You and the COVID-19 vaccine.

Delta is believed to be the most transmissible variant yet, spreading more easily than both the original strain of the virus and the Alpha variant first identified in Britain. Public health officials there have said that Delta could be 50 percent more contagious than Alpha. Delta may also cause more severe illness. A recent Scottish study, for instance, found that people infected by the Delta variant were roughly twice as likely to be hospitalized than were those infected with Alpha.

Source: CDC: Variants of the Virus that cause COVID-19, Medical News Today: Delta Variant, Imperial College London

The Delta variant is unlikely to pose much risk to people who have been fully vaccinated. According to one recent study, the Pfizer-BioNTech vaccine was 88 percent effective at protecting against symptomatic disease caused by Delta, nearly matching its 93 percent effectiveness against the Alpha variant.

Source: CDC: Variants of the Virus that cause COVID-19

Actually, it seems to affect the younger population more often. In the United Kingdom, studies showed that children and adults under 50 years old were 2.5 times more likely to become infected. Plus, the symptoms are a bit different. A cough is becoming less common and loss of smell is no longer listed in the top 10 common symptoms. Researchers are concerned people may mistake symptoms for a bad cold and avoid quarantine, helping the variant spread.

Source: CDC: Variants of the Virus that cause COVID-19, Medical News Today: Delta Variant

The Food and Drug Administration has given emergency authorization to the Pfizer-BioNTech vaccine for young people aged 12 to 17. The dosage of Pfizer vaccine authorized for 12- to 17-year-olds is identical to the dosage given to adults: two doses of 30 micrograms each given three weeks apart.

Source: CDC: COVID-19 Vaccines for Children and Teens

Yes. Both the Centers for Disease Control and Prevention (CDC) and The American Academy of Pediatrics (AAP) recommend vaccinating all children ages 12 and older who are eligible for the federally authorized COVID-19 vaccine.

Source: CDC: COVID-19 Vaccines for Children and Teens,  American Academy of Pediatrics Calls for Children and Teens Age 12 and Up to Get the COVID-19 Vaccine

While most children do not get severely ill from COVID-19, thousands have been hospitalized and hundreds have died. Vaccination will help protect children from developing serious illness as the Pfizer clinical trials demonstrated 100% efficacy and robust antibody responses in ages 12-17. Additionally, since adolescents can transmit COVID-19 to others, vaccinating children may prove to be an important part of safely getting back to normal activities of life, including attending school in person, participating in team sports and spending time with friends. In order to reach herd immunity, it is important to have a high percentage of the community immunized, including adolescents.

Sources: Pfizer: COVID-19 Vaccine Study in Adolescents, American Academy of Pediatrics Calls for Children and Teens Age 12 and Up to Get the COVID-19 Vaccine

Non-severe side effects may be experienced following vaccination. The most commonly reported side effects have been pain and swelling at the injection site. Other common side effects include tiredness and headache. Similar to young adults, some adolescents have experienced fever, chills, muscle aches and joint pain, which may be more common after the second dose. These effects are short-lived and most resolve within one to two days.

Source: CDC: COVID-19 Vaccines for Children and Teens

Both the Centers for Disease Control and Prevention (CDC) and The American Academy of Pediatrics (AAP) have stated that children can receive other vaccines at the same time as the COVID-19 vaccine.

Source: CDC: COVID-19 Vaccines for Children and Teens, American Academy of Pediatrics Calls for Children and Teens Age 12 and Up to Get the COVID-19 Vaccine

All persons 18 years of age and older are eligible to receive the vaccine in Florida. As of Monday, April 5, all Florida residents shall be eligible to receive any COVID-19 vaccine as prescribed by the Food and Drug Administration.

Persons under the age of 18: The Pfizer vaccine is authorized for persons 12 and up. The Moderna and Janssen (Johnson and Johnson) vaccines are authorized for persons age 18 and up. All individuals under the age of 18 receiving a vaccine must be accompanied by a guardian and complete the COVID-19 vaccine screening and consent form found here.

There are recommendations for people who have had allergic reactions to other vaccines. If you have had allergic reactions to any ingredients found in the COVID-19 vaccines or in a vaccine for another disease, regardless of severity, you should ask your TopLine MD affiliated physician if you should receive the COVID-19 vaccine. Your physician will help you with deciding if the COVID-19 vaccine is safe for you.

Source: CDC: Vaccines and Allergic Reactions

UPDATE: April 14, 2021

The American College of Obstetricians and Gynecologists (ACOG) issued a press release encouraging young women and pregnant women to preferentially receive either the Pfizer or Modena vaccine series. It also mentions that if a patient has already been vaccinated with the Johnson & Johnson vaccine and displays any clinical signs or symptoms of a deep vein thrombosis to not treat with heparin. Please review the statement here.

The Advisory Committee on Immunization Practices (ACIP) recommends that people who are part of the recommended groups (see “Who is recommended to get the COVID-19 vaccine?”) and women who are pregnant can choose to be vaccinated. As the COVID-19 vaccines do not contain live virus, experts believe the vaccines are likely to be safe when used during pregnancy, based on what is known about how the vaccines are made. However, since there has been no testing with the COVID-19 vaccines and women who are pregnant, researchers are not aware of any known risks.

There is data that shows pregnant people with COVID-19 have an increased risk of severe illness. Pregnant women with COVID-19 may also be at an increased risk of adverse pregnancy outcome, such as preterm birth, when compared with pregnant women without COVID-19.

If you are pregnant and have questions on receiving the COVID-19 vaccine, talk with your TopLine MD affiliated obstetrician-gynecologist (ob-gyn) or provider to help you make an informed decision. Your providers can discuss your risk of getting COVID-19 and assess risks for severe illness if you were to get sick.

For more information, you can find additional vaccine advice for pregnant or breastfeeding women composed by the Society for Maternal-Fetal Medicine or you can read Vaccination Considerations for People who are Pregnant or Breastfeeding from the CDC. 

For general information on COVID-19 vaccines, read How do we know the COVID-19 vaccines are safe and effective? One expert explains from the American College of Obstetrics and Gynecology (ACOG)

Source: ACOG: Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients, ACOG: How do we know the COVID-19 vaccines are safe and effective? One expert explains, CDC: COVID-19 Vaccines and Allergic Reactions, CDC: Vaccination Considerations for People who are Pregnant or Breastfeeding, Society for Maternal Fetal Medicine: Vaccine Advice if You Are Pregnant or Breastfeeding

Yes. The American College of Obstetricians and Gynecologists (ACOG) recommends that breastfeeding women receive the COVID-19 vaccine. Because the COVID-19 vaccine does not contain live virus, mRNA vaccines are not thought to be a risk to breastfeeding infants or on milk production/excretion. The CDC recommends that people who are breastfeeding can choose to be vaccinated.

For more information, you can read additional vaccine advice for pregnant or breastfeeding women composed by the Society for Maternal Fetal Medicine or you can read Vaccination Considerations for People who are Pregnant or Breastfeeding from the CDC.

Source: ACOG: Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients, Society for Maternal Fetal Medicine: Vaccine Advice if You Are Pregnant or Breastfeeding, CDC: Vaccination Considerations for People who are Pregnant or Breastfeeding

Appointments may be required and vaccine availablilty will vary at each vaccine location. It is recommended that you contact the vaccine location to find out more information on appointment requirements and vaccine availability beforehand. Through the Florida Department of Health, you can find a vaccine location that is near you.

Source: Florida Department of Health: COVID-19 Vaccines in Florida  

After receiving the vaccine, vaccination sites have a recovery section where people are asked to wait 15 minutes for additional monitoring.
You may experience some side effects, which are normal signs that your body is working to build protection against COVID-19. While these side effects may impact certain daily activities, they should go away in just a few days.

With the Janssen COVID-19 vaccine, you will need a single dose in order to receive full vaccination

With the Moderna and Pfizer-BioNTech COVID-19 vaccines, you will need 2 shots in order for them to be effective. Even if you experience side effects from the first shot, you should still receive the second shot or dose, unless you are instructed by your physician to not receive the second shot. COVID-19 vaccines that require 2 shots may not provide protection for up to two weeks after you receive your second shot. After any vaccination, it takes time for the body to build protection.

For more information on side effects, you can print out this handout from the CDC What to Expect after Getting a COVID-19 Vaccine- Handout and see “What are the side effects of the COVID-19 vaccine” below.

Source: CDC: What to Expect after Getting a COVID-19 Vaccine

Pain and swelling on the arm that you received the COVID-19 vaccine shot are common side effects as well as fever, chills, tiredness, muscle pain, nausea, and headache.
If you are experiencing pain or discomfort, talk to your TopLine MD affiliated physician about using over-the-counter medications, such as ibuprofen or acetaminophen, to help manage. You can also try other methods to alleviate pain from the vaccination site by applying a (clean) cool, wet washcloth or exercising the arm. To help reduce discomfort from fever, you should ensure you drink plenty of water or fluids and dress lightly.

Source: CDC: What to Expect after Getting a COVID-19 Vaccine

Most cases of discomfort from fever or pain from the vaccination site are normal and to be expected after receiving the vaccine. If the redness or tenderness where you received the vaccine increases after 24 hours and/or if your side effects do not appear to be subsiding after a few days, you should contact your TopLine MD affiliated physician. If you do not have a primary care physician, it is important to consider selecting a primary provider when seeking routine care or annual exams.

If you think you are having a severe allergic reaction after receiving the COVID-19 vaccine and have left the vaccination site, seek immediate medical attention by calling 911.

For more information on allergic reactions to the COVID-19 vaccine, see “What do I do if I have an allergic reaction to a COVID-19 vaccine?”

Source: CDC: What to Expect after Getting a COVID-19 Vaccine

There are two types of allergic reactions: a non-severe allergic reaction and a severe allergic reaction.

For non-severe allergic reactions, you may experience hives, swelling, and wheezing (respiratory distress) within 4 hours of receiving the COVID-19 vaccine. This is also known as an immediate allergic reaction. If you have experienced an immediate allergic reaction to any ingredients found in an mRNA COVID-19 vaccine, regardless of severity, the CDC recommends that you should not get either of the available mRNA COVID-19 vaccines. If you experience an immediate allergic reaction after receiving the first dose of an mRNA COVID-19 vaccine, you should not receive the second dose. You can discuss your options further with your TopLine MD affiliated physician who may refer you to an allergist and immunologist.

For severe allergic reactions, there are reports that some people have experienced anaphylaxis after they received the COVID-19 vaccine. An allergic reaction is considered to be severe when a person needs to be treated with epinephrine or if they must seek immediate medical attention at a hospital. If you have experienced a severe allergic reaction to any ingredients found in an mRNA COVID-19 vaccine, you should not get either of the available mRNA COVID-19 vaccines. If you experience a severe allergic reaction after receiving the first dose of an mRNA COVID-19 vaccine, you should not receive the second dose. You can discuss your options further with your TopLine MD affiliated physician who may refer you to an allergist and immunologist.

Source: CDC: COVID-19 Vaccines and Allergic Reactions

If you have experienced an immediate or severe allergic reaction to any ingredient that is found in an mRNA COVID-19 vaccine, you should not get either of the available mRNA COVID-19 vaccines. If you had an immediate or severe allergic reaction after receiving the first dose of an mRNA COVID-19 vaccine, you should not receive the second dose. You can discuss your options further with your TopLine MD affiliated physician who can provide additional guidance or care. If you do not have a primary care physician, it is important to consider selecting a primary provider when seeking routine care or annual exams.

If you have experienced a severe allergic reaction after receiving the COVID-19 vaccine, you may consider seeking immediate medical attention by going to the hospital or calling 911 if you have already left the vaccination site. You should let your vaccination provider know about your severe allergic reaction and they will send a report to the Vaccine Adverse Even Reporting System (VAERS), a national system that collects reports on the adverse events that happen after vaccination.

Source: CDC: COVID-19 Vaccines and Allergic Reactions

If you have been vaccinated and have been exposed to someone with suspected or confirmed COVID-19, you are not required to quarantine if you meet all of the following criteria:

• Are fully vaccinated (i.e., 2 or more weeks following receipt of the second dose in a 2-dose series, or 2 or more weeks following receipt of one dose of a single-dose vaccine)
• Are within 3 months following receipt of the last dose in the series
• Have remained asymptomatic since the current COVID-19 exposure

If you do not meet all 3 criteria above, you should follow the current quarantine guidance after exposure to someone with suspected or confirmed COVID-19.

Source: CDC: Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States 

According to the CDC, if you are fully vaccinated (i.e., 2 or more weeks following receipt of the second dose in a 2-dose series, or 2 or more weeks following receipt of one dose of a single-dose vaccine) you can:

• You can resume activities that you did prior to the pandemic.
• You can resume activities without wearing a mask or staying 6 feet apart, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.
• If you travel in the United States, you do not need to get tested before or after travel or self-quarantine after travel.
• You need to pay close attention to the situation at your international destination before traveling outside the United States.
• You do NOT need to get tested before leaving the United States unless your destination requires it.
• You still need to show a negative test result or documentation of recovery from COVID-19 before boarding an international flight to the United States.
• You should still get tested 3-5 days after international travel.
• You do NOT need to self-quarantine after arriving in the United States.
• If you’ve been around someone who has COVID-19, you do not need to stay away from others or get tested unless you have symptoms.

Plus, it is important to note that in the clinical office or clinical space, including hospitals, skilled nursing facilities, clinical home care, assisted living facilities, physical therapy, etc., the practice of mask wearing, hand washing and social distancing should continue to be maintained.

We are still learning how effective the vaccines are against variants of the virus that cause COVID-19. With that said, although restrictions have been eased for fully vaccinated people, the CDC says:

• You will still need to follow guidance at your workplace and local businesses.
• If you travel, you should still take steps to protect yourself and others. You will still be required to wear a mask on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States, and in U.S. transportation hubs such as airports and stations. Fully vaccinated international travelers arriving in the United States are still required to get tested 3 days before travel by air into the United States (or show documentation of recovery from COVID-19 in the past 3 months) and should still get tested 3-5 days after their trip.
• You should still watch out for symptoms of COVID-19, especially if you’ve been around someone who is sick. If you have symptoms of COVID-19, you should get tested and stay home and away from others.
• People who have a condition or are taking medications that weaken the immune system, should talk to their healthcare provider to discuss their activities. They may need to keep taking all precautions to prevent COVID-19.