DOCS: DO NOT FEAR VACCINE SIDE EFFECTS
As shots surge, all data point to safety, even amid reports of alergic reaction and blood clots
“The side effects all go away, and they’re not deadly. Nobody has died from any one of them.” DR. PETER CHIN-HONG
With the White House hitting its goal of administering 100 million shots six weeks ahead of schedule, COVID-19 vaccines are entering the arms of Americans at unprecedented levels.
That means experts keep getting better and better data about possible side effects and allergic reactions.
Questions raised about everything from delayed skin reactions dubbed “Moderna Arm” to concerns about possible issues with blood clotting or bleeding have attracted headlines and scrutiny but no new serious safety concerns, some doctors told the Daily News.
“The side effects all go away, and they’re not deadly. Nobody has died from any one of them,” said Dr. Peter Chin-Hong, an infectious diseases expert at the University of California-San Francisco.
“And they may actually be a good thing,” he said. “Think of them as your immune system being trained so that when the real COVID comes along, the army is all trained and fit and coordinated to fight this potential invader.”
He said more than 95% of doctors at his medical center have opted to receive a COVID vaccine.
The European Union’s heath agency said Thursday that it found no causative link between reported cases of blood clots and abnormal bleeding and AstraZeneca’s vaccine, which is not yet authorized in the U.S. On Friday, several countries in Europe resumed giving the shots.
Chin-Hong said overall, the rate of blood clots noted by AstraZeneca recipients was “even lower than the background rate of people in the community,” so connecting the two was “not valid.”
He also said it’s a “misplaced” worry to think the vaccine might affect blood platelets to the point that someone on blood thinners might have problems with bleeding.
“There’s absolutely no reason why people on blood thinners shouldn’t get the vaccine. In fact, one might say that people on blood thinners tend to have an underlying medical condition, and people with such conditions are at a higher risk of getting bad COVID. So these patients have more reason to get the vaccine than others, to tell you the truth,” he said.
Overall, severe allergic reactions for vaccine recipients remain super-rare, the doctors said.
According to the CDC, anaphylactic reactions occurred in only 2.5 cases per 1 million doses of Moderna vaccine administered. For the Pfizer-BioNTech shot, the rate was 11 per 1 million.
“It’s very rare to have anaphylaxis to the Pfizer or Moderna vaccines, but of course it has happened to people in the U.S. because we’re vaccinating so many people,” said Dr. Kimberly Blumenthal, an allergist and immunologist at Massachusetts General Hospital and assistant professor at Harvard Medical School.
Interestingly, all 10 anaphylaxis cases related to the Moderna COVID-19 vaccine and scrutinized by the CDC occurred in women.
Experts have also noted that women and younger people are reporting higher rates of milder
side effects such as headache and fatigue, likely a function of their more active immune systems.
In terms of women, estrogen has been showed to increase immune response while testosterone is more of an “immune suppressor,” Chin-Hong said. Furthermore, many of the genes involved in making immune cells sit on the X chromosome, and women have two Xs, he said.
A more recent study by Blumenthal tracked more than 52,000 health care workers who filled out a symptom survey after their first dose of either the Pfizer or Moderna vaccine through Mass General Brigham.
“We found that significant allergic reaction occurred in just 2.5 per 10,000 people, which is really low,” she said, the equivalent of 0.00025%.
Anaphylaxis was confirmed in 16 of the cases — seven from the Pfizer-BioNTech vaccine and nine from the Moderna vaccine. All of the people recovered.
The much more common side effect, showing up about 2% of the time, was a skin reaction such as rash, swelling, redness or hives, she said.
Typically, such reactions are minor and resolve themselves in a matter of hours or days. In the meantime, people can treat any pain with Tylenol and any itching or rash with antihistamines such as Allegra or Zyrtec, Blumenthal said.
She said a “more peculiar” side effect has been dubbed “COVID vaccine arm” or “Moderna arm,” where people, most commonly Moderna recipients, see a delayed skin reaction in the form of a large rash near the site of injection that begins a week or so later.
“We don’t know how frequently this specific reaction is happening. It was reported in the trial for Moderna at 0.8% of participants, but I have a feeling it’s much more common than that because we’ve just seen so much of this,” Blumenthal, who published a recent paper on the topic, said.
In the Moderna trial, participants were tracked closely for their first week after injection but then were left to voluntarily self-report issues after that, she said.
Either way, the rash is temporary and might actually be a good sign, she said.
“We know that there are T-cells involved in the delayed large local reactions to Moderna because we biopsied one of the individuals. The T-cells are some of our immune fighters,” she said.
“It might be the body’s natural and good immune response to making our antibodies against COVID or could be an allergic response to inactive vaccine ingredients. We don’t know yet,” she said.
“We usually think of hives as ’allergic,’ but hives happen with viral infections quite often and hives could be your body making the immune response we want,” she said.
The experts said people are asked about their allergy histories before getting their vaccines as a precaution, a sort of proxy to determine if they might benefit from monitoring after injection.
“I’ve encouraged all of my patients with latex, shellfish, contrast, penicillin, whatever allergies to go get whatever vaccine is available for them first,” Blumenthal said.
“If you’re an adult, there’s no reason not to get it,” Chin-Hong said. “In fact, I’d rush out and get it.”