Get the lowdown about these vaccines and why you should consider getting vaccinated.

 

COVID-19 vaccinations have already begun for the seniors with those over 70 started getting vaccinated in February and those between 60 and 69, end of March. Still some are concerned about getting vaccinated.

Ageless Online gets the lowdown from Dr Anson Wong Hei Man, consultant in the Department of Infectious Diseases at the Singapore General Hospital, and hopefully this might help to allay some concerns:

 

Why is it important to get vaccinated for COVID-19 for seniors? 

Individuals of any age may acquire SARS-CoV-2 infection which causes COVID-19, but multiple studies have shown that older adults e.g. age more than 50 are more likely to develop severe illness. Older age is also associated with increased mortality. Furthermore, seniors may also have underlying comorbidities such as cardiovascular disease, diabetes mellitus, hypertension, chronic kidney disease and obesity which have been associated with severe illness and mortality. As such, it is important and advisable for seniors to be vaccinated to protect themselves against COVID-19.

 

The vaccination does not give full immunity and someone who has COVID-19 can still spread it to another person who has the vaccine. Is this true? Why then get vaccinated? 

It is true that COVID-19 vaccination does not confer 100-percent immunity to the vaccinated persons. However, the safety and efficacy of COVID-19 vaccines for all Singaporeans is of utmost importance. Only vaccines that comply with the World Health Organization’s guidelines and meet strict standards of safety, quality and efficacy will be used for our population.

Taking the Pfizer-BioNTech COVID-19 vaccine as an example, a recent large study from Israel that included nearly 570,000 vaccine recipients showed the estimated vaccine effectiveness seven days or more following the second dose was 92 percent for documented SARS-CoV-2 infection, 94 percent for symptomatic COVID-19, 92 percent for severe COVID-19, and 87 percent for COVID-19 resulting in hospitalisation.

This means that while the vaccinated person may still be vulnerable and contract the SARS-CoV-2 virus, the risk of this person having symptomatic or severe life-threatening COVID-19 is significantly lower than the unvaccinated person. This protects the vaccinated person on the individual level.

As more people in the country are vaccinated and protected against the virus, we believe that this helps to prevent onward transmission and in turn resulting in less infection by SARS-CoV-2 in the community, which will indirectly help protect those who are unable to get vaccinated due to the presence of contraindication(s). This also reduces the additional burden due to COVID-19 on the healthcare system, thereby allowing the medical teams to continue to focus on the health of our seniors especially in the management of their chronic medical conditions.

Vaccination is one of the key strategies to protect us and our loved ones against COVID-19, along with safe management measures, contact tracing and testing. The Expert Committee on COVID-19 Vaccination proposed to vaccinate the population as widely as possible to not only reduce the number of people susceptible to the disease but also the chances of transmission. As more of us are vaccinated, the harder it will be for the virus to spread, and the safer we will all be as a society.

A comprehensive vaccination coverage will then enable us to re-open further, allow more social activities to resume, and facilitate the recovery of our economy. However, until a significant proportion of the population is vaccinated, Singaporeans must continue to observe safe management measures.

In the absence of absolute contraindication such as history of anaphylaxis or active cancer on treatment, seniors with or without chronic illnesses are recommended to receive the COVID-19 vaccine for personal protection as well as protecting their loved ones.

 

What about the variants that have now come out. Can you share about those variants and whether the vaccinations in Singapore protect against those as well? 

Since the COVID-19 pandemic has started, various SARS-CoV-2 variants have evolved and emerged and this is not unexpected for a virus as it spreads amongst humans. A virus with one or more new mutations is referred to as a ‘’variant’’ of the original virus.

The notable variants which have garnered global attentions include the B.1.1.7, B.1.351 and P.1 variants. B.1.1.7 was first identified in the UK in late 2020 with some suggestions that it is more transmissible and may also be associated with greater disease severity. Similarly, for the B.1.351 lineage which was identified in South Africa also in late 2020, surveillance data suggests that this variant also has the potential for increased transmissibility. These variants have been detected in Singapore, with the majority from persons returning from overseas.

Scientists across the world are studying these variants to better understand how easily they might be transmitted and the effectiveness of currently authorised vaccines against them. There are some concerns arising from some preliminary data that the currently available COVID-19 vaccines may be less effective against these variants. More research needs to be carried out in this aspect to confirm this.

Regardless, these vaccines are still expected to provide at least some protection against new virus variants according to the World Health Organization. This is because when vaccines are created, they are designed to create many different antibodies to differing parts of the virus so that even if one part of the virus mutates, the antibodies may recognise another part of the virus.

