Battling the ‘infodemic’ on vaccines: All your questions on allergies, efficacy and dosage answered
Where are we now, a year after this pandemic gripped the world, leaving a trail of deaths in its wake? The number of infected cases worldwide has climbed to 140 million while the global death toll now stands at over three million (and counting).
As of this writing, a fresh and more ferocious third wave of infection is sweeping across countries in the Asia-Pacific region, including the Philippines.
On a brighter note, we now have the COVID-19 vaccines and the ramped-up vaccine rollouts across the world could spell a glimmer of hope at the end of the pandemic tunnel. However, we're up against another kind of epidemic called “infodemic.” There's just too much information (misinformation) floating around that we don't know what and who to believe.
Here to separate fact from fiction and shed light on some questions we've always wanted to ask about COVID-19 vaccines is Dr. Joseph Adrian Buensalido, infectious disease specialist at Manila Doctors Hospital, Makati Medical Center, and Asian Hospital, where he's chair of Infection Prevention and Control and research committee member of the Department of Internal Medicine.
Dr. Buensalido is also clinical associate professor and deputy training officer, Section of Infectious Diseases, Department of Medicine at the University of the Philippines-Philippine General Hospital. Excerpts:
First of all, are you done with your shots?
Dr. Joseph Adrian Buensalido: Yes, I was one of the first 100 people to sign up for the Sinovac/CoronaVac vaccine at the UP-Philippine General Hospital. At the time, many people still had vaccine hesitancy, even among healthcare workers.
On March 31, I got my second dose. It will take around two weeks before I get the expected optimal protection from the two-dose vaccination series. Nonetheless, I will still continue the tried-and-tested strategies for infection prevention and control: wearing a mask and face shield correctly, physically distancing, and performing hand hygiene before touching my eyes, nose, and mouth.
Is now the right time to get vaccinated or should I wait, say till next year, when we should have learned more about these vaccines?
When it's available and offered to you, it’s the right time. We are in an emergency, like in the Titanic ship which is slowly sinking. But what's good is that the "life vests" have arrived and they've started distributing them to us. When a vaccine is offered to you, take it, don't wait for the shiny, colorful life vests the other ships have been giving out. These vaccines are all designed to protect us individually.
But more importantly, there is such a thing as herd immunity. When most of the population have immunity (or protection from SARS-CoV-2), whether from vaccination or from natural infection from a contagious person, the virus will have a difficult time jumping from a sick person to another susceptible person. This is the best chance of stopping the chain of transmission.
Based on scientific computations, if less than 67% of us get immunity, the virus will still have a lot of warm bodies to infect and the pandemic will continue.
Those on chemotherapy can get their shots at any time before or after their chemo session. HIV patients, whose present condition is known and stable, may get immunized. So can people with autoimmune diseases.
Are the currently available vaccines effective against the new COVID-19 variants?
The vaccines may lose some of their protective effect against COVID-19 variants of concern, particularly the South Africa variants. Even so, there will still be some protective effect, and not zero. In addition, science is not static. As doctors and scientists learn more about these variants and how they affect our present vaccines, researchers and vaccine developers will be fighting back by updating or making new ones to boost our immunity against the variants of concern.
American scientist/immunologist Dr. Anthony Fauci said we should take any vaccine as quickly as possible. Does this mean no vaccine is better than the other?
Some vaccines are a little better in terms of preventing mild and moderate COVID-19 diseases. But the vaccines we have so far are almost all uniformly very good in preventing severe COVID-19. This means that when we get vaccinated, there is still a chance that we'll get mild disease presenting as colds, cough, sore throat, fever, and aches, but we won't be sick enough to have to go to the hospital or be admitted into the intensive care unit. More, we won't be at risk of dying. The good news is that the vaccine will protect us from the severe or critical type of COVID-19.
Each vaccine may have their differences, but each one will provide some protection against mild to moderate COVID-19, while giving excellent defense against the bad kind of COVID-19.
Can I get vaccinated if I have allergies? What health conditions are not eligible for a COVID-19 vaccine?
The best advice is to see your doctor to discuss your eligibility for any of the vaccines available. In general, if you are clinically healthy and you do not have an allergy to any components of the vaccine that you plan to receive, you will likely get the go signal from your doctor.
If you find out that you are allergic after the first dose, then you cannot get the second dose of that same vaccine. There's no medical condition that makes one ineligible to receive a COVID-19 vaccine. However, please talk to your doctor as there are some conditions that may need a delay or earlier immunization in relation to a specific health condition. For example, it would be best to finish the vaccination series two weeks before a transplant, or three to six months after, if it could not be done prior to the procedure.
