Covid Vaccine, The Good, The Bad And The Ugly - index

Covid Vaccine, The Good, The Bad And The Ugly

Last week I had my first covid vaccine- the AstraZeneca vaccine.

Developed by a team based in Oxford, UK, this vaccine has had some really bad press recently. I’ve got to be honest, it floored me. I spent 3 days off work, feeling really unwell, with high fevers, muscle aches, and awful fatigue. And in 12 weeks, I’m going to have another one. Am I anxious about feeling that unwell again? No, because if it means I’m reducing my risk of catching Covid-19, and more importantly, spreading it to more vulnerable members of the community, then, in my opinion, a couple of days of feeling unwell are definitely worth it.

The science (The good)

The vaccine is a non-replicating virus vector vaccine, not a live vaccine. It doesn’t reproduce the virus in your body, so you cannot give someone else covid-19 by having the vaccination. Instead the vaccine works by producing the antigen to the virus, thereby eliciting an immune response in the body, essentially “priming” our immune system in readiness for exposure to covid-19.

Efficacy rates of 63% – 76% against Covid-19 have been quoted for the AZ vaccine, with the World Health Organisation stating that anything about 50% efficacy will help control the pandemic. Furthermore, trial data for the astra-Zeneca vaccine have shown no hospitalisations or deaths in people who contracted covid-19 after being immunised. Countries which are ahead of us with their vaccine programme, have shown really positive results, in terms of cases dropping, fewer hospitalisations and deaths.

The second “booster” vaccine is given 4-12 weeks after the first, but there have been reports that efficacy of the vaccine improves when the gap between vaccines is closer to 12 weeks, hence Australia’s vaccine programme being 12 weeks between doses.

The bad

As mentioned at the beginning of this article, it has side effects in some people. I was the unlucky one in my practice – my colleagues all seemed to have very few side effects, so nasty side effects certainly aren’t universal.

Very common side effects in the 1-2 days following vaccination include:

  • pain, tenderness or local swelling in the arm where you had your injection
  • feeling tired
  • feeling generally unwell
  • headache
  • general muscle aches
  • fever
  • chills
  • joint pain
  • nausea

Advice is to take regular Panadol and ibuprofen, and in most cases side effects settle within 1-3 days. If they are going on longer, you should seek advice from your health professional.

Side effects are not an allergy to the reaction, and should not prevent patients receiving the second immunisation. The good news is that anecdotal reports from countries who are ahead of us with the vaccine programme- side effects are far reduced with the second AstraZeneca vaccine, so hopefully I won’t need another 3 days off work in 12 weeks’ time!

The ugly

In Europe, various countries stopped giving the AZ vaccine after a few cases of an incredibly rare thromboembolic event (cerebral venous sinus thrombosis- CVST) occurred in people who had received the vaccine.

The rates are incredibly low- 25 cases reported from over 20 million vaccines given. Women under 55 appears to be the most at risk, with these thromboembolic events typically happening 4-10 days after vaccination. Obviously they are now frantically researching whether there is a causal link between the vaccine and these rare, but potentially incredibly serious, side effects. The countries who had paused vaccination programmes because of this potential risk, have now restarted their programmes, as there is no causal link at this stage and the risks are vastly outweighed by the benefits of the covid-19 vaccination.

Anaphylaxis is the other important risk with any vaccination. People who have experienced an anaphylactic reaction to a previous vaccine must inform their doctor of this when they attend for immunisation. The clinics are set up to manage anaphylactic reactions, and all staff giving the vaccines are well trained at managing these situations. Most anaphylactic restrooms occur within 30 minutes of receiving the vaccine, so people who have suffered a severe allergy in the past, will be monitored for at least 30minutes to ensure they are well post-vaccine (everyone is monitored for at least 15minutes after immunisation).

Who is currently able to receive the vaccine

We are currently in phase 1b of the immunisation programme.

Covid vaccinations and the appointments to receive the vaccine are free for all patients.

Who can be vaccinated under phase 1b?

