I've been thinking recently on a few levels that I am intimidated about accepting the public responsibility of becoming a nurse. I have already been a resource for people about how to navigate the hospital as a patient or sort things out with insurance or some empathy for living with a chronic condition, but once I complete the program and claim the title behind it, well, there's a public obligation and expectation that comes with it.
So let's claim part of it. We're talking about vaccines today.
***SCIENCE BACKGROUND TIME***
Let's talk about the immune system. There are a lot of parts that work together in the process, lots of working cogs. For my purposes here, let's pretend that the body is an indoor shopping mall.
There are all kinds of different parts of the mall that work independently but they have shared connected spaces and shared connected concerns--there's a crew that maintains the facility, shared walls and entrances, shared water and electrical connections, and a shared security team.
The roof protects the mall; the walls protect the mall; keeping the entrances maintained and repairing any leaks protects the mall. All of these pieces working allow the stores to do their own tasks.
There's a passive part of the immune system, a prevention element--keeping the skin intact keeps a lot of viruses, bacteria, parasite, or whatever from even starting. Hair, eyelashes, saliva are working on the same kind of physical level. Stomach acid, enzymes, and even the temperature of the body can work on more of a chemical level--so sanitizer stations around the mall, window cleaners, cart clean-off supplies, etc.. And then when something is there that is outside of the normal, firmly in the something is "off" territory, the store will call mall security. If something is truly awry, they'll call the police proper to escalate it from there.
The mall security are kind of like the primary or innate immune response--this includes some more generic responses in terms of the body. The alarm is raised, but the attack isn't targeted yet. So, maybe it's more like pulling the fire alarm, in a sense. This manifests in the body as a fever--raising the temperature in the body to hopefully use up too much of foreign bacterium's energy or make it too hot to survive--or even something like vomiting or a runny nose or coughing to get the perceived threat outside of the body, if possible. Certain kinds of cells are the plain-clothes cops, walking around trying to quietly remove threats, too. Again, at this point, it's not a targeted response, just general procedures.
Then, information moves further up the chain of command--let's say mall security found some bags of unknown substances in an abandoned backpack. We're going to call in some specific experts at that point. The older mall guard on staff remembers the obscure protocols from here, knows what is supposed to be done next. Here's we're getting into the secondary or adaptive immune response. This takes a little longer than the innate/primary response. The innate/primary is a reaction, a general response; the secondary/adaptive is looking at specific information from the scenario and responding to it appropriately based on that information. Then, if things are seriously out of hand, we can look at calling in outside police, which I'm saying are your healthcare provider and/or medications in the analogy.
So how's this apply with vaccines?
Vaccines are an outside company that comes in and teaches your mall security how to respond to situations. They provide a simulation to help them react appropriate in a real-life case scenario. In the case of COVID-19, the body is introduced to what the protein looks like, which the body rightly recognizes as "off" and then it triggers the primary/innate response immediately (fever, chills, achy, blah) and starts taking in data for the secondary/adaptive response. Then, if/when it runs into that same "off" again, it can pull up that action protocol sheet and move through the steps much more efficiently. Then a booster shot or a second shot in a series is a reteaching to ensure that the information is solidly remembered in the case that it's needed, updating the security protocol sheets and the like.
That's it. That's the entire process. And it works.
Or in meme form:
I have a few textbooks in my room that can explain it in more depth, if/when anyone wants to dig into it further.
SO. Let's get into some of the COVID specific FAQs that I've run into, at least. Some of these conversations have been about specific concerns, some have repeated...interesting theories, others have been concerned about their particular situation or heard conflicting information. My nursing program is having us students participate in administering these as part of upcoming vaccine clinics, meaning that we had to review and test on specific, current CDC literature on these vaccines and how to safely administer and check these vaccines. These guides are accessible to anyone willing to look for them--there were no credentials I had to enter in to go through these modules, if anyone would like to look through them. I've linked some sources as made sense and summarized ideas in places that didn't.
Can I still spread the virus if I get the vaccine?
Short answer is two weeks after your second dose, you're unlikely to be a virus firehose, but it also doesn't magically turn you into a Clorox wipe--this virus spreads through droplets, meaning that if you still touch something and touch something else, etc., that you're able to spread things. Unlikely is not zero but statistically is still MUCH better. Wearing a mask is still needed, particularly as there is still research on what vaccines might be effective against new strands. There are also multiple strains of the virus and evidence is still coming in whether the vaccines are equally strong against all strains. The Moderna one specifically has been showing promising signs toward broader effectiveness (presumably, Pfizer is still being tested). Setting a good example for the good of the community is also meritorious--these precautions (sanitizing surfaces, wearing masks, staying home, etc.) is also brilliant at preventing the spread of other diseases.
What's the difference between the Pfizer and the Moderna versions?
I didn't know much about this one, to be honest, until I went through the CDC vaccine training. Here's the short version of what I gleaned reading their different sheets.
