Over the weekend, the Food and Drug Administration approved an Emergency Use Authorization (EUA) for the Johnson and Johnson COVID vaccine. The big thing is that this is a single dose vaccine with very easy to meet storage requirements:
Good to chat with @thsaey @ScienceNews about implications of EUA for J&J #covidvaccine. Having an effective single-dose vaccine could be a global game changer. @dukeghic @DukeGHI @DukeMargolis https://t.co/y0whFoVxqm
— Krishna Udayakumar (@krishna_u) February 28, 2021
This generates a few questions:
Which vaccine should I get?
Get vaccinated by whichever vaccine is locally available as soon as possible. All of the vaccines that have an EUA are equally effective in protection against death and severe disease. From a risk assessment point of view, all of the vaccines definitely reduce the consequences of infection. We are generating evidence on transmission effects at this time, but there are hints that the vaccines reduce transmission risk as well.
When should I get vaccinated?
As soon as possible. Pay attention to your state/local prioritization orders but once your group can vaccinated, go get vaccinated.
Where should I get vaccinated?
The federal government is setting up mass-vaccination sites. Primary care providers are likely to be able to get access to the one-shot vaccines and distribute through those channels. Get a vaccine from whatever source is easiest for you to schedule.
What should I do after I get vaccinated?
Go get ice cream. After that, still remember that you don’t get protection from infection for several days. Continue to mask-up and maintain outside social engagement whenever possible. After a week or two hugs are way lower risk. As more people get vaccinated, the odds that July 2021 look way more like July 2019 than July 2020 increase. We can get through this. We just need to ride out another couple of months as restrictions ease but we stay smart with behavioral modifications as well as built environment modifications. For instance I have a hard time seeing myself sitting and drinking in a bar while bullshitting with friends for a long time; however I’m more than willing to grab a beer and go out to the patio to geek out about price-linked subsidies in a month or two.
On The Road – Albatrossity – Yucatan #2
debbie
My first shot is this afternoon. Ice cream is an excellent suggestion!
p.a.
J&J also working on a 2-shot vaccine. (Source: guy on lacrosse podcast whose J&J worker mom worked on the 1 shot. #weirdwebconnections)
germy
Is it true that aspirin and other painkillers should be avoided after the jab?
wvng
We got our second Moderna shot last week. The next day we were very fatigued and arms sore, but that was the extent of negative reactions. The mental reaction is overwhelmingly positive. Now we continue to take the same precautions to protect the unvaccinated in our bubble and elsewhere, at least until data comes in that says that is not necessary. But even with all that the sense of freedom is amazing.
debbie
@germy:
I’ve heard that it’s before that’s the problem. Afterwards, it’s okay, as is an ice pack.
snoey
@germy:
Per my daughter the ID doc use tylenol instead of ibuprofen.
“no data, but the witchcraft is to allow the inflammation to occur”
Nelle
@snoey: I was told no anti-inflammatories but tylenol is okay.
raven
I got my second pfizer two weeks ago. I had one day of feeling shitty, no big deal.
The Fat White Duchess
Second Pfizer shot coming up in about two hours.
Anybody know if aspirin is OK? I can’t do Tylenol or ibuprofen.
PST
I just read 5 Pandemic Mistakes We Keep Repeating in The Atlantic. It is very persuasive, especially since that has been a source of excellent reporting. The main point is how counterproductive much public messaging has been and continues to be even when it is well intended. Historically, this includes how long we stuck with an insistence on “hygiene theater” after it was clear that ventilation, especially in workplaces, was far more critical, and the shaming of people engaged in outdoor activity after it should have been clear that spending time outside minimizes risk. Today, the author believes we are devoting way to much bandwidth to cautioning people about possible limitations on the effectiveness of vaccines when we should be emphasizing the high probability of their effectiveness against spread and against variants. The effect is to discourage people from taking advantage of a nearly miraculous development. There is much more.
Juju
I got my first Pfizer yesterday. I felt fine then and still do feel fine. My brother, a physician, said most o people have the issues after the second shot, and that lasts about 12 hours. He spiked a fever of 104 for about 12 hours and then he was fine. My almost 88 year old mother is getting her second on Tuesday. I’ll have to keep an eye on her.
Richard Guhl
My wife and I got our second Moderna shot Friday. She experienced chills and I some aches on Saturday, but it passed within 36 hours. The prospect of liberation (though we’ll still wear masks) by St. Patrick’s Day brings us joy. (And I’m getting choked up as I write this).
snoey
@The Fat White Duchess:
Aspirin is an anti inflammatory, so no, if the allow the inflammation theory is correct.
