Dr. Shyam P Lohani

There has been increasing concern for the general public and even healthcare professionals alike regarding the safety and efficacy of various vaccines developed against COVID-19. The rapid pace with which vaccines were developed is praiseworthy. Several controversial news reports surrounding vaccine safety have caused confusion among various stakeholders including both healthcare professionals and the general public.
Since the vaccination campaign, more and more people are receiving one of the COVID-19 vaccines. As vaccination becomes more widely available, it is usual that many are wondering or have concerns about the potential side effects of those vaccines. Healthcare professionals are now receiving an increased number of inquiries regarding the safety issues such as COVID-19 side effects, contraindication, and precaution.

Safety evidences
It is important to note that vaccine side effects are not new or unusual. As the pandemic continues, it is increasingly evident that universal vaccination is essential to containing it. Physical distancing, universal face coverings, and frequent hand washing are effective preventive measures only if followed strictly.
It has been proved that a COVID-19 vaccine might prevent from getting COVID-19 or from becoming seriously ill or dying due to COVID-19, and more importantly prevents us from spreading the COVID-19 virus to others. It also increases the number of people in the community who are protected from getting COVID-19, thus making it harder for the disease to spread and contribute to the development of herd immunity. Vaccines also prevent the COVID-19 virus from spreading and replicating, which restrict the virus to mutate and possibly become more resistant to vaccines.
It is natural for all of us to wonder if brand new vaccines against a novel coronavirus, developed at unprecedented speed, are effective and safe to take. The overall effectiveness of those vaccines has been reported in the range of 70- 95 per cent. A Pfizer/BioNTech vaccine found to be 95 per cent effective. A Moderna vaccine reported effectiveness of 94 per cent. An AstraZeneca/Oxford vaccine was reported to average effectiveness of 70 per cent with full doses. Johnson & Johnson (Janssen) reported overall effectiveness of 66 per cent in preventing moderate to severe COVID-19. A recent report says the Janssen/Johnson & Johnson COVID-19 vaccine also provided protection against severe complications by variants identified in South Africa and Brazil.
There has been concern that the COVID-19 vaccine produces COVID-19 which is not true as the COVID-19 vaccines currently so far developed do not use the live virus that causes COVID-19. It is here important to mention that not only do these vaccines appear to lessen the risk of developing COVID-19, but they also appear to lessen the risk of severe complications.
It is not unusual that some people may experience side effects post vaccination. These are usually mild and of course, are much less serious than developing coronavirus disease or complications associated with the disease. Like any medication or supplement, it is usual that vaccines can cause minor side effects and reactions. Those side effects usually abate within a few days.
The most common side effects after vaccination are usually mild including pain, swelling, or redness at the site of injection, mild fever, chills, feeling tired, headache, muscle and joint aches and fainting can also happen after vaccinations. Few people may develop a fever after a vaccination that usually occur within 48 hours and usually goes away within next 48 hours.
People should be aware of the fact that the most common side effects are a sign that our body is starting to build immunity against a disease. Although, extremely rare, serious side effects from vaccines can be life threatening. Difficulty in breathing, swelling of face and throat, a fast heartbeat, a severe rash all over the body, dizziness, and weakness are the signs of serious side effects. After getting COVID-19 vaccines, it takes a few weeks for our body to develop immunity; therefore, it is possible that we could become infected with the virus that causes COVID-19 just before or after being vaccinated.
There are segments of populations for whom vaccination is not recommended as yet. People with a history of severe allergies, most pregnant women, and children under 16 are not recommended for vaccination. People who have an underlying medical condition can safely get a COVID-19 vaccine provided there is no allergic reaction to a COVID-19 vaccine or any of its ingredients. Still, we lack sufficient information about the safety of the COVID-19 vaccines in people with weakened immune systems or autoimmune conditions.
People who already had COVID-19 may develop some natural protection or immunity from reinfection with the virus that causes COVID-19. Although, we are still not clear how long the protective effects last. There is evidence that reinfection is possible and COVID-19 can cause severe medical complications, it is recommended that people who have already had COVID-19 get a COVID-19 vaccine. However, people who had COVID-19 might delay vaccination until 90 days after diagnosis as the reinfection with the virus that causes COVID-19 is uncommon in the first 90 days after being infected.

Vigilance
As the vaccination covers more people and the number of different vaccines against coronavirus grows, vigilance should be more widespread. What we know today about side effects and safety might change tomorrow with the additional data on it through post-marketing surveillance.
The relevant stakeholders should carry out vaccine pharmacovigilance in order to detect side effects after mass vaccination. It is still unknown that having the vaccine stops us from spreading the virus to others. So it is important that we all continue to follow basic preventive measures such as face coverings, avoiding crowds, cleaning hands and surfaces regularly, and maintaining physical distancing of at least two metres.

(Professor Lohani is the founder and academic director at Nobel College. lohanis@gmail.com)