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10 Questions About the Covid Vaccine for Providers, Patients

Healthcare providers and their patients have all kinds of questions about the Covid-19 vaccines, not the least of which is when they can get one. Dr. Paul Sax, a professor of medicine at Harvard Medical School, put together a list of the most common ones with answers that will help you and your patients.

We excerpted a few from his list in the New England Journal of Medicine:

1. How long do the vaccines work?

Having waited to get a vaccine, you and your patients probably don’t want to do go through it again anytime soon. Unfortunately, Sax says, there is not a lot of evidence yet on how long the effects of the vaccine last, though some Moderna data suggested “neutralizing antibodies persisted for nearly 4 months with titers declining slightly over time.”

2. Do the vaccines prevent transmission of the virus to others?

This is an excellent, unselfish question from people who are concerned that they could still pass along the virus even if they themselves are protected. Sax again says that the evidence is sparse, but some tests hint the vaccine may prevent asymptomatic infection and he notes that vaccines, in general, prevent disease and infection. “If there is an example of a vaccine in widespread clinical use that has this selective effect — prevents disease but not infection — I can’t think of one!” he says.

3. Is one vaccine preferable to the other for specific patients?

In short, no.

4. Can a patient with a history of an allergic reaction get the vaccine?

Yes, “it doesn’t matter whether it’s an allergy to other vaccines or medications or to bee stings or food or pollen,” but those patients should be observed for 30 minutes instead of the usual 15 minutes after their shot.

5. Should acetaminophen or nonsteroidal antiinflammatory drugs be taken prior to vaccination to prevent postvaccination symptoms?

No. “Although these drugs could decrease subjective side effects, theoretically they could also blunt immune response and make the vaccines less effective — hence they are not recommended before vaccination.” Although taking them after to relieve side effects is fine.

6. Is a second dose given later than 21 or 28 days still effective?

If delays continue to hamper the rollout of the vaccine, patients may be concerned that there won’t be a vaccine available for them when it’s time for their second dose. However Sax says “there is no biological reason why receiving the second dose late would diminish the effectiveness of the vaccine, provided it’s received before too long an interval.”

7. Should a vaccination be delayed if a patient has any symptoms or is actively ill?

The shot should be delayed for patients with acute illness until they recover, he says, but there is no need to delay the shot for people with chronic diseases and stable symptoms.

8. Should a patient who was exposed to Covid-19 get the vaccine to prevent the disease?

There’s no data to show this would work. A patient who has been exposed to Covid-19 should finish their 10- to 14-quarantine before getting the vaccine, Sax says.

9. Should patients who have recovered from Covid-19 get the vaccine?

Yes. The exception would be patients who were treated with monoclonal antibodies or convalescent plasma, who should wait 90 days. “These treatments might inactivate the vaccines, making them less effective,” Sax notes.

10. Does the second inoculation need to be the same vaccine?

“There are no data to indicate that receiving a different vaccine as a second shot would be unsafe or less effective, but the vaccines have not been studied this way and such hybrid dosing strategies should be avoided,” he writes.