Dr. Whitney
Hello and welcome to episode 3 of "Ask a Health Expert." I'm your podcast host, Dr. John Whitney, Vice President here at Anthem.
You may be wondering what you can expect when you go for your shot. How can you prepare for it? What should you do during your vaccine appointment and right after? And what do you need to know once you're fully vaccinated? To answer these questions and more, I'm joined by Dr. Shantanu Agrawal, Anthem's Chief Health Officer.
Dr. Agrawal oversees Anthem's community health strategy, addressing social drivers of health. He also leads the Anthem Foundation, and we appreciate having him on with us today. Dr Agrawal, it's great to have you here.
Dr. Agrawal
John, thanks very much. I'm happy to be here.
Dr. Whitney
Listen, there's a lot of conflicting information out about pain killers and other medications and how they might affect the COVID-19 vaccines. Can you tell me, is it safe to take these medications before or after your appointment? Should you take them?
Dr. Agrawal
Yeah, that's a great question. I know a lot of people have heard about potential side effects from the vaccine, like maybe feeling a low-grade temperature or getting some muscle aches and pains. In general, the guidance is prior to the vaccine, it's not actually recommended that you take any over-the-counter medications such as ibuprofen, aspirin, or acetaminophen, and not to actually do that in advance in an effort to prevent vaccine related side effects - like I talked about, the fevers, the muscle aches. And the main reason for this guidance is because we don't know how these medications might affect how well the vaccine works. We obviously want the vaccine to be as effective as possible and to, therefore, play it safe. Now, look, if you take these medications regularly for other reasons, you can, and obviously should, continue taking them before being vaccinated. But just not to do it in advance or in anticipation of the vaccine itself.
It's also not recommended that you take antihistamines like Benadryl before getting the vaccine in order to prevent any kind of reaction. One reason for that is because in the event that you did have some kind of allergic reaction, taking an antihistamine might actually make it harder to diagnose that reaction and delay appropriate treatment.
Now, having said all that, that's sort of prior to the vaccine. If post vaccine it turns out you develop soreness in your arm, which has been a commonly reported finding, then you can try an ice pack. You can try a warm washcloth to help deal with that soreness. And after the shot, if you're experiencing symptoms, the CDC does actually say it's OK to take acetaminophen or ibuprofen in order to deal with the fever or body aches and pains that you might be experiencing.
Dr. Whitney
Great, that makes a lot of sense. So try to avoid taking anything that might interfere with the vaccine - it's so important to get vaccinated - and try to manage it just with some local treatments if possible afterwards.
Dr. Agrawal
Yeah, I think that's exactly right. One way to think about it is the vaccine really is trying to create an immune response. That's how the vaccine is working. So, in a sense, blunting the immune response in advance actually can be counterproductive. And perhaps this is the glass half full kind of view, but if you are having that immune response - the fever, the muscle aches - well, that's how you know the vaccine is working. And that's almost a good thing. And then maybe treating the symptoms after the fact is appropriate.
Dr. Whitney
Makes sense. So what about other vaccinations at the same time or other health screenings? Are there any reasons why you should or shouldn't get those done at the same time as your COVID-19 vaccine?
Dr. Agrawal
Yeah, also a really great question. The CDC currently does recommend that you wait about 14 days around the time of your COVID vaccine before you get any other vaccine. So that is either 14 days before or after, and that includes a flu shot or a shingles vaccine. And if you have received one of those other vaccines, then you really ought to be waiting at least the 14 days before getting your COVID-19 vaccine.
Now we know that the COVID-19 vaccine can cause certain reactions or side effects - for example, causing your lymph nodes to become temporarily enlarged. And that actually has been found to lead to some false positive tests like mammograms. So there's also some guidance from the CDC that basically says if you're due for a mammogram around the time of your vaccine, that you actually wait four to six weeks until after you're fully vaccinated to get that mammogram. And that's to make sure that your lymph nodes return to their normal size and doesn't lead to a false positive on that screening test. But again, here too, I think if you have any particular questions, you should communicate with a trusted caregiver and make sure both of you are on the same page and have a really good plan for proceeding both before and after the vaccine.
Dr. Whitney
That's great information, and it makes a lot of sense to try to do everything you can to make sure that vaccine will be effective by avoiding other vaccines in the immediate aftermath or before. And I hadn't heard about the lymph node enlargement, so lots of different things happen, I guess, when your immune system gets engaged. What else should you do when you're preparing for your vaccine? Anything else you should avoid or plan to do?
Dr. Agrawal
There's some really good formal guidance, and I can just sort of tell you a little about my informal experience. So formally, you really should avoid alcohol the day before, and it's important to stay hydrated. If you can take some time off from work, or at least sort of schedule around maybe not feeling at your best, feeling a little bit under the weather, that would be a great thing to do. Just being in a position where you can get some rest if needed is always a good idea.
