK, Is It Working? Can I Take Tylenol?

Every day practically three million folks within the United States are getting the Covid-19 vaccine. And each new jab prompts new questions on what to anticipate after vaccination.

Last week I requested readers to ship me their questions on vaccinations. Here are some solutions.

Short-lived negative effects like fatigue, headache, muscle aches and fever are extra widespread after the second dose of each the Pfizer-BioNTech and the Moderna vaccines, which every require two photographs. (The Johnson & Johnson vaccine requires solely a single shot.) Patients who expertise disagreeable negative effects after the second dose usually describe feeling as if they’ve a nasty flu and use phrases like “it flattened me” or “I used to be ineffective for 2 days.” During vaccine research, sufferers have been suggested to schedule a couple of days off work after the second dose simply in case they wanted to spend a day or two in mattress.

Data collected from v-safe, the app everybody is inspired to make use of to trace negative effects after vaccination, additionally present a rise in reported negative effects after the second dose. For occasion, about 29 p.c of individuals reported fatigue after the primary Pfizer-BioNTech shot, however that jumped to 50 p.c after the second dose. Muscle ache rose from 17 p.c after the primary shot to 42 p.c after the second. While solely about 7 p.c of individuals acquired chills and fever after the primary dose, that elevated to about 26 p.c after the second dose.

The New York Times interviewed a number of dozen of the newly vaccinated within the days afterward. They recounted a large spectrum of responses, from no response in any respect to signs like uncontrolled shivering and “mind fog.” While these experiences aren’t nice, they’re an indication that your personal immune system is mounting a potent response to the vaccine.

An evaluation of security knowledge from the primary 13.7 million Covid-19 vaccine doses given to Americans discovered that negative effects have been extra widespread in girls. And whereas extreme reactions to the Covid vaccine are uncommon, practically all of the instances of anaphylaxis, or life-threatening allergic reactions, occurred in girls.

The discovering that ladies usually tend to report and expertise disagreeable negative effects to the Covid vaccine is in step with different vaccines as nicely. Women and ladies can produce as much as twice as many antibodies after receiving flu photographs and vaccines for measles, mumps and rubella (M.M.R.) and hepatitis A and B. One examine discovered that over practically three many years, girls accounted for 80 p.c of all grownup anaphylactic reactions to vaccines.

While it’s true that ladies could also be extra more likely to report negative effects than males, the upper price of negative effects in girls additionally has a organic rationalization. Estrogen can stimulate an immune response, whereas testosterone can blunt it. In addition, many immune-related genes are on the X chromosome, of which girls have two copies and males have just one. These sturdy immune responses assist to elucidate why 80 p.c of autoimmune ailments afflict girls. You can learn extra about girls and vaccine negative effects right here.

Side results get all the eye, however in case you take a look at the information from vaccine medical trials and the true world, you’ll see that many individuals don’t expertise any negative effects past a sore arm. In the Pfizer vaccine trials, about one out of 4 sufferers reported no negative effects. In the Moderna trials, 57 p.c of sufferers (64 or youthful) reported negative effects after the primary dose — that jumped to 82 p.c after the second dose, which suggests virtually one in 5 sufferers reported no response after the second shot.

A scarcity of negative effects doesn’t imply the vaccine isn’t working, mentioned Dr. Paul Offit, a professor on the University of Pennsylvania and a member of the Food and Drug Administration’s vaccine advisory panel. Dr. Offit famous that through the vaccine trials, a major variety of folks didn’t report negative effects, and but the trials confirmed that about 95 p.c of individuals have been protected. “That proves you don’t must have negative effects as a way to be protected,” he mentioned.

Nobody actually is aware of why some folks have a number of negative effects and others have none. We do know that youthful folks mount stronger immune responses to vaccines than older folks, whose immune methods get weaker with age. Women usually have stronger immune responses than males. But once more, these variations don’t imply that you just aren’t protected in case you don’t really feel a lot after getting the shot.

Scientists nonetheless aren’t certain how efficient the vaccines are in folks whose immune methods could also be weakened from sure medical circumstances, akin to most cancers therapies or H.I.V. an infection or as a result of they’re taking immune suppressing medicine. But most consultants imagine the vaccines nonetheless provide these sufferers some safety towards Covid-19.

The backside line is that despite the fact that particular person immune responses can fluctuate, the information collected thus far present that every one three vaccines authorised within the United States — Pfizer-BioNTech, Moderna and Johnson & Johnson — are efficient towards extreme sickness and demise from Covid-19.

