SAP in India organized the awareness session on COVID19 vaccination and vaccines, by vaccination expert / doctors from UNICEF.

NOTE: Only questions/ doubts around hesitancy in getting vaccinated have been covered below. Questions related to the treatment of COVID-19 or case-specific questions don’t fall under the purview of the document. Readers are requested to visit the Ministry of Health (MoHFW) website for detailed and up to date information, guidelines, and queries. Kindly approach your doctors or experts about any queries pertaining to the COVID19 and Vaccination. Kindly note that information can change from time to time based on the protocols and guidelines issues by Ministry of Health (MOH), Government of India. We highly encourage every one to review & follow the latest guidelines from MOH.

GENERAL/ COMMON

1. I don’t trust the vaccine as it is developed in a hurry. Developing a vaccine requires intensive research. How safe are these vaccines for people? This doubt is holding me back from getting vaccinated.

Vaccines have undergone thorough safety, clinical, and efficacy trials as per the protocols. COVID-19 vaccine took just as much time as it is taken for developing a vaccine for any other disease. It just seemed quick to us because the health teams across the globe started working on it really quickly and are still working extensively on it. Hence, we got the results so quickly. The rush that people are talking about is about the bureaucracy and red-tapism between two pieces which has been cut through due to the urgency and gravity of the situation so that it reaches to the common public at the earliest.

2. For how long a COVID+ve person should wait before getting vaccinated?

As per the current guidelines, one can take the vaccination 4-8 weeks after recovering from the infection i.e. testing -ve. (NTAGI- recommendations under review). Further reviews on the exact duration is being going on but as for now, it is 4-8 weeks.

3. Does getting vaccinated ensures that one will not contract the virus? Or will one test positive for Covid-19 after vaccination?

Vaccine will not lead you to test COVID+ve. No, getting vaccinated doesn’t ensure that one will not be infected in the future as it doesn’t provide full or 100% immunity. But it surely helps prevent severe diseases, reduce morbidity & mortality which outweighs all odds against not taking the vaccine.

4. Does being COVID+ve means one has been naturally vaccinated?

Immunity from natural infection may not last very long, hence, vaccination is important. If this wouldn’t have been true then people who have had contracted the virus during the 1^st wave of the pandemic should have stayed safe now (though, there is no clear data on this). Hence, vaccination gives better protection.

5. Does being vaccinated means one has contracted the virus and must isolate or quarantine?

No, getting vaccinated doesn’t mean that one is COVID+ve because the vaccine doesn’t use live virus but only a component of it to spur antibody production. The vaccine is built up from either a killed virus or from the protein of the virus so it in no way can give anybody COVID-19. Despite this if anybody is tested +ve, it surely means that the patient must have contracted the virus prior to vaccination. Also, there is no need to get isolated or quarantine post vaccination, but one must take all safety precautions (face masks or shields, sanitizers, social distance, etc.) when going for vaccination.

6. With following drawbacks associated with vaccination:

• So many side-effects associated with the vaccine,
• no surety about developing any long-term health issues due to the vaccine,
• it lowers the immunity for initial days of vaccination which further makes one vulnerable to contracting the virus,
• it doesn’t guarantee any 100% safety from the virus. I mean vaccinated people are still contracting the virus and dying.
• People still got to take all the precautions (drinking kadha, inhale vapour or take steam, etc.) even after vaccination,

Then what is the use of getting vaccinated. Why should I take the risk of injecting myself with a substance whose effects I am unsure of? At least I don’t see vaccine of much help. Why can’t I just continue to take all the precautions, follow all the COVID protocols, enhance my immunity, and be safe.  I don’t see much difference the vaccine will make. Please convince me otherwise.

You should be vaccinated because of the following reasons:

• Most effective and safe way of preventing disease and saving lives
• Reduces risk of severe disease
• Protects people around you who cannot get vaccinated due to any reasons
• Additional layer pf protection against COVID-19.

The side-effects (however grave) that you are talking about here is nothing as compared to severity that COVID-19 brings with it. It takes us to ICU and deathbeds. Hence, we should not leave any chance for ourselves to get protected.

7. Why are people still dying even after getting vaccination?

It is because the vaccine is not 100% efficient but it does offer protection. The pluses of being vaccinated have already been shared above.

8. For how long is the vaccine effective? Or for how long is a vaccinated person expected to be considered safe? One year? Ten years? Or?

Duration of immune response varies for different vaccines. It is not yet known for COVID-19 vaccines. Hence, there is a lot of discussions going on around the world on developing a booster dose which might be available to us very soon.

9. Why is the vaccine not safe for pregnant and lactating women? If it is not safe for them, it is (however remotely) might not be safe for the rest? How do we ensure the safety of pregnant, lactating women, and children?

The vaccine is undoubtedly safe but in case of pregnant and lactating women it is just that there is no data on the effect of vaccine on a growing embryo as of now. Hence, we are not ready to take any chance on expecting and lactating mothers.

10. Is it safe to take the vaccination during menstruation?

There is absolutely no correlation between menstruation and getting COVID-19 vaccination. It is completely alright to take the vaccine pre, during, or post menstrual cycle.

11. Do I have to take the COVID-19 test before going for vaccination? Why is the test not mandatory? How will one know without the test if one should take or avoid the vaccine? Although the tests are not mandatory, one must be cautious and aware of the signs or symptoms such as fever, cough, cold, body aches, etc. If one feels or shows any of these symptoms, one must take a test before going for vaccination.

