By Dr Krishna Reddy Nallamalla
Despite accumulation of large data on safety and efficacy of various Covid vaccines that have been approved on emergency use authorization (EUA) basis across the world, people continue to show hesitancy in getting vaccinated. The hesitancy may be because of misinformation flooding social media or may be because of the controversy surrounding the vaccine approval process. The hesitancy being demonstrated by frontline healthcare workers is a matter of concern. The article attempts at addressing some of the concerns.
Are the vaccines safe?
Yes. Apart from the safety established in various pre-approval clinical trials, there is a growing real-world experience in millions of people across the world. Adverse events are generally graded as minor or major. Similarly, adverse events are adjudicated by independent monitoring committees as to whether the event is related to the vaccine or not. Even the sight of a needle induces adverse events of fainting in some people. Soreness at the site of the injection is common with many injections and more so with various types of vaccines. Development of fever and muscle pains is a sign of immune response to the vaccine or the adjuvant; hence, it is normal. Some people have the allergic tendency to various items, including food, drugs, lotions, dyes, cold, heat, sun light etc. These people can develop an allergic reaction to a vaccine or drug. However, the majority of them tend to be mild. That is the reason for insisting that people wait for 30 minutes at the vaccination facility after receiving the vaccine so that they can be attended to if they develop any serious allergic reaction.
Safety data is mounting from various countries. CDC has reported (from 13.8 million Americans vaccinated) any adverse event rate of 1 in 2000 and serious adverse event rate of 1 in 20,000. Death rate observed was 1 in 100,000 in 13.8 million Americans vaccinated. Even these deaths were causally unrelated to the vaccine. Hospitalization rate in India's vaccine program is ~0.0007% (1 in 1.4 lakh people vaccinated). Given these real-world experiences, there should not even an iota of doubt on the safety of the vaccines asserts Dr Krishna Reddy Nallamalla, President, InOrder Regional Director (South Asia), ACCESS Health International
Are the vaccines effective?
Yes. Vaccines have been demonstrated to be effective in inducing robust immune response and in preventing Covid illness. Real-world efficacy has been clearly demonstrated from Israel, the first country to have vaccinated more than two-thirds of their population. While efficacy rates may differ depending on various criteria, all approved vaccines are effective in preventing Covid illness. If people have concern whether the vaccine they received is going to be effective, they can get their antibodies tested two weeks after the 2nd dose of the vaccine. They can opt for a second vaccine, if there is antibody response with the first vaccine.
Can people with heart disease take the vaccine?
Yes. People with heart diseases and other co-morbidities should take the vaccine, as they carry higher risk of hospitalization, ICU stay, ventilation and death if they develop Covid illness.
Can people on blood thinners take vaccine?
Yes, if on antiplatelets like Aspirin, Clopidigrel, Ticagrelor, Prasugrel etc. There are two types of blood thinners – antiplatelets (aspirin, Clopidigrel, ticagrelor, prasugrel etc.,) and anticoagulants (dicoumarol, warfarin, dabigatran, rivaroxaban etc.,). People on anticoagulants may develop hematoma (collection of blood) after any intramuscular injection. Since Covid vaccines are generally given intramuscularly, same caution applies like any other intramuscular injection and is not specific to Covid vaccine. These people should consult their doctor for advice. Unlike anticoagulants, people on antiplatelets can safely take the vaccine. Hematomas are, in general, very innocuous and are self-limiting.
Can very old (more than 70 or 75 years of age) people take the vaccine?
Yes. While the majority of vaccine trials do not include very aged patients, they can get the same benefit as people who have been studied. In fact, aged population is the first priority in many countries. Hence, elderly people can safely take the vaccine.
Can people avoid face masks after vaccination?
No. It is strongly advised to continue with face mask, hand wash, and social distancing even if one is vaccinated until there is a scientific directive. There are still some unanswered questions – how long the immunity will last after a vaccine and whether the vaccine is effective against new variants. Scientists across the world are closely monitoring the pandemic to gain more and more understanding. Global bodies like WHO will notify as to when the pandemic has come under control. Until such time, everyone should continue the personal protection measures. Incidentally, these measures also protect people against other respiratory infections and air pollution. It is prudent to continue face masking as a public health measure even after Covid pandemic ends.
The author is a cardiologist and President, InOrder Regional Director (South Asia), ACCESS Health International