- Moderna: 28 days between doses, not mixed with any diluent, 0.5ml shot, 10 doses per vial, cannot be packed in dry ice
- Pfizer: 21 days between doses, mixed prior to administration, 0.3ml shot, can be packed in dry ice
- Both: no preservatives, antibiotics, adjuncts, thimerosal, etc.; must be kept cold until ready to administer; efficacy above 90% for both (which is better than some other vaccines, actually); the most common side effects for both and in the same order is as follows: pain at the injection site, fatigue, headache, and muscle pain
Can you mix the vaccines?
According to the CDC, not at this time. If your first was Moderna, stick with Moderna. If your first was Pfizer, stick with Pfizer. Just this week there was news about testing out whether they could be interchangeable, but we need to wait for the data to come in. They were tested individually and verified individually. Wherever you get your first dose should help coordinate where and when you get the second of the proper kind.
Is it safe? Was it made too fast?
Yes, it is safe. What normally slows a vaccine's development is trying to get funding. There were some steps made to help expedite the process, recognized under the emergency authorized use, but it has still tested safely. There are also two systems to help track vaccine side effects as they go, namely a voluntary smartphone-based tool called V-Safe and the official Vaccine Adverse Event Reporting System (VAERS).
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| Screenshot from CDC information, used without permission |
What about reactions?
So after you receive your vaccine, the site will likely have you linger for fifteen minutes afterwards, to ensure that you do not have a serious reaction. A small group of persons might have an allergic response. And by small, I mean less likely than being struck by lightning, by some accounts, and here are some additional specifics on COVID-19 in particular--the main point of that article is that the benefits outweigh the risks. Also, there are no preservatives used in either the Moderna or Pfizer, which have historically been the source of the bulk of these allergic reactions; this is why it is so important that the vaccines are refrigerated to specific temperatures. A larger small group might have vasovagal syncope (i.e. pass out). However, there are still side effects to consider post vaccination, the most common of which are the following: pain at the injection site (sore shoulder), fatigue, headache, aches/pain/chills, and fever. These usually clear up within a day or two and are evidence that your immune system response is indeed being activated. Anecdotally, the second dose's side effects tend to hit people harder than the first, so if you can plan for a lighter day after your second dose, it may not be a bad idea. In preparation for my second dose, I picked up some of my sick-day staples, like crackers, soup, and Sprite. Here's another perspective on those pieces. In summary, the risk is miniscule and the temporary pain tolerable compared to the benefits.
Do I really need both?
Yes. Here's why--so, yes, the body has been exposed to it before, but a series is designed to keep the information fresh, to have a consistent, trained response, to have a specific level of antibody response. Think about your work protocols--there are some things you talk about once in training for a job but keep the protocol sheets accessible; there are other situations that the group will have to renew every other year or so. Some information simply needs emphasizing; there are some cases where your immune system needs additional, specific training, too, to ensure it's reacting to the right information. The two doses were found to be needed to achieve an adequate response to either prevent entirely or significantly mitigate the symptoms of contracting COVID-19. It's not arbitrary--it's the right procedure to get the most people the best results with the least amount of inconvenience. If it could be designed safely into one shot (knowing our collective attention spans), I assure you it would have been done that way.
Does the vaccine cause infertility?
I have been searching for some kind of academic article somewhere with my school resources and have come up dry--there is no scientific evidence to this rumor that I can find anywhere, which means it's currently an unsubstantiated rumor. You know what definitely causes infertility though? Being dead. Or killing your partner. And for those willing to risk it, there have been some documented studies pertaining to having COVID-19 and lower sperm count and some additional that agree it might be there but not permanent--still, the vaccine is different than the disease; knowing a fire drill isn't the same as being in a building that's currently burning. I have greatly enjoyed the resource Mama Doctor Jones on YouTube as a resource on gynecology and obstetrics and she posted a good video that explored these pieces.
...But secret microchips?
*Sigh* To be frank, this is just stupid. If it were true, the needle would be MUCH bigger, for one. And each vial holds several doses--specifically, the Moderna vial holds ten doses and the Pfizer one holds six. The nurse is usually just kind enough to draw this into a single syringe out of your eyesight when possible to decrease anxiety. I'm sure you can ask to see it if you don't believe me. So how would someone magically ensure that each dose has a chip? Do these persons think the vial has them floating around in the clear liquid and we have to spend four minutes to fish them out? Otherwise one person would get four and another would get none? Also, if Bill Gates was so good at mind-control, we'd all be using Zunes and Windows phones. There is no logic in this theory. And many other bodies have pointed out that our smartphones track our movement most anywhere we go anyway by pinging off of other wireless points--that's how your maps app can give you directions.
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So, these are explanations designed to be approachable to the layperson. I enjoy educating people who are interested in learning. There are going to be nuances and "Well, technically..." pieces that fall into place as we dig into the subject, particularly when it comes to my chosen analogy. Genuine discussion is encouraged; bad faith arguments are not. That said, if you've a question, I will see what I can do about answering it as my schedule allows, excited to see what I can learn in the process to. Responses that are browbeating or otherwise without substantial reasoning will be removed.
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