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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Preventative Health, Central West

Did you know?

Chronic diseases are the leading cause of illness and disability in Australia today with 89% of deaths in 2018 associated with these chronic conditions.

These include;

Cardiovascular Disease, some cancers, Type 2 Diabetes and Chronic Obstructive Pulmonary Disease (COPD).

Not included in this death rate but equally important is the rising burden of mental health disease which has significant adverse health outcomes for many Australians.

There has been a huge rise in these chronic conditions which are largely preventable. They are are associated with obesity, an increase in sedentary lifestyles, poor diet, smoking and excessive alcohol intake. It is important to note that not only are they the leading cause of premature death in Australia, they also impact negatively on how individuals are able to lead their lives – decreasing their quality of life.

Preventative health is a term used to describe a type of health care aimed at preventing illness, disease and other health problems as well as maintaining and improving overall health.

It is an important health initiative which if delivered efficiently, will reduce the number of Australians developing these diseases. This will increase individual’s quality of life and in turn improve the economic burden associated with managing these illnesses in our society.

Unsurprisingly, a healthy lifestyle is vital for preventing chronic disease.

This includes:

Eating a balanced and nutritious diet

This can help reduce the risk of developing lifestyle disease such as cardiovascular disease, diabetes and some cancers. Included in our diet should be 5 servings of vegetables and 2 servings of fruits every day. Healthy fats in things like avocado, fatty fish, nuts and oils should replace unhealthy fats (processed meats, hard cheese, butter etc.) and adequate proteins should be included in every meal. DO NOT do fad diets. They do not work and have serious health consequences as most recommend excluding an essential food group (for example carbohydrates).

Moving your body

Physical activity is one of the most important things we can do for our overall health. Not only does it increase life expectancy, it also makes us stronger; helps improve and mental health; helps maintain a healthy body weight; Reduces cardiovascular disease, diabetes and some cancers; increases bone density and reduces the risk of developing osteoporosis; improves balance and decreases falls in the elderly.

Smoking cessation

Everyone knows that smoking is just BAD!! It is probably the single most avoidable cause of disease, disability and death. Yet people are still smoking. Smoking is known to increase the risk of developing cardiovascular disease, stroke, chronic obstructive pulmonary disease and lung cancer. In addition, its expensive!!! Its $50 that could be better spent on a gym membership!!!

Limiting alcohol consumption

Alcohol is associated with a wide range of physical and social problems. Alcohol contributes to a major health burden in Australia. Harms related to drinking result in more than 4,000 deaths and 70,000 hospital admissions every year. Not only is it associated with a wide range of psychical problems; it also is associated with many social problems too (gambling and domestic violence).

The current Australia guidelines state that we should drink no more than 10 standard drinks in any week and no more than 4 drinks on any one day.

Remember that age, gender and other factors will influence this and the guidelines are a recommendation only. Alcohol is not recommended at all in pregnancy or when breastfeeding; and not recommended in children under 18 years of age.

Being sun smart

Every year in Australia skin cancers account for 80% of all cancer diagnosis. We have one of the highest incidences of skin cancer in the world; 2-3 times more than Canada, the UK and he US. Most skin cancers are directly related to sun exposure so it is imperative to be sun smart at all stages of life. The age-old mantra… slip, slop, slap, wrap and find some shade!!

Other important preventative health activities include immunisation programs, screening programs (e.g. cervical & breast screening) and opportunistic patient education.

Immunisation is recommended from birth for all children and then at particular stages throughout life.

Information and education is available from birth and systems such as the Australian Childhood Immunisation Register (ACIR) and GP recall systems make it easier by sending out reminders which vaccination are due. There are certain groups of Australians in whom additional vaccinations are recommended and some in whom vaccinations are contraindicated.

Screening programs:

Cervical screening program

  • Women aged 25-74 years are invited to participate in the cervical screening program every 5 years. Women of any age who have symptom s (pain, bleeding etc.) should have a clinical assessment which may include a CST +/- co-test if appropriate.

Breast cancer screening:

  • Screening (mammogram) is offered for women aged between 50 and 74 years every 2 years for women at average risk of developing breast cancer. There are some women who are at an increased risk (family members with breast cancer) who may require earlier and more frequent testing +/- additional tests – Risk needs to be determined by your doctors.

Bowel cancer screening:

  • If detected early, bowel cancer can be treated in more than 90% of cases. The foecal occult blood test (FOBT) is a test that is sent in the mail every 2 years for those aged 50 – 74 years. For individuals who are at increased risk of developing bowel cancer (family history or certain bowel diseases) earlier screening +/- colonoscopy may be recommended. It may seem a bit weird playing with your poo… but it is far better than developing bowel cancer that is not picked up until it is too late!! So, don the gloves and get it done.

