Here at Len’s Pharmacy, we have had a wild ride in 2020, and it looks like 2021 (part II) is lining up for more adventure! One thing we have learned over the last year is that life is full of choices, and each one of us needs to make the choices we feel are best for our situation.

A major choice coming up this year for most of us is when do we get vaccinated for COVID-19? Let’s take a look at a few of the factors that will go into making this decision.

Some initial questions that will help us make the decision are:

• Would we like to see the COVID-19 pandemic end?

• Has anyone I know been personally affected by COVID-19?

• Have previous vaccination programs been successful in ending pandemics or outbreaks of diseases?

• Does the potential benefit of the vaccine outweigh the potential risks of the vaccine?

Obviously, these are not the only questions, but they provide a good start for gauging our decision to receive the vaccine.

Now let’s take a look at why this vaccine is not as easy to distribute and administer as the annual influenza vaccine. Currently, there are two COVID-19 vaccines approved for administration in the United States, Pfizer BioNTech and Moderna. The storage requirements of these vaccines are very stringent and must be followed to ensure the vaccine’s viability. Pfizer BioNTech’s COVID-19 vaccine needs to be stored, which includes transportation, at negative 112 to negative 76 degrees Fahrenheit (-112°F and -76°F). That is cold — colder than Seneca’s 1933 Oregon State record low of -54°F. Our standard home freezers are normally set at 0°F. Special Sub-Zero Freezers are needed to store and maintain the Pfizer BioNTech COVID-19 vaccine.

The Moderna COVID-19 vaccine requires a storage and transportation temperature of between negative 13 and 5 degrees Fahrenheit (-13°F to 5°F). More than likely, Grant County will see the Moderna COVID-19 vaccine.

Even after it is in the local freezer, there are more restrictions that limit how freely it is thawed and how long it can be at this higher temperature. Each vial of the vaccine contains an official 10 doses and, once punctured for the first vaccine administration, must be discarded after six hours. The logistical ramifications of this is that all 10 doses must be given in a short window. This prevents “drop-in” vaccinations, as we are able to do for the annual influenza vaccine and many others. There must be a schedule for those 10 vaccine doses prior to beginning the first vaccination. What this means is that you must watch for group vaccination opportunities. This can be positive as people are allowed to alleviate each other’s concerns during these times.

Once you have the first COVID-19 vaccination, you will need a second dose 28 days later. The CDC recommends pretending that you have not been vaccinated until two weeks after your second dose of COVID-19 vaccine. This only means that, during the four weeks between the doses, you carry on with your normal COVID-19 precautions, as all the studies show that both doses are needed for proper immune response.

Since the beginning of the COVID-19 vaccinations, a very well done database has been kept on people’s experience with the vaccination and any side effects that may have occurred. One convenient method of tracking people’s response to the vaccine is CDC’s v-safe smart phone app. The v-safe app interacts with the person daily to get their input as to any reactions following the vaccine dose. Typical side effects of the Moderna vaccine are fairly standard reactions for vaccinations. At injection site (arm), common effects are pain, swelling and redness. Common other effects throughout the body can be fever, chills, tiredness and headache.

Important to note are the contraindications of the vaccine. The CDC says that you should not have the vaccine if any of the following are true:

• If you have had a severe allergic reaction (anaphylaxis) or an immediate allergic reaction — even if it was not severe — to any ingredient in an mRNA COVID-19 vaccine, you should not get an mRNA COVID-19 vaccine.

• If you have had a severe allergic reaction (anaphylaxis) or an immediate allergic reaction — even if it was not severe — after getting the first dose of the vaccine, you should not get another dose of an mRNA COVID-19 vaccine.

• An immediate allergic reaction means a reaction within four hours of getting vaccinated, including symptoms such as hives, swelling or wheezing (respiratory distress).

• This includes allergic reactions to polyethylene glycol (PEG) and polysorbate. Polysorbate is not an ingredient in either mRNA COVID-19 vaccine but is closely related to PEG, which is in the vaccines. People who are allergic to PEG or polysorbate should not get an mRNA COVID-19 vaccine.

If you have had an immediate allergic reaction — even if the reaction was not severe — to a vaccine or injectable therapy for another disease, ask your doctor if you should get a COVID-19 vaccine. Your doctor will help you decide if it is safe for you to get vaccinated.

This has been just a small glimpse into the COVID-19 vaccine and some help in determining when it is right for you. Len’s Pharmacy recommends that everyone gets the vaccine at the earliest opportunity, based upon the vaccine priority. If all the channels of the COVID-19 vaccine production, distribution and administration occurs as currently planned, it could be late summer before the United States reaches an 80% vaccination rate that would lead to “herd immunity” for our population. Stay safe!

Greg Armstrong is a pharmacist at Len’s Drug in John Day.

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