Richard Guhl
@The Fat White Duchess: if you experience cold-like symptoms, using aspirin, ibuprofen or naproxen is discouraged.
Mousebumples
First shot scheduled for tomorrow morning. Still a bit cold for ice cream in Wisconsin, but i may end doing a happy dance after the shot. ?
Richard Guhl
@germy: I’ve heard that this pertains to cold-like symptoms due to concerns about Reye’s syndrome.
satby
OK people, straight from the CDC website on what to do after getting a vaccine:
Helpful tips
If you have pain or discomfort, talk to your doctor about taking over-the-counter medicine, such as ibuprofen, aspirin, antihistamines, or acetaminophen, for any pain and discomfort you may experience after getting vaccinated. You can take these medications to relieve post-vaccination side effects if you have no other medical reasons that prevent you from taking these medications normally. It is not recommended you take these medicines before vaccination for the purpose of trying to prevent side effects, because it is not known how these medications may impact how well the vaccine works.
(satby) This insanity about suffering through discomfort otherwise the vaccine won’t work is straight out of the middle ages.
MazeDancer
If you live in dose-challenged, website-challenged areas like Upstate NY, you may be saved by CVS.com
Easy to use website. They post new batches every day, though you don’t know when. People in my teeny village are driving 30 to 120 miles, but at least they’ll get a dose.
As an immuno-compromised person, I must take one of the mRNA vaccines. Cannot take J&J.
That’s why I am making a 3.5 hour excursion, door-to-door, this afternoon. Before the only kind you can get in the boonies is J&J.
dmsilev
Scheduled for Pfizer #1 this coming weekend. Whoo!
I’m looking forward to the prehensile tail, but if this is one of the side effects I might be a bit less enthusiastic.
The Fat White Duchess
@satby: Thanks very much!
P.S. Blessings on you and the feral cat.
Alex
From what I see, all the vaccines prevent hospitalization and death, though it’s hard to compare them head to head because they were tested under different circumstances. None of them were tested on whether they prevent transmission. But do we really have no basis to compare the likely effects on transmission? Doesn’t it look like the mRNA vaccines are better at preventing even mild infection, and isn’t it likely that they will work better on cutting transmission as well? Is this yet another example of agencies like the FDA saying “well, we don’t know for sure, so we have to pretend we can’t make an informed prediction”? Or is there actually reason to believe based on what we know that Johnson and Johnson will have a similar profile for transmission?
Wag
I would like to add
my positive experience with the vaccine to the growing list of 5 star reviews. I got my first shot at my job (health care) in late December, second shot in mid January. The feeling of relief was nearly immediate. I still mask when at work and indoors, but otherwise life is returning to normal. We have gotten together with my vaccinated elderly parents, had dinner indoors without masks, and hugged without hesitation.
I would urge everyone to get vaccinated as soon as possible with whichever vaccine they offer.
Cheryl Rofer
@Alex: Data are beginning to come in on transmission. One vaccine, I think the Astra-Zeneca vaccine that isn’t available in the US, does slow down transmission. It’s looking like the others do too.
There are two reasons to get a vaccine:
Both are important, and 2 protects you as well. If there are fewer cases, there will be fewer mutations that might get around immune protection.
If we don’t know the effect of a vaccine on transmission, it’s prudent to continue facemasking. Also, until facemasking is generally not needed, which won’t be for several months at least, we don’t know who’s been immunized and who hasn’t just by looking. So there are good reasons to continue facemasking in general settings.
What Have the Romans Ever Done for Us?
I have to say as the spouse of a front line health care worker I’m extremely frustrated that family members of essential workers are not being given even the slightest of preferences for getting vaccinated. I don’t want to jump ahead of a Septuagenarian but it would be nice to be at or near the front of the line when my age group comes eligible, to compensate for living with the fact that my wife could have brought the virus home at any point in the past year. But, her hospital (Children’s National in DC) won’t do jack for family members and boy have they seen the last dime in charitable donations they’re ever getting from me as a result, and MoCo MD where I live isn’t doing jack either. We just have to keep sucking it up like we have been while providing essential workers with companionship and emotional support, and get big fat nothing in return.
Alex
@Cheryl Rofer: I’m really hoping they do all block transmission. If know more by the time I’m eligible for a vaccine (June?), I will put some effort in to getting the kind that seems to block transmission the best if there seems to be a meaningful difference. Because that’s my main concern. I’m low risk if I get ill, but likely to be exposed because I have an unmasked toddler and poorly masked preschooler in school. I care for my father, who is very high risk if he gets ill. I wear an elastomeric N-95, but he can’t wear an N-95. Just got his first dose of Moderna, so 6 weeks to decent immune protection.
