How to get ready for your shot

The rollout of the COVID19 vaccine is continuing across the state of Virginia. As of Tuesday, 697,870 Virginians are fully vaccinated against COVID-19 and 15.5% of the state’s population is vaccinated with at least one dose. With the addition of Johnson & Johnson’s single-dose COVID-19 vaccine authorized for use in the United States by the FDA on Saturday, more people are reaching the point where they can get appointments.

Here are a few things you may want to know before you get your vaccination.

Before your appointment

Individuals should wait at least two weeks between getting any other vaccination and getting their COVID-19 vaccine, Dr. Allison Huffstetler, assistant professor in

the Department of Family Medicine and Population Health at Virginia Commonwealth University School of Medicine, said in a phone call. It’s also best to wait if you’re feeling sick, she added.

“Ideally, people are healthy prior to getting a vaccine,” Huffstetler said. That gives your immune system the best chance to build a response to the COVID vaccine, preparing it to fight off the real virus if it has to.

There’s no special proof of residence or ID that you need to worry about bringing once you’re preparing for your appointment. According to the VDH website, it’s important to “have some way to confirm your identity (i.e. name, date of birth),” but no photo ID or other government documentation is necessary. Individuals with highrisk medical conditions do not need to show proof of their condition, either.

In other words, any request for ID or personal information would be “to confirm that you are the person who was given the appointment,” according to Irene Ferrainolo, public information officer for the Peninsula Health Department, not to prove residency or eligibility.

The COVID-19 vaccine is “offered to everyone at no cost,” according to the VDH website, with fees either covered by insurance companies or the “U.S. Health Resources and Services Administration Provider Relief Fund.” Either way, there should be no out-of-pocket cost to the person being vaccinated.

It can make things go more smoothly if you dress for the occasion. Because the COVID-19 vaccine is administered in the upper arm, “the vaccination process is easier if you wear a jacket that is easily removed over a sleeveless shirt or a shirt/sweater with a sleeve loose enough to roll up,” Ferrainolo said in an email.

Cindy Williams, vice president and chief pharmacy officer for Riverside Health System, said in a phone call that Riverside vaccination facilities have access to privacy screens in the event that someone has to remove their shirt, but layers or loose sleeves can make it a more “comfortable, smooth process.”

Williams added that arriving no earlier than 10 minutes before the time of the appointment can help prevent long lines from forming.

During appointment

When given the vaccination, you should receive a fact sheet with information specific to the vaccine that you were given, according to Ferrainolo. You will also receive a card “that contains the name of the vaccine manufacturer, the vaccine lot number, the date and the location of where you were immunized,” she said. That card is necessary when you return for your second dose of the Pfizer or Moderna vaccine, so health care workers know which vaccine to administer.

There are no restrictions on activity the day of your vaccine appointment, Ferrainolo said, or in the days after. Once you have your shot, you can go about your day as normal.

However, to make sure that the individual receiving the vaccine can get medical care in the event of a rare anaphylactic response, “all people receiving a COVID-19 shot should be monitored on site for 15-30 minutes, depending on health history or previous reactions to other vaccines,” she added.

Pharmacies and other vaccination sites are required to have epinephrine, Benadryl or another antihistamine medication, and people with basic CPR training on-site in the case of one of those rare reactions.

“Many people experience no adverse effects,” Ferrainolo said. “Some people have arm pain at the injection site, tiredness, headache or other body aches and some had a fever for a few days,” more often in younger people and after the second dose.

The side effects are short term, normal and are not a sign that the vaccine has given you COVID-19, Ferrainolo said. The Pfizer and Moderna vaccines contain no live or dead virus particles, due to the mRNA technology they utilizes.

Though it is not required, registering for and downloading the v-safe app allows individuals to track any side effects experienced in the aftermath of getting vaccinated and report them to the CDC’s Vaccine Adverse Event Reporting System. That database records any negative results that an individual reports after they are vaccinated for any illness, and helps the CDC keep track of potential patterns to study in the name of safety.

The app can also remind you if you need your second dose, but it cannot be used to schedule vaccine appointments.

“At Peninsula and Hampton Health Districts, where we are vaccinating with Moderna, a link is sent out via email to everyone who came through the clinic for the first dose, 1-2 days prior to their second dose clinic day,” Ferrainolo said in an email. “If they do not have an email, or the email was incorrect and sent back to us, they receive a call.”

Moderna vaccines require at least 28 days between the first and second shot. Pfizer vaccines require at least 21 days. Due to limited vaccine allotment and recent delays in shipments because of snowstorms, some people will end up waiting a few more days to get their second dose, rather than having an appointment scheduled 21 or 28 days later.

“The CDC has stated that the efficacy of the Moderna vaccine is still viable up to 42 days, if necessary,” Ferrainolo said. “If they have not received an email or a phone call from us, and it is well before the 42-day mark, then their second dose clinic appointment has yet to be scheduled.”

What not to do

According to Ferrainolo, individuals getting vaccinated should not take any NSAIDs — “non-steroidal anti-inflammatory drugs” including acetaminophen (Tylenol), ibuprofen (Advil) or naproxen (Aleve) — before their vaccine appointments.

“Their anti-inflammatory effect may interfere with the body’s ability to create immunity to COVID19 infection,” Ferrainolo said in an email.

However, should the expected side effects such as arm pain or fever occur after you have received the vaccine, NSAIDs are safe to take after the vaccine has been administered.

Williams and Huffstetler confirmed the same information.

“Anti-inflammatories are designed to suppress your immune response when you have things like a fever,” Huffstetler explained. “If you are using them prior to getting a vaccine, it’s possible that the immune cells are going to be suppressed,” which could produce a weaker response to the COVID-19 vaccine and therefore to the virus itself later.

This effect from NSAIDs was known before COVID-19 when it came to things like the seasonal flu vaccine, and applies then as well. However, according to Williams, NSAIDs are “clearly recommended” for use if someone experiences uncomfortable side effects after the vaccine has been administered.

There’s also some early, recent research that suggests steroid injections may have a similar, limited effect on the body’s immune response, but “I don’t believe I’ve seen clear recommendations come out (on) what does that mean,” Williams said. If a patient getting steroid injections is concerned, they should consult their doctor.

And while taking multivitamins or probiotics will not harm anyone about to get their COVID-19 vaccine, there’s not much research to suggest that it will support the immune response the body produces after getting the vaccine, according to University of Virginia Heart and Vascular Center registered dietitian Katherine Basbaum.

“The short answer is that there isn’t anything that has been shown” to suggest multivitamins can provide a stronger effectiveness to the COVID vaccine by supporting the immune system, she said in a phone call.

Even for elderly adults, or younger people on restricted diets or who are underweight due to malnutrition, taking multivitamins a few days before their vaccine appointment won’t help — the benefits come from taking multivitamins over a period of weeks, according to Basbaum.

“Taking a reasonable amount of a vitamin is probably not going not hurt you,” Huffstetler said, but it probably won’t help your body’s immune response as much as being healthy and waiting two weeks after any other vaccines to get the COVID shot.

“Balanced nutrition … is just overall important” to staying healthy, Williams said.