SIDE-EFFECTS

1. What are the signs one may look for any serious side effects post vaccination?

Most common side-effects for Covidshield – pain & tenderness at injection site, headache, tiredness, muscle or joint aches, fever, chills, nausea, and very rarely demyelinating disorder.

Most common side-effects for Covaxin – pain & tenderness at injection site, headache, tiredness, muscle or joint aches, fever, bodyache, abdominal pain, nausea & vomiting, dizziness, sweating, tremors, cold & cough.

These side-effects are mostly due to some allergies or anaphylactic reaction that the person is not even aware of. This is the reason people are asked to wait for 30 minutes at the vaccination centre for observation. Those 30 minutes are very important as most of the allergic reactions occur within 30 minutes of getting vaccinated and which can be treated through medicines on the spot. Further, it is recommended to take a paracetamol (but not immediately after the vaccination) and being hydrated also helps through. But if one is having fever for more than the prescribed days or any other irregular symptoms, then one must consult a doctor.

2. What are the long-term side-effects associated with COVID-19 vaccination? Will this affect fertility among both the genders?

Infertility is a very old rumour associated with any sort of vaccine for which there isn’t any proven studies or scientific relevance. There are many developed countries who have covered more than 30-40 % of vaccination drive among its citizens. If infertility would have been a concern, they wouldn’t have been doing mass-vaccination as it is suicidal, and no country would do that.

3. Which of the available vaccines (Covaxin/ Covidshield/ Sputnik) better in terms of less side effects? Which vaccine should one prefer?

There is no stamp that certifies as to which vaccine is better than which. This is not the time to be picky and make choices on this one. It is more important to get protected through vaccination.

4. Can you please shed some light on the side-effects of vaccination on person having diabetes, hypertension, kidney-transplant, asthma, epilepsy, polio, intolerance towards penicillin medicines, person undergoing cancer treatment, Parkinson’s and multiple other co-morbidities, pacemaker installed, SVT (Supra Ventricular Tachycardia) other allergies etc. Any word of caution for these categories of patients?

Diabetic and hypertension patients are on the priority list to get vaccinated. In fact, most of these mentioned group are listed under most priority people to get vaccinated. Further, there is a list made available at the MoHFW website which mentions 12 categories of patients who have been put on priority list for vaccination. One can look that. However, there are very specific kind of illness or diseases related to blood profiling where one needs to consult a doctor.

5. Is it okay to not have the side-effects at all? Or should one doubt/suspect the originality of the vaccine? Is it possible that one has been injected with fake vaccine?

It is perfectly okay not have any side-effects at all. There are many who don’t experience any side-effects at all after receiving the vaccine.

BLOOD CLOTTING

1. How common is the occurrence of blood-clotting post vaccination? Which categories of people/ patients is it common among?

This has been labelled as very rare side effect of vaccine. Bleeding and clotting cases following COVID vaccination in India are minuscule and in line with the expected number of diagnoses of these conditions in the country, as per report submitted by the National AEFI (Adverse Event Following Immunization) Committee to the Ministry of Health & Family Welfare. (17^th May 2021). The reporting rate of these events in India is around 0.61/million doses, which is much lower than the 4 cases/million reported by UK’s regulator Medical and Health Regulatory Authority (MHRA). Germany has reported 10 events per million doses. Benefits of vaccine in terms of preventing deaths and severe disease from COVID-19 clearly outweigh the risk of blood clots

2. What are the signs of blood-clotting? Is it visible? How do we find out if it occurs to us? Is RTPCR indicator of it?

It is a difficult question to ask but if one feels numbness in limbs or pain in any part of the body, then one needs to consult a doctor.

VACCINE DOSAGE

1. What should be the gap between the 1^st and the 2^nd dose of the vaccine? Does this gap vary for different categories of people (say old or ill, etc.)? What if the prescribed gap exceeds due to some reasons? Are there any ill-effects associated with it? Will I have to repeat the 1^st dose? Take the 1^st dose as early as possible. The gap for Covishield is 12 – 16 weeks while that of Covaxin is 4-6 weeks. The gap window gives one enough time to schedule the 2^nd dose and one must definitely try to get the slots within the gap window. One should not panic or be too laid down. It is not a case of meeting or missing a deadline. It is just advisable to get the 2^nd dose as early as possible.
2. What if I have had the 1^st dose of Covaxin/ Covidshield but the 2^nd dose of it is not available? Can the 2^nd dose of vaccine be interchanged? How mandatory is the 2^nd dose or how effective is taking just the 1^st dose?

This situation is called vaccine interchangeability which is a full-fledged study. As of now since the disease and vaccines both are evolving, the interchangeability data is not available. So, if you take one dose of vaccine A and take the 2^nd dose of vaccine B, there is no guarantee if both these vaccines in combination will help you build the required immunity as there is no data available on this at this point of time. So, till the time that data or science gets evolved, please stick to one vaccine which you have taken.

3. Heard or read somewhere that immunity goes down for few weeks after taking 1st vaccine dose, and that the person becomes more prone towards contracting COVID during this period. Is this true?

It is very important that every one maintains good nutritional diet and keen one self safe. There are no direct scientific proof to infer that the immunity goes down after 1st shot of vaccine. Therefore, it is advised to continue taking all the safety measures, eat healthy, boost your immunity, stay hydrated, and still stay indoors for as long as possible.