Those on chronic steroids may get vaccinated (except if a live vaccine). Those on chemotherapy can get their shots at any time before or after their chemo session. HIV patients, whose present condition is known and stable, may get immunized. Those with autoimmune diseases, even if they're receiving medicines that may make them a bit immunosuppressed, may still get the vaccine.
If you have hypertension, diabetes or asthma, and you appear and feel clinically well, you may be given the vaccine.
How safe are these vaccines for pregnant women and breastfeeding mothers?
At present, there are no actual data as to the safety of these vaccines for pregnant women and breastfeeding mothers because they were not included in the vaccine clinical trials. However, pregnant and breastfeeding women are encouraged to talk to their doctors about the possibility of getting a vaccine after discussing their specific risks and potential benefits.
Why is the Johnson & Johnson vaccine only a single dose while all the others require two doses? If I take a two-dose vaccine, can I stop after the first?
Each vaccine (Pfizer-BioNTech, Moderna, AstraZeneca, Sinovac, etc.) was developed by different experts and each one has certain unique characteristics. What's unique about the Johnson & Johnson vaccine is that one shot has been shown to provide acceptable levels of protection already. But the truth is, they're still testing the vaccine to see if a second shot will improve the acquired immunity even more.
On the other hand, most of the other vaccines were developed as two-dose vaccines and so we need to get both doses or else we will have less than the expected level of protection.
Infectious disease specialist Dr. Joseph Adrian Buensalido: “This is our war and there's no silver bullet. What we need is to unite against this virus that we cannot reason with.”
Do we already know how long COVID-19 vaccines will protect us?
Remember that COVID-19 is just around a year old. This means that the clinical trials and studies are less than a year old as well. Therefore, we don't actually know yet how long our protection from immunization will last. This is why we should make the most of what the vaccines can offer us in terms of benefit and protection, both individually and as a community, and do it fast.
Do I have to get vaccinated every year?
We do not know yet if we need to get a shot yearly. However, if we achieve herd immunity, there's a good chance we won't need to. For example, the transmission of the original severe acute respiratory syndrome (SARS) ended within a year. Smallpox is a thing of the past because of vaccination.
If I already tested positive for COVID-19, can I still get vaccinated?
Yes, it is recommended that those who already recovered from COVID-19 be vaccinated. After you get COVID-19, you will still have the antibodies that you naturally developed because of the infection for the next three months. However, if you are at high risk of getting the infection, particularly if you're a health worker, then you can be immunized once you have recovered from COVID-19 (and after the recommended isolation period has been lifted by your doctor).
When will this pandemic end?
Historically, pandemics last around two to three years. I hope history repeats itself by ending this pandemic in two or three years’ time, instead of breaking a record or setting a precedent.
A common sentiment among Pinoys is this: No to vaccine. I will just live a healthy lifestyle to avoid getting COVID-19. What do you say to this?
That alone will not cover up the other holes in a person's defenses. The other holes should be covered by the other effective infection prevention strategies that I have mentioned. And those strategies will include the final piece of our defense—vaccination.
Some people are posting home remedies to prevent COVID-19 (like inhaling steam, drinking hot tea, taking vitamins C and D and zinc). Do these remedies really protect against COVID-19?
These home remedies may help, but the protection they provide has not yet been proven without a shadow of doubt. In fact, many of them have insufficient scientific evidence, as of the present time, to say they're effective in preventing (or treating) COVID-19.
Take steam inhalation (or what we call suob) for example. It can help us for our symptoms, but there's no sufficient evidence that it can treat or prevent COVID-19. By insufficient data, we don't mean it's prohibited. What we mean is it's not the sole cure for COVID-19 although it can help if the one using it thinks he's feeling better.
Similarly, zinc intake when sick has good evidence that it shortens the duration, not of COVID-19 but of viral upper respiratory infections (in which coronavirus is the second most common cause), but it is not good at preventing it. Regular intake of vitamin C has evidence that it modestly decreases the duration of illness of viral upper respiratory infection if it's acquired (similarly, not specific to COVID-19), but it is not so good when just taken when sick.
Again, all this may help, but we should not rely solely on these remedies.
To sum it up, what's your message to the Filipino people?
Just as our ancestors and grandparents went through World War I and World War II, this is our war and we share common enemies: SARS-CoV-2 and its end product COVID-19. They have drastically changed our way of life and we have to fight back.