Other preventable health conditions:

Type 2 diabetes:

Type 2 diabetes is a condition of insulin resistance; risk factors include age, race, family history, women who have had gestational diabetes, polycystic ovarian syndrome and being overweight. GPs can identify those at high risk opportunistically or if you think you may be at increased risk present and ask to be tested for diabetes – a simple blood test.

Sexually transmitted disease:

Anyone who is sexually active should consider testing for sexually transmitted infections which include chlamydia, gonorrhea and syphilis. Particularly at risk of these disease are young people, men who have sex with men and those that participate in other risky behaviours (drug use). Many of these infections are asymptomatic but can have huge impacts on our reproductive organs which may affect fertility. Please don’t be embarrassed!! Most of these diseases can be screened for with a simple urine test; the blood borne viruses like HIV will need a blood test.

Cardiovascular disease and Cholesterol:

Cardiovascular risk assessment combines risk factors to calculate the probability that someone will develop a cardiovascular event (heart attack) or other vascular disease (Stroke). This should be started every 2 years from 45years on most individuals (earlier in some groups e.g. ATSI). This mostly involves a chat with you doctor, a simple examination (BP) and a blood test +/- other investigations.

These are only a few of the preventable diseases that impact on our health in Australia. Not mentioned is arthritis, back pain, chronic kidney disease, mental illness and osteoporosis. As you can see, many of these diseases are silent – therefore they are not picked up by the individual until they are advanced and have already caused some damage to the body.

This is why it is important to get yourself a good GP; and make sure you pay them a visit at least every year so that they can assess your risk and conduct appropriate investigation to maintain your health and prevent illness.

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Road Trip – On The Art Trail From Orange to Eugowra

Road Trip Part One – Art and Culture itinerary

If you are looking for school holiday activities that are fun for the entire family, stimulating visually, as well as budget friendly, then exploring the art and culture on a road trip in the Central West will tick those boxes. There is lots to discover in each of the quaint and heritage towns in the region too, which you can plan as a day trip or plan as a staycation.

We experienced this recently with a few friends with children aged between 7-14 years, which is ideal for this itinerary. All they need is a little imagination and the day will be golden.

There are few items you can prepare and pack to make the journey even more engaging.

To encourage your children to get into the mindfulness of art and culture, talking about colour as a way of seeing through new eyes before you set off is a good way to set the tone for the road trip. A guided imagery engaging all the senses (you could be imaginative and describe any story), ending with a colour glowing in a woman’s palm can be facilitated using chalk pastels or even paint colour charts. A range of 72 colours is ideal so that each person can choose their colour and spends the day looking for their colour as part of their journey.

Starting from Orange, the distance to Eugowra is approximately one hour by car.

About 25 minutes in on the Mitchell Highway you may spot the Platypus on a penny farthing and Frog on a Bike – part of the fantastic Animals on Bikes paddock art sculptures. Blink and you might miss them! (There are over 100 on display between Molong  and The Dubbo Zoo via Cumnock and Yeoval).

Activity:

Talk about recycled sculptures and mailboxes and how you will see them in many places.

Arrive in Eugowra

Stop at the mural walking tour sign and wander around the murals. The murals represent the town’s unique history and community including the Spring Racing Carnival, Canola Cup and Eugowra Show.

Activity:

Take a picture of you in the mural; not just standing still but somehow interacting with the content. There’s more than 30 murals around town, and you can scroll through the gallery of photos below to see all the fun the children had in front of them! You can find more about the public art and culture map at Culture Maps Central NSW

Food and Drink stop

If you’ve packed a picnic, there are some lovely grassy spots close to the Mandagery Creek or wonderful little cafes that are thriving in town. I stopped for a coffee at The Fat Parcel Food Van which was a good drop and they also offer burgers, sandwiches, toasties, cakes and more. There’s some outdoor seating with some tables providing shade too.

There are also good public bathroom facilities here too, so best to refresh if continuing on.

Eugowra is in the heart of bushranger country so If you have time, stop into the Eugowra Historical Museum & Bushranger Centre where you can learn about Eugowra’s claim to fame in the history books during 1862.

Eugowra has a lovely community pool which might come in handy if it is a cracking hot day; although check the hours of opening as they tend to be limited in small towns.

From here you can continue on the art trail to Grenfell – see link here.

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