I'll tell you informally, I had a pretty good experience with the vaccine. I did kind of follow this overall guidance. Particularly after the second shot, I felt like I had more of those symptoms from just an inflammatory immune response. I did get a low-grade temp, I felt a little bit run down. But it really lasted for less than 24 hours, in my case, and then I felt a lot better. And that seemed to be at least typical for other people that I've talked to that have gotten vaccinated.
Dr. Whitney
That is great common-sense advice. And I'll tell you, I had a very similar experience when I was vaccinated as well with really very little in the way of symptoms after either the first or the second dose, and the little that I had went away pretty quickly too. So I felt fortunate for that. But I also think that we represent the norm. The majority of people are also going to have not in the way of major side effects.
OK, so you're ready for your appointment. You didn't take any medications, you didn't drink, you got a good night's sleep. Other than choosing the arm for the shot, anything else you should do at that appointment or shortly after?
Dr. Agrawal
I think it's really important with a few different vaccines that have been authorized for use in this case, you definitely want to make sure you know what vaccine you're getting. Two out of the three require two doses, so just get familiar with how far apart those two doses are. Make sure either before or once you've been vaccinated at the vaccination site you inquire about scheduling for that second dose. And again, different states do this differently. Some will reach out to you and schedule after you've left the vaccination site. Others want you to schedule that second appointment prior to departing. So make sure you understand is it three weeks apart or four weeks apart and exactly when you're supposed to schedule that second dose so that you don't miss it. It is really important to try to stick to the timetable to really maximize the efficacy of the vaccine and make sure that you're getting the full protection that it affords.
And there's actually a CDC app that you can use to monitor your side effects, to enter information if you feel like there might be something unusual. And I do encourage people to do that because we've certainly already seen it in action with one of the vaccines, but the information really does help the CDC monitor the safety of the COVID-19 vaccines. And that app, the v-safe app, can also remind you when it's time for a second dose if you need one.
And then the last thing is you'll get a really nifty vaccine record card after your first vaccination, and then they'll update it after your second if the second is necessary. And I just encourage you to keep that in a safe place. I think it's important, it's a great piece of evidence that you've been vaccinated.
Dr. Whitney
Thanks, makes sense. Yeah, when I got my vaccination, I took a photo of it with my phone. But don't post it to social media because it does contain your health information on it.
OK, so we've talked about what to do or not to do before the vaccination, how to get ready for it. Now you've had it. When does immunity kick in? And what's safe to do after you're fully vaccinated?
Dr. Agrawal
So in terms of when immunity kicks in. Look, the good news is that, even in a two-dose regimen, after the first dose you do have a measurable level of immunity. And there's been a lot of data released about that, a lot of public dialogue around that. However, that is not to suggest that you shouldn't get your second dose. You absolutely should because, again, the purpose of this is to optimize your immunity against COVID-19. And so the guidance really is that about two weeks after the second dose of a two-dose series or two weeks after the first dose in a single-dose vaccine is when you've really achieved your optimal immunity. So it really does take the full two weeks, and that's because there's just some biological processes that get initiated with a vaccine that do take some time to play out in order to really optimize your immune system. We have seen cases of people contracting COVID between the first and second shot, or even very close to the second shot. So I think there's some good data to really believe these numbers and make sure before you change anything about the way you've been socially distancing or really taking sensible public health precautions that you wait the full duration of time before any change to that. It's sensible to keep taking precautions like washing your hands, socially distancing where appropriate, wearing a mask in public. I think we have to acknowledge even once you've been vaccinated, we've been vaccinated, that there are still unvaccinated people out there, and we have to do our best to safeguard their health as well.
Dr. Whitney
Makes sense. Yeah, those recommendations continue to change. And I think we're all hopeful that as more people become vaccinated and the cases continue to fall, that we'll return to normal. I know in some other countries where higher penetration of the population's been vaccinated, they've really returned to a much more normal existence. And I, for one, am looking forward to that.
Well, Dr. Agrawal, thank you so much for taking time out of your busy schedule to answer our questions. I have one last question for you. Where can someone find a location to receive their vaccine?
Dr. Agrawal
Great. So first of all, I really thank you for the time. It's great to be here. I encourage people to go to vaccinefinder.org to find a vaccination site near you. And, again, I think the really optimistic news is we've really opened the door to anyone wanting a vaccine being able to get vaccinated. So go to vaccinefinder.org, find out a vaccination site that is near you, and make an appointment. And please go get vaccinated.
Dr. Whitney
Fantastic. I do want to add that Anthem covers the COVID-19 vaccine at 100%. This applies to all members regardless of the type of health plan they have or which doctor or healthcare professional they choose to visit for vaccination.
And we hope you'll join us soon for another episode of “Ask a Health Expert.”