Therefore, changes or mutations in the virus should not make vaccines completely ineffective. Furthermore, stopping the spread of the virus prevents mutations that may reduce the efficacy of existing vaccines. As such, it is still recommended to receive the vaccine despite the presence of these variants.

 

Why two vaccinations, for example for the Pfizer one, and the time period in between? 

In the development of the mRNA-based COVID-19 vaccines, it was found that a relatively weak immune response was produced when just one dose was given. However, there was a stronger immune reaction when a second dose was added. This strategy to produce a stronger immune response from vaccine is not uncommon and some examples include the widely administered and efficacious hepatitis A and B vaccines, the shingles vaccine and the measles-mumps-rubella vaccine.

The Pfizer-BioNTech vaccine is given intramuscularly in two doses, three weeks (21 days) apart, while the Moderna vaccine is also given intramuscularly in two doses, but four weeks (28 days) apart.

 

If a person has allergies, is it best not to be vaccinated? What other issues (such as weakened immune system, etc) deem it not wise to get vaccinated for seniors? 

A person with a history of anaphylaxis to drugs, vaccines, food, insect stings or unknown triggers should not receive the mRNA-based COVID-19 vaccines. This is because persons with a history of anaphylaxis may be at an increased risk of developing severe allergic reactions or even anaphylaxis after COVID-19 vaccination.

Anaphylaxis is a life-threatening allergic reaction with two or more of the following three criteria: hives or face/eyelid/lip/throat swelling, difficulty breathing or dizziness. Also, persons with a history of an allergic reaction to a previous dose of the COVID-19 vaccine or to any of its components and persons with active cancer on treatment with radiation therapy, chemotherapy or immunotherapy should not receive the mRNA-based COVID-19 vaccine.

Otherwise, persons with a history of allergic reactions not amounting to an anaphylaxis can be vaccinated after discussion with their doctors, especially if they are at increased risk of contracting the infection or at risk of developing severe COVID-19.

It is advisable for the seniors to see their own doctors to discuss about their risks and contraindications for COVID-19 vaccination.

 

I heard that with the second dose of the vaccination, some people get flu-like symptoms? What other symptoms (rashes, tenderness in the site area, etc) can they get and should be aware of? I heard some people also getting high blood pressure, etc. What should seniors take note of before and after vaccinations? 

Prior to the vaccination, it is prudent for the seniors to inform the screening personnel at the vaccination site of their medical conditions including history of any allergic reactions to determine their suitability for the COVID-19 vaccine.

The two currently available COVID-19 vaccines have similar systemic side effects, such as fatigue, fever, chills, headache, body aches and pains, nausea and swollen lymph nodes at the neck or arms. Local injection site reactions, which are not uncommon, may include pain, redness or swelling.

Generally, these systemic and local symptoms should resolve within two to three days with the exception of lymph node swelling, which usually gets better by itself in a week or so. The seniors may self-medicate with paracetamol (if they are not allergic to it) to alleviate such symptoms. However, if the side effects persist or get worse, or the seniors develop a fever which persists for more than two days, or an allergic reaction such as facial swelling or rashes, it is advisable that they should seek immediate medical attention.

As the COVID-19 vaccine is not 100-percent effective and may take time to produce the desired protective effect after the second dose, it is advisable for the seniors to seek medical attention too should they develop symptoms of acute respiratory infection such as cough, sore throat, runny nose or change of taste or smell, as these could be the symptoms of COVID-19.

 

Do you have to wait for a certain period before the medical staff can let you go after you are vaccinated? 

All persons vaccinated with COVID-19 vaccine will be observed at the vaccination site for 30 minutes for any adverse and allergic reactions. Vaccination sites are equipped with the capability to provide emergency medical care. If you feel unwell during the observation, do inform any staff present at the vaccination site so that the on-site medical personnel can attend to you as soon as possible.

 

Even after one gets vaccinated, it is still crucial that one continues to wear a mask. Can you share the reasons why, and advice for seniors? 

As mentioned earlier, the COVID-19 vaccine is not 100-percent protective and hence by wearing a mask, it will continue to reduce the risk of contracting SARS-Cov-2. Furthermore, there are many other respiratory viruses circulating in the community and hence by continuing to wear masks in the public areas, the risk of acquiring these infections is reduced.

Also, as the vaccinated person could still get an asymptomatic or symptomatic COVID-19, the virus could still be transmitted from the infected vaccinated person to another person. As such, wearing a mask will also minimise such onward transmission in the community. Similarly, regular hand washing and observing social distancing are important precautions to prevent the spread of COVID-19.

 

 

(** PHOTO CREDIT: Unsplash/Mat Napo)