Also from a public policy perspective, it makes a difference if we invest in vaccines that cut transmission or not when choosing which ones to expand. The different cold-chain requirements and oneshot/ two shot regimens pose a real risk that entire communities may get “second-class” protection if we don’t consciously plan around potential differences in effectiveness or transmission effects. Systematically disadvantaged communities will get the shot that’s more convenient to administer because they lack access to health care and transportation. That doesn’t have to happen, but we don’t know if it’s worth devoting extra resources to getting the mRNA vaccines to people, or if it’s better to just try to get everyone whatever kind of shot they can get, unless we collect data on relative effects on transmission. We need to think about that when we are designing the vaccination rollout.
Cheryl Rofer
@Alex: As David makes clear in the OP, the primary objective right now is to get as broad vaccine coverage as possible. That will slow down spread and all the other things that come with it.
That is why we shouldn’t dither around which vaccine is “best.”
We will learn more as more people are vaccinated. There are still something like 100 vaccines in development. It is possible that some people will need boosters or a shot of a “better” vaccine later on.
We have one job now: stop the spread. We can argue about the rest later.
Citizen Scientist
*raises hand *. I have a question: my employer, in conjunction with a local pharmacy, is offering vaccinations to all workers soon (March timeframe; no idea how this pharmacy is going to get these vaccines when our large hospital is not apparently functioning as a vaccination site yet). I am a healthy sub-45 aged person with no comorbidities or other underlying health conditions (except, perhaps the ridiculous amount of bread products that I consumed over the weekend). My question is: should I get the vaccine knowing that there are probably many older Pennsylvanians in the area that still haven’t been able to get it? I’m guessing my spouse won’t be getting it any time soon. Trying to avoid an ethical issue here…
UncleEbeneezer
Most of the older people I know are now getting vaccinated here (SoCal) which is very encouraging. Now, if fucking Texas would start getting their shit together so my 80 year old in-laws with serious health issues could get some…
Cheryl Rofer
@Citizen Scientist: If you are offered vaccine, take it. The primary need now is for as many as possible to be vaccinated as soon as possible. It’s ethical to be part of that.
Six weeks or so ago, our local paper had a story of workers at a soup kitchen and teachers getting vaccine “out of their priority order.” I hadn’t had mine by then but saw no problem with them getting vaccine.
WaterGirl
@Citizen Scientist: Yes, even at your age you should take the vaccine if it is offered to you!
Roger Moore
@PST:
The biggest mistake we keep making is forgetting the importance of compliance. Public health people want to impose very strict rules in the hopes of crushing the pandemic quickly. In a lot of places, the people who would be tasked with enforcing the rules (local law enforcement) refuse to enforce even the flimsiest public health orders, so we depend on voluntary compliance. Many people just aren’t willing to comply with the strictest rules, so the public health orders are really just a recommendation. We’d do better spending more time and effort making voluntary compliance more bearable by coming up with safer ways to do what people are going to do anyway rather than trying to come up with stricter rules we can’t enforce.
Roger Moore
@What Have the Romans Ever Done for Us?:
You shouldn’t blame this on her employer. It’s the state government that comes up with the rules on who is prioritized for vaccination, and the healthcare providers have to comply. Blame your state government for not thinking about you.
RoonieRoo
@UncleEbeneezer: What part of Texas are they in? I know of several groups helping the elderly get appointments since the process is deeply unfriendly to the non-tech savvy.
Rand Careaga
I received the first dose of the Pfizer pflavor in a vast parking lot near the racetrack in Berkeley over the weekend. I was gratified at how well-organized and efficient the operation was, and when it was over, the dog got a bayside walk at the adjacent Albany Bulb. The shoulder remains surprisingly sore after forty-eight hours (pro tip: if you’re a side sleeper, opt for the other arm if possible), which is something I’ve not experienced from flu shots. If dose #2 leaves me feeling temporarily like eight miles of bad road, well, I’m retired, and can budget the time for that.
When I hear people carping about hiccups associated with the rollout, I remember that last spring most of us were thinking that we’d be lucky to have a vaccine by 2023.
PST
@Roger Moore:
That’s a valid point and one the author makes in that article I was touting. We all have the experience of starting a strict diet or exercise program, then giving up altogether when we fall short. For me, that means sitting on the couch eating Girl Scout Thin Mints from the handy single-serving sleeve (it’s that time again). Much better to think of the levels of compliance as incremental and try to nudge yourself and others farther down the safe path. For example, my wife makes herself a kick-ass multi-layer mask every morning. I’m good about masks, but if I had to do that every day I would probably give up.
snoey
@PST:
Rather than safe or not safe we should think in terms of a risk budget. Outdoors masked but a bit crowded for an hour means no grocery trip for today. Balance risk/reward on your terms, but to do that we have to be clearer on what level of risk is involved, not the simplistic safe/not safe binary.
kindness
I didn’t have a choice when I got my vaccines. They only had the Moderna on hand and I was happy to take it. My daughter’s on a wait list with Kaiser and I advised her she take which ever one they have to give her just to get it. Not much difference between the Pfiser & the Moderna. I don’t think th J&J is available yet so not a lot of choices out here.