People eligible for vaccination under phase 1b are:

  • Elderly people aged 70 and over
  • Healthcare workers currently employed and not included in Phase 1a
  • Household contacts of quarantine and border workers
  • Critical and high risk workers who are currently employed
  • Aboriginal and Torres Strait Islander people aged  55 years and over
  • Adults with an underlying medical condition or significant disability

If you are unsure whether you qualify, there is an excellent tool you can use this government health website

Phase 2 involves immunising the remainder of the Australian adult population, and the timing of this rollout is not yet entirely clear.

Phase 3 involves immunising children, if it is recommended. There are currently trials going on in the UK and other countries to look at the efficacy of immunising our children against covid-19.

Where can I get my covid-19 vaccination?

The Central Western Daily produced a list of all the clinics offering covid-19 vaccination from 22nd March. Other GP clinics may well administer vaccines during phase 2 of the vaccination programme. If you are unsure, please contact your usual GP practice who will be able to advise you on your options.

Orange clinics administering vaccines from week one of Phase 1B:

  • Colour City Medical Practice
  • Orange Family Medical Centre
  • The Wellness House
  • Orange Aboriginal Medical Service
  • Orange Respiratory Clinic

Central West clinics administering vaccines from week one of Phase 1B:

  • Medispring Family Medical Centre (Cowra)
  • Cowra Respiratory Clinic (Cowra)
  • Forbes Medicine and Mind (Forbes)
  • Forbes Medical Centre (Forbes)
  • Loxley House Family Practice (Bathurst)
  • Westpoint Medical Practice (Bathurst)
  • Kelso Medical Centre (Bathurst)
  • Bathurst Respiratory Clinic (Bathurst)
  • Lithgow Valley Medical Practice (Lithgow)
  • Bowenfels Medical Practice (Lithgow)
  • Dubbo Family Doctors (Dubbo)
  • Mudgee Respiratory Clinic (Mudgee)

What about flu immunisations?

We are coming up to influenza season, and the immunisations will be rolling out for this, alongside covid-19. You need to have at least 14 days between receiving flu vaccine and covid-19 vaccine, otherwise there is a risk of the 2 vaccines cancelling each other out and you not developing immunity against either. I have concerns that after last year’s lockdown, where many of us were not exposed to the usual number of “winter viruses” we could have a severe flu season, and will therefore be encouraging all my patients to have their flu immunisations, as well as covid-19.

Don’t forget Testing

Whilst we hope the vaccination programme leads to a significant reduction in covid-19 cases across the world, we are going to have to live with covid-19 for a while to come, and it’s effects are as dangerous now as they were a year ago. We need to remain vigilant, continue our social distancing, hygiene, and most importantly go for testing if we develop symptoms. Even with immunisation, we can still catch covid-19, and we need to protect everyone in our community.

If you have any concerns and questions about covid, and about the vaccine, please speak to your doctor- we’ve all gone through lots of training recently on the vaccination process and also on covid in general!

References

  1. The Oxford/AstraZeneca COVID-19 vaccine: what you need to know

https://www.who.int/news-room/feature-stories/detail/the-oxford-astrazeneca-covid-19-vaccine-what-you-need-to-know

  1. AZD1222 vaccine met primary efficacy endpoint in preventing COVID-19

https://www.astrazeneca.com/media-centre/press-releases/2020/azd1222hlr.html

  1. Information on AstraZeneca covid-19 vaccination

https://www.health.gov.au/sites/default/files/documents/2021/03/covid-19-vaccination-information-on-covid-19-astrazeneca-vaccine.pdf

  1. Information on COVID-19 vaccine AstraZeneca (ChAdOx1-S) in NSW

https://www.health.nsw.gov.au/Infectious/covid-19/vaccine/Pages/az-info-sheet.aspx

  1. COVID-19 Vaccine Eligibility Checker

https://www.health.gov.au/resources/publications/covid-19-vaccine-eligibility-checker

  1. COVID-19 vaccination program phase 1b

https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/phase-1b

  1. COVID-19 vaccination in Orange: where to get the Phase 1B jab

https://www.centralwesterndaily.com.au/story/7170952/where-you-can-get-your-covid-19-phase-1b-vaccination-in-orange/

 

 

 

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