Even as India faces a shortage of vaccines amid rising COVID-19 cases, citizens are making a beeline to register and book slots for their vaccine doses. There are a lot of doubts and questions in their minds about the vaccine shots. Rumours and false information are doing the rounds on Social Media groups fuelling apprehensions.
Dr Wasim Ghori, Director for Healthcare at Indian Economic Trade Organisation (IETO), Consultant Diabetologist and currently the Medical Director for a chain of Specialty Clinics in Mumbai, clarifies on several important FAQs about the COVID-19 vaccine doses.
What precautions should be taken before the COVID-19 vaccine?
If you are allergic to certain medication or drugs, discuss with your doctor before getting the shot.
People with diabetes or blood pressure need to keep their blood sugar and blood pressure levels in check before scheduling their appointment. It is advisable to consult your treating physician regarding the same.
Eat a healthy diet before getting the vaccine.
People who have received blood plasma or monoclonal antibodies should wait for two months before taking the vaccine.
Wear proper clothing which gives easy access to upper arm area.
Follow COVID-safe practices at the vaccination site i.e. wear a mask, wash/sanitise hands frequently, maintain social distance
If I was infected with COVID, after how much time can I take the vaccine?
Getting COVID is like getting a vaccine dose. Hence, I recommend waiting at least four to eight weeks after recovery before taking the vaccine as you have naturally made antibodies during infection. Since you would still be responding to the infection, vaccinating at that time would be a waste of the vaccine.
In India, most doctors recommend arbitrary gaps between recovery and vaccination, typically between one and three months.
Waiting to get vaccinated after recovery not only allows others who have remained uninfected to receive their first dose, but also improves immune response...
WHO recommends waiting up to six months and it is based on evidence that infection provides reasonable protection while US Centers for Disease Control and Prevention (CDC) recommends that a person get vaccinated immediately after recovery.
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If you’ve received Monoclonal Antibodies, you must wait 90 days after recovering from COVID-19 to receive the vaccine. According to the Food and Drug Administration (FDA), monoclonal antibodies are proteins made in a laboratory that mimic your body’s immune response. Some people might not need to be hospitalised for COVID-19, but might receive these antibodies from their doctor as an infusion treatment to help fight the virus.
If you’ve had that monoclonal antibody, it is going to keep you from being able to develop a nice, robust response to the vaccine. So, that’s why we have to wait for 90 days until that monoclonal antibody has gotten out of your system.
Is it necessary to take the second dose in the stipulated time given? Or is it just the minimum time in which you should take the second dose?
For Covishield, it is 12 weeks, although the Indian recommendation is for 6-8 weeks, while Covaxin, a gap of four weeks is recommended.
Missing the second dose simply postpones the boosting of the antibodies and does not result in any loss of protection in the short term. Missing the time period allocated does not require a repetition of the first dose.
If you get your first dose and don’t get your second dose for a couple of years, you probably need to repeat your first dose.
What if I catch COVID in between two vaccine doses?
For a majority of people, the disease is likely to be mild or moderate, depending on how many days after vaccination exposure occurred.
If exposure and disease occurs within one to three weeks of receiving the first dose, the vaccine is unlikely to have a major effect and is not expected to modify the course of the infection. However, if a person tests positive after three weeks from their first dose, they are highly likely to only get a mild disease.
Once infected, the body starts producing antibodies, and it is once again effectively akin to getting a vaccine.
In principle, follow the same protocol, i.e. wait at least four weeks after recovery before you take the second dose.
What happens if I take the vaccine when I’m positive?
When we get infected, the first antibody a person’s body makes is the IgM antibody. Production of these antibodies start a week into the infection, peaks at three weeks, and declines very quickly afterward.
About three weeks after infection, the IgG antibodies start to get produced. These are the more crucial antibodies to look out for for long term protection with most infections and vaccines, and they climb in quantity from four to eight weeks after infection. Subsequently, they decline slowly.
The blocking of viral infection requires neutralising antibodies, and the bulk of neutralising antibodies are IgG. They are made in response to the first infection or vaccination, but for some vaccines such as the mRNA vaccines, there is little neutralisation after the first dose but the second dose provides a large rise in this antibody response.
Vaccinating after recovery acts like a booster shot, with previously infected people making a very strong response with the first dose of vaccine.
Can pregnant/lactating women take the vaccine?
Based on data, it appears safe for pregnant and lactating women to take the currently available vaccines.
Although there have been no results from trials for COVID vaccines except for no safety signal from a small number of women who later found out that they were pregnant, large numbers of pregnant healthcare workers globally have taken the vaccine already after the vaccines were rolled out and have not had any adverse outcomes.
Antibodies induced by the vaccine or infection can also pass on to the foetus through the placenta. Only IgG antibodies pass through and the most transfer occurs in the second trimester and early third trimester. Maternal antibodies in children protect for about four to six months, after which their own immune system’s efficiency improves rapidly.
Antibodies also pass through breast milk to an infant, but these are IgA antibodies that protect the gut and the upper respiratory tract.
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Can I take the vaccine if I have allergies? Are there any conditions that require not taking the vaccine?
The only people who should not take the vaccine are those who have already taken the vaccine and had a severe allergic reaction to it.
There is no evidence right now that identifies any kind of allergy to a food or a drug and associates it with the vaccine. The vaccine is safe for people with all kinds of food allergies, as well as drug allergies, including allergies to antibiotics such as penicillin.
Immunocompromised patients and those undergoing chemotherapy should take the vaccines without safety concerns. However, as they are immunosuppressed, they might not make as good an immune response as others.
How long after the COVID shots should I take other vaccines?
Our immune systems are quite capable of handling multiple infections and don’t easily reach a point of exhaustion with just one infection.
The objective is to maximise immune response and hence the general guidance is that if two vaccines are to be given - live vaccines in particular - they should be given together or separated by four weeks.