PST
@snoey: Good point. My risk calculus, by the way, is shifting fast. I got my second Pfizer stick on Wednesday and temperatures are rising. I’m going to feel quite safe on a bicycle.
lowtechcyclist
@PST:
I got my first shot at a local CVS yesterday. They had us sit in a waiting area for 15 minutes afterwards in case of adverse reactions, which was fine.
But after someone’s 15 minutes was up and they vacated their seat, one of the CVS employees would wipe the seat down with disinfectant. As if we were going to pass Covid along by the butts of our jeans.
Roger Moore
@Rand Careaga:
The nurses where I got my shot advised everyone to move their arm a lot immediately after the shot. They literally told us to do the chicken dance during our 15 minute observation period. This is supposedly a standard thing that is supposed to reduce soreness with any immunization.
@PST:
In retrospect, I think one of our biggest mistakes was not making better use of existing public spaces. It’s nice that we’ve turned some parking spaces into outdoor dining for nearby restaurants, but we could do so much more. We should have areas roped off in parks every Sunday morning (and other days of the week for other religions) so churches that don’t have the space can hold outdoor services. The rest of the time, we should be encouraging people to socialize with their friends there rather than indoors at their houses. Helping people cope with their need for human contact would make the other restrictions much more bearable.
What Have the Romans Ever Done for Us?
@Roger Moore: Bullshit. I know I’m not eligible now for reasons of age but they also didn’t offer to vaccinate my wife’s 81 year old mom whose a cancer survivor. No help, whatsoever, from the hospital to get her vaccinated. We did get her in but it was no thanks to them.
J R in WV
@Citizen Scientist:
Yes, you should.
You will almost certainly be much less likely to spread the virus to others, including older fellow citizens and your spouse. Everyone should get a vaccination asap.
My $0.02 worth of ethical advice, worth everything you paid for it!
J R in WV
@What Have the Romans Ever Done for Us?:
I don’t think that, so far, anyone is going to be “offering” to vaccinate anyone who isn’t actively seeking out a vaccination. It isn’t like people will ever go door-to-door with vaccine looking for people to shoot up.
Should there be work ongoing to seek out people who need vaccination? Probably, but right now people are desperately seeking the shots, far more people want and need a vaccination than there are doses to administer.
I hope and expect that by summer, when doses should be ample, finally, there will be a great deal of PR on TV and the Innertubes asking people to call or drop by their local vaccination center to get a vaccination. Call NOW, and also get a free alcohol swab and a FREE cup of tap water!!
J R in WV
@Rand Careaga:
So…
I clicked on your nym to see where it would take me. WOW, that’s funny, esp the Diebold parody site. Thanks for the link!!!
What Have the Romans Ever Done for Us?
@J R in WV: That’s not what I’m expecting. We reached out. They gave us no help. The hospital my sister works for actively tried to schedule family members who were in eligible age groups for vaccination. They could do better, they just aren’t, IMO.
JaneE
@germy: I just read that all anti-inflammatories should be avoided (nsaids like high dose aspirin, advil, etc) because they may lessen the immune response and they want as strong a response as possible. I saw one bit of advice to avoid antihistamines as well, because they don’t know what kind of interaction they may have. And women should not get mammograms for a month after the shot (two months total for most) or at least tell the radiologist, because they may get slightly swollen lymph nodes which would normally be suspicious. The swelling is generally unilateral on the side where the shot was given, so that would be a clue that it is part of the immune response.
Bill Arnold
@Roger Moore:
It also has to do with anti-public-health propaganda saturation in a locale.
I’m in New York State, and the statewide mask (face covering) mandate was April 17, before the anti-masker propaganda ramped up, so mask usage was normalized, and remains close to 100 percent in indoor public places (as observed by me).
Other places had to contend with existing anti-masker propaganda, and some with anti-masking as a Republican tribal marker.
Matt McIrvin
@snoey: That’s an interesting point: I’m on aspirin as an anti-clotting measure after knee surgery (and until recently I was on massive doses of ibuprofen as well). It’ll probably be a while before I can get the COVID vaccine anyway, but I need to get my second shingles shot too. Maybe I should postpone that as long as I can?