Medical Discussion of Coronavirus

[Dicast]

I had pretty bad chills about 15 hours after the second pfizer shot. Had myalgias the whole next day. Mild 2/10 headache.
Chills 36 hours after the first shot.

No injection site findings.

I did do a pretty intense (for myself) rowing workout after each shot before symptoms set in. I'm not sure if that is a good or bad thing.

[toofy]

Yeah - had GRounds yesterday by ID team and pretty much the same general tone: #2 gonna have more symptoms for the young. They said 'okay' for tylenol, especially after the 2nd dose is considered okay. - Our ID team runs pretty conservative by-the-book too so think it's ok to antipyretic

Is ibuprofen bad for this?

[Tim]

“If I’m eligible for vaccine now, how do I get one?
The week of January 11, Texas will direct most COVID-19 vaccines received to large sites or hubs around the state to vaccinate