You shouldn’t attempt to stave off discomfort by taking a ache reliever earlier than getting the shot. The concern is that premedicating with a ache reliever like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), which might stop negative effects like arm soreness in addition to fever or headache, may also blunt your physique’s immune response.

While it’s potential that taking a ache reliever earlier than your photographs might need dampened your physique’s immune response, vaccine consultants say you shouldn’t fear, and also you shouldn’t attempt to get one other shot. Studies of different vaccines recommend that whereas premedicating can uninteresting the physique’s immune response to a vaccine, your immune system can nonetheless mount a powerful sufficient protection to struggle an infection. A overview of research of greater than 5,000 youngsters in contrast antibody ranges in youngsters who took ache relievers earlier than and after vaccinations and those that didn’t. They discovered that ache relievers didn’t have a significant impression on immune response, and that youngsters in each teams generated ample ranges of antibodies after their photographs.

The excessive efficacy of all of the Covid vaccines means that even when taking Tylenol earlier than the shot did blunt your physique’s immune response, there’s some wiggle room, and you might be doubtless nonetheless nicely protected towards Covid-19. “You ought to really feel reassured that you just’ll have sufficient of an immune response that you just’ll shall be protected, particularly for vaccines which are this good,” mentioned Dr. Offit.

“It’s OK to deal with” negative effects with a ache reliever, mentioned Dr. Offit, however in case you don’t actually need one, “don’t take it.”

While most consultants agree it’s protected to take a ache reliever to alleviate discomfort after you get vaccinated, they advise towards taking it after the shot as a preventive or in case your signs are manageable with out it. The concern with taking an pointless ache reliever is that it might blunt among the results of the vaccine. (In phrases of the vaccine, there’s no significant distinction in case you select acetaminophen or ibuprofen.)

During the Moderna trial, about 26 p.c of individuals took acetaminophen to alleviate negative effects, and the general efficacy of the vaccine nonetheless was 94 p.c.

Research and anecdotal reviews recommend that folks with a beforehand recognized Covid-19 an infection could have a stronger response and extra negative effects after their first dose of vaccine in comparison with those that have been by no means contaminated with the virus. A powerful response to your first dose of vaccine additionally is perhaps an indication that you just have been beforehand contaminated, even in case you weren’t conscious of it.

If you beforehand examined optimistic for Covid-19 or had a optimistic antibody blood take a look at, be ready for a stronger response to your first dose, and contemplate scheduling a couple of days off work simply in case. Not solely will it’s extra snug to remain residence and get better in mattress, the vaccine negative effects can resemble the signs Covid-19, and your co-workers received’t need to be close to you anyway.

Studies recommend that one dose is perhaps ample for individuals who have a beforehand confirmed case of Covid-19, however thus far the medical pointers haven’t modified. If you’ve acquired the Pfizer-BioNTech or Moderna vaccines, it’s best to plan to get your second dose even in case you’ve had Covid-19. Skipping your second dose might create issues in case your employer or an airline ask to see proof of vaccination sooner or later. If you reside in an space the place the single-dose Johnson & Johnson vaccine is accessible, then you definately may be totally vaccinated after only one dose. You can learn extra right here concerning the vaccine response in individuals who’ve had Covid-19.

The vaccines look like efficient towards a brand new variant that originated in Britain and is shortly changing into dominant within the United States. But some variants of the coronavirus, significantly one first recognized in South Africa and one in Brazil, look like more proficient at dodging antibodies in vaccinated folks.

While that sounds worrisome, there’s purpose to be hopeful. Vaccinated folks uncovered to a extra resistant variant nonetheless look like protected towards severe sickness. And scientists have a transparent sufficient understanding of the variants that they already are engaged on creating booster photographs that can goal the variants. The variants recognized in South Africa and Brazil aren’t but widespread within the United States.

People who’re vaccinated ought to nonetheless put on masks in public and adjust to public well being pointers, however you shouldn’t dwell in concern of variants, mentioned Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. “If you’re vaccinated, it’s best to really feel fairly assured about how protected you might be,” mentioned Dr. Hotez. “It’s unlikely you’ll ever go to a hospital or an I.C.U. with Covid-19. In time you’re going to see a advice for a booster.”

I hope these solutions will reassure you about your personal vaccine expertise. You can discover a extra full listing of questions and solutions in our particular vaccine device “Answers to All Your Questions About Getting Vaccinated Against Covid-19.”

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