As many of you are probably aware, the FDA gave emergency approval for a vaccine against Covid-19 developed and produced by Pfizer. The vaccine distribution plan has been in place for months with the final details coming to fruition over the last few weeks as we prepared and anticipated for the FDA approval. A rank of priority persons to receive the vaccine was developed and healthcare workers were top of the list. I am fortunate and privileged to practice emergency medicine in Rhode Island and have been given the opportunity to be vaccinated among the first Americans. This week I wanted to detail my experience leading up to, getting and soon after the vaccine.
The Pre-approval days…
As a provider we get asked many questions, what do I do about… (fill in the blank). But increasingly we have been fielding questions regarding the Covid-19 vaccine and whether our patients, family members and ourselves should get it? Earlier this year we published a story about what a potential vaccine could look like, the differences in types and what the research studies should be like. This doubled as an opportunity to do my own research in preparation for the article. What I found was that the vaccine was safe, and the efficacy (usefulness) was good from these early and initial stages. At the same time, we received an email from my boss (the Director of Emergency Medicine) outlying a potential time frame for when we could expect the vaccine in the coming weeks.
There were many discussions held among the staff and friends about what this would mean for us, whether we were going to get it or not and what we thought the future post vaccination would be like. The general consensus at that time was that most of my colleagues planned to get the vaccine but had questions regarding its safety. On December 11th, 2020 the FDA granted emergency approval for the distribution and administration of the Pfizer vaccine. This is an MRNA based vaccine (see previous post for more details) and required special shipping and scheduling considerations. A few days later we received another email from our employer at the hospital that had a survey asking whether we planned to get the vaccine or not and to please schedule a time to do so if we intended to receive it. The email contained a link to the survey and another link to register for a time slot. The time slots listed were in half hour to hour long increments with multiple people able to sign up in each slot.
Day of the Vaccine…
My appointment was scheduled for December 21st at 1:15 pm which would be shortly before reporting to work that day for my “swing shift.” This morning I worked out, did the dishes and carried through my morning routine before I left for work. Upon arrival I dropped my stethoscope, scrub top and respirator in the office and headed down the hall out of the ER and towards the conference room where the vaccine clinic was being held. Along the way I was met by colleagues who were also getting vaccinated that day and there was some nervous but polite energy and smiles. You see, while all of this is happening our hospital has been full, the ER where I work has been “boarding” patients. This means that upon admission instead of being brought upstairs, patients are kept in the ER for their care because there is nowhere left to physically put them in the hospital. This results in enormous strain on the ER staff and resources, a strain felt in our bones and our core but one that is hopefully to be relieved with the very vaccine we were to receive that day.
The Conference center where the vaccine clinic was established is a drab but large room. The walls are beige and made of that fabric type stuff that often lines temporary cubicles. As I opened the door, I was greeted by a volunteer register worker. She smiled and asked if I was here to get the vaccine? I replied that I was, although I had to lean in so she could hear me through my mask. She handed me a clipboard and told me to fill out all the sections and bring it back up. I was to take a seat on the right side of the room where the “not yet vaccinated” people were sitting. There was a rope separating us from those who had already been vaccinated and the chairs were spread to about 6 feet apart in a staggered fashion.
The questionnaire started off with basic contact and name information. Then it proceeded to check-box questions about my medical history and recent activities. There were about 20 questions in all, ranging from recent symptoms to prior reactions to vaccines. Once I had completed the questionnaire, I returned it to the registration desk and was told to take a seat until I was called. The wait was less than 5 minutes when a nurse appeared from behind a curtain and called my name. I followed her back through a row of curtains that would function as makeshift patient rooms. Our room was at the end on the left and was no bigger than 12x12 feet. There was a box on the floor with supplies and a small table for her to document and write on. The nurse confirmed my information and wrote my vaccine lot number and date on a card which she returned to me.
“Would you like a picture as you get the shot?” she asked.
“Sure, why not, seems to be the trend these days” I replied.
After confirming my information and that I would like to receive the shot in my left shoulder, she cleansed my arm with an alcohol swab and said, “Ok, on the count of three!” Boom, done, she quickly, smoothly and painlessly injected me with less than 0.3 mL of liquid. For reference a Tetanus vaccine has 0.5 mL of liquid. A Band-aid was applied, and a colleague snapped a photo of the whole process. The nurse then handed me back my papers with a date circled to return for my booster shot. I was then ushered back into the initial waiting room but on the other side of the ropes where the “already vaccinated” people were waiting. The chair setup was the same, but the environment naturally had a more relaxed feel to it. After a group of about 7 of us had accumulated in this new location a different nurse came out to give us instructions.
We were to stay here for the next 10 minutes, to ensure that no adverse reactions occurred, then we would be free to go. Over the next few days we should expect arm soreness at the injection site, mild body aches and some chills. These symptoms would soon dissipate, and we should then return in 14-21 days to receive our booster shot. I returned to work shortly after my 10 minutes were up and fielded the usual, “How’d It go?” questions from my colleagues. I told them the process was easy and painless and many of them expressed their intentions to get the vaccine in the next day or so.
Later that evening I noticed some soreness to my left arm where I had gotten the shot. It was mildly tender although definitely worse when I tried to raise it. Nothing that wasn’t expected though. The next day, a day off for me, I noticed I felt a little more tired than usual and perhaps just a little achy. This dissipated by midafternoon and beyond the arm soreness I have had no other side-effects.
For what it is worth, I take some amount of pride in being among the first vaccinated although I’m not completely sure where that pride stems from. I know I will likely be asked to answer many more questions regarding the vaccine by both family, patients and coworkers in the coming weeks and months. But for now, this is what I can say:
The immediate safety of the vaccine is great, on par with the rest of childhood vaccines
The data regarding its efficacy is strong although does not include long term studies
Many of us in healthcare see this vaccine as the only way out of the rat race that has been Covid.
While it is certainly a personal choice whether to get vaccinated or not, I do believe we owe some responsibility to each other to attempt to bring our world back to “normal.” The easiest way to do that is through immunity.
Going forward, if you have any questions about the vaccine, Covid-19 or next steps in the pandemic please don’t hesitate to reach out to firstname.lastname@example.org, I may not have all the answers but will do my best to provide you with information to help make whatever decision you are considering easier. Lastly, look for our final letter of 2020 coming out on Wednesday, December 30th!
As always, your feedback, personal thoughts, stories and suggestions are always welcome!
Ben Velardi, Author/Founder