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Is the second dose bad? If I feel okay, can it work normally? Can I take Tylenol?



In the United States, nearly 3 million people receive the COVID-19 vaccine every day. Each new jab will prompt new questions about what will happen after the vaccination.

Last week, I asked readers to send me questions about vaccination. Here are some answers.

Q: I have heard about the side effects of the COVID vaccine, especially after the second dose, which may be really bad. Should I be worried?

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Answer: After both Pfizer-BioNTech and Moderna vaccines require a second injection, short-term side effects such as fatigue, headache, muscle aches and fever are more common. (The Johnson & Johnson vaccine only needs to be injected once.) Patients with unpleasant side effects after the second dose usually feel like they have a flu and use phrases such as “flatten me”

; or “I didn’t use it for two days.” . During the vaccine research period, patients are advised to arrange a few days off after the second dose in case they need to lie in bed for a day or two.

Data collected from v-safe (which encourages everyone to use the app to track side effects after vaccination) also showed an increase in side effects reported after the second dose. For example, about 29% of people reported fatigue after the first injection with Pfizer BioNTech, but jumped to 50% after the second injection. Muscle pain rose from 17% after the first injection to 42% after the second injection. Although only about 7% of people felt chills and fever after the first dose, it increased to about 26% after the second dose.

In the following days, the “New York Times” interviewed dozens of newly vaccinated people. They stated a variety of reactions, from no response at all to symptoms such as convulsions and “brain fog.” Although these experiences are unpleasant, they show that your own immune system is responding effectively to the vaccine.

Q: Indeed, are women more susceptible to the side effects of the vaccine than men?

A: An analysis of the first 13.7 million doses of the COVID-19 vaccine for Americans found that side effects are more common in women. Although severe reactions to the COVID vaccine rarely occur, almost all cases of allergic reactions or life-threatening allergic reactions occur in women.

The findings that women are more likely to report the COVID vaccine and suffer unpleasant side effects are also consistent with other vaccines. After receiving flu shots and vaccines against measles, mumps and rubella (MMR), and hepatitis A and B, women and girls have twice as many antibodies. A study found that in the past three decades, women accounted for 80% of all adult allergic reactions to vaccines.

Although it is true that it is more likely to report side effects than men, there is a biological explanation for the higher incidence of side effects in women. Estrogen can stimulate the immune response, and testosterone can inactivate it. In addition, many immune-related genes are on the X chromosome, with two copies in women and one copy in men. These differences may help explain why the number of patients suffering from autoimmune diseases is much higher than that of men, which occur when a strong immune response attacks the healthy tissues of the body.

Q: I don’t have any side effects. Does this mean that my immune system is unresponsive and the vaccine is not working?

A: The side effects have caused everyone’s concern, but if you look at the data obtained from vaccine clinical trials and the real world, you will find that many people have no side effects other than arm soreness. In the Pfizer vaccine trial, about a quarter of patients reported no side effects. In the Moderna trial, 57% (64 years or younger) of patients reported side effects after the first dose-it jumped to 82% after the second dose, which means that one in five patients There was no response after the second injection.

Dr. Paul Offit, a professor at the University of Pennsylvania and a member of the Food and Drug Administration’s vaccine advisory group, said the lack of side effects does not mean that the vaccine will not work properly. Offit pointed out that during the vaccine trial, many people did not report side effects, but the trial showed that about 95% of the people were protected. He said: “This proves that you don’t have to have side effects in order to protect yourself.”

No one really knows why some people have many side effects while others don’t. We do know that the immune response of young people to vaccines is stronger than that of the elderly, whose immune systems weaken with age. Women usually have a stronger immune response than men. But again, these differences do not mean that if you feel uncomfortable after shooting, you will not be protected.

Scientists are still not sure how effective this vaccine will be for people who have weakened their immune systems due to certain medical conditions (such as cancer treatment or HIV infection) or are taking immune-suppressing drugs. But most experts believe that the vaccine still provides protection against COVID-19 for these patients.

