As many of you will know the last few weeks have brought the COVID-19 pandemic to the Kootenays. Up until this time we have been extremely lucky to have had only sporadic cases with no evidence of community spread. In recent weeks we are seeing a significant increase in cases across the Kootenay Boundary including cases of community spread (this means someone contracting COVID-19 without being able to trace back where they got the infection).
The physicians of Castlegar have recently met to discuss how we can address this and keep our citizens healthy.
We urge everyone to continue to do their best to adhere to Public Health guidelines. We are all tired. Tired of the pandemic, tired of the restrictions, tired of masks, tired of not seeing our family and friends. Yet it has never been more important that we strive to limit our contacts, wear masks, maintain distance, monitor ourselves for symptoms and isolate and get tested if we have any sense of feeling unwell.
It is a cliche, but we are in the crucial last miles of the race. While vaccine rollout has been frustratingly slow, it is coming. And the good news is, we have seen marvellous benefits of the vaccine in dramatically reducing death and serious illness in those populations that have been able to receive the vaccine.
So if we can just hang in there and continue to stick with those simple guidelines for just a while longer, we will get enough vaccine administered that numbers will improve and we can start returning to our “normal” lives.
Looking forward to the near future, when more people will have access to vaccines, we felt it would be helpful to address some common questions that we have been hearing from our patients. While we know that these vaccines are very effective, we also know that many of our patients feel a bit nervous about the vaccines being new and have questions about safety, side effects, how the vaccines work and if they have a reason why they shouldn’t have a vaccine.
In summary, hang in there! Keep following the rules to the best of your ability, get your vaccine when you are eligible and talk to your primary care provider if you have any questions or concerns about vaccines. We can finish this race together!
The answers to questions from local patients will be published in a series of articles.This is the first in the series.
How do Covid Vaccines work?
There are two types of vaccines being used in BC right now, mRNA vaccines (Pfizer and Moderna) and viral vector vaccines (Covishield/AztraZeneca). Both of these vaccines carry the code that has the instructions for building the spike protein that is on the outside of the SARS CoV-2 Virus.
Our cells read this code and make many copies of the spike protein. The protein is then transported to the surface of cells where it is displayed. Our immune system recognizes this protein as foreign (not self) and makes antibodies against it. This means that if we come into contact with the SARS CoV-2 virus our immune system is primed to attack it and can stop the virus before it makes us sick with serious COVID-19 illness.
The code that was taken into our cells to build the spike protein does not stay in our cells. It is quite fragile and is broken down by the machinery of our cells in under 24 hours.
Does the vaccine give me a mild case of Covid?
No. The COVID-19 vaccines are not live vaccines. They do not contain a modified version of the COVID-19 virus, just a bit of code to make the spike protein. It is not possible to get COVID-19 from the vaccine.
How well does the vaccine work?
All of the vaccines work exceedingly well to prevent serious illness, hospitalization and death (close to 100 per cent effective at preventing these things). We don’t know yet how well they prevent mild infections or the ability to spread COVID -19 without knowing that you have it (asymptomatic carriage).
Early studies suggest that all of the vaccines will reduce mild infections and transmission, but we don’t have exact numbers yet. It takes two to three weeks after vaccination before the immune system has responded fully to the vaccine. This means it is possible to get an infection after getting vaccinated if you are exposed to the virus before the vaccine has had time to work.
Was proper testing done of these vaccines?
It seems like it happened pretty fast. Vaccines go through four phases of testing. Phase 1 is safety (tested on a small group of people to look for major safety concerns). Phase 2 is immunogenicity (the ability to generate an immune response). Phase 3 is efficacy (the ability to prevent COVID-19 disease). In the case of the COVID-19 vaccines — 40,000 people were studied in Phase 2 and 3 of each vaccine trial.
Phase 4 is ongoing. This is the continued monitoring of vaccine safety and effectiveness. These vaccines went through all of the normal testing. No shortcuts were taken. However scientists and governments around the world worked together to share information and technology, provide funding and quickly review applications. This working together and sharing of information allowed the process to move forward much more quickly than normal.
I have allergies to medications, I have heard that means I can’t get the COVID vaccine.
Having an allergy to penicillin, or anything else, does not increase your risk of having an allergic reaction to the COVID-19 vaccines. The only allergy that is a concern is if you have had an allergic reaction to the COVID vaccine (ie. a first dose) or if you have an allergy to PEG (polyethylene glycol) which is a component of the vaccine.
People who have a history of anaphylaxis reaction to anything in the past — whether medication or food, will be asked to wait for 30 minutes after vaccination, rather than the usual 15 minutes. Of note, the rate of allergic reaction to the COVID-19 vaccines is not higher than the rate of allergic reaction to all of our standard vaccines (it is very rare).
Will the Covid Vaccine give me a blood clot?
Each year 1-2/1000 people will develop a blood clot. COVID-19 infection is commonly associated with blood clots. About 1 per cent (1/100) people who have a mild infection (do not need hospitalization) will get a blood clot. While 5 per cent (5/100) with a moderate infection and 20 per cent (20/100) with a severe infection will develop a blood clot.
The COVID-19 vaccines including the AstraZeneca vaccine do not increase the risk of this type of blood clot. Even if you have a history of having a blood clot before, the vaccine does not increase your risk of a clot, though COVID-19 infection certainly does.
The AstraZeneca vaccine may be associated with a very rare type of serious blood clot that is triggered by a different mechanism than the usual type of blood clots that we think about. This type of clot occurs in two to four people for every one million people who receive the vaccine (1/250 000 – 1/500 000). You can read more about this at thrombosiscanada.ca.
Where can I get more information about vaccines?
The website bccdc.ca/covid19vaccine has comprehensive information about the vaccines, how they were developed, the approval process and ongoing monitoring. We also encourage you to talk to your family doctor or nurse practitioner. We are here to support you and answer your questions.