Most importantly, although individual immune responses may vary, the data collected so far shows that all three vaccines approved in the United States (Pfizer-BioNTech, Moderna, and Johnson & Johnson) are effective against severe illness and death from COVID- 19 diseases. .

Q: I have taken Tylenol before the COVID vaccine injection, and there is almost no reaction to the injection. Did I make a big mistake?

Answer: Do not take painkillers to relieve discomfort before shooting. Worryingly, the use of painkillers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can prevent side effects such as arm soreness, fever or headache, and may also weaken your body’s immune response.

Although taking painkillers before the vaccine may weaken the body’s immune response, vaccine experts say that you don’t need to worry and should not try a new round of alternative injections. Studies on other vaccines have shown that although the body’s immune response to the vaccine can be reduced before taking the medicine, your immune system can still provide strong enough defenses to fight infection. A review of a study of more than 5,000 children compared the antibody levels of children who took painkillers before and after vaccination with children who did not receive painkillers. They found that the painkillers had no significant effect on the immune response, and that both groups of children produced sufficient levels of antibodies after the injection.

The high efficacy of all COVID vaccines shows that even if taking Tylenol before the injection does make your body’s immune response dull, there is still some room for maneuver and you may still be able to protect yourself from COVID-19. Infringe. Offit said: “You should rest assured that you will get an adequate immune response and can be protected, especially for this vaccine.”

Q: What should I do if I take painkillers after injection?

A: Offit said, “can be treated with painkillers” side effects, but if you really don’t need one, then “don’t take it.”

Although most experts believe that it is safe to relieve pain after vaccination, they recommend not to take it as a preventive measure after injection, or to relieve symptoms if it is not used. The concern about taking unnecessary painkillers is that it may dull some of the effects of the vaccine. (As far as vaccines are concerned, if you choose acetaminophen or ibuprofen, there is no obvious difference.)

During the Moderna trial, about 26% of people took acetaminophen to relieve side effects, and the overall efficacy of the vaccine was still 94%.

Q: If you already have COVID-19, will the side effects be more serious?

A: Research and anecdotal reports indicate that people who have been previously diagnosed with COVID-19 infection may have stronger reactions and more side effects after the first vaccination compared to people who have never been infected with COVID-19 infection. A strong reaction to the first dose of vaccine may also indicate that you have been previously infected, even if you don’t know it.

If you have previously tested positive for COVID-19 or tested positive for antibodies in your blood, be prepared to have a stronger response to the first dose and consider arranging a few days off just in case. Not only can you rest at home and rest in bed, but it will also be more comfortable. The side effects of the vaccine may be similar to the symptoms of COVID-19, and your colleagues will not want to be near you anyway.

Q: I already have COVID-19. Does that mean I can only take one dose?

A: Studies have shown that for people who have previously been diagnosed with COVID-19, one dose may be enough, but so far, the medical guidelines have not changed. If you have already received the Pfizer BioNTech vaccine or Moderna vaccine, you should plan a second vaccination even if you have been vaccinated against COVID-19. If your employer or airline asks to see the vaccination certificate in the future, skipping the second dose may cause problems. If you live in an area where a single dose of Johnson & Johnson vaccine is available, you can get the vaccine completely with just one dose.

Q: Are these vaccines against new variants emerging around the world?

A: The vaccine seems to be effective against new variants that originated in the UK and quickly became dominant in the United States. However, certain variants of the coronavirus, especially those first discovered in South Africa and those first discovered in Brazil, seem to be better at avoiding the antibodies of vaccinated people.

Although this sounds worrying, there are reasons for hope. People exposed to vaccinated variants of more resistant variants still seem to be protected from serious diseases. Scientists have a clear enough understanding of the variant, and they are already developing enhanced shooting for the variant. The variants found in South Africa and Brazil have not yet spread widely in the United States.

Peter Hotz, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, said that vaccinated people should still wear masks in public places and follow public health guidelines, but you should not be afraid of variants. Hotz said: “If you are vaccinated, you should feel very confident about your protection.” “You are unlikely to go to the hospital or intensive care unit due to COVID-19. Over time, you will See the recommended enhancer.”

This article was originally published in The New York Times.

©2021 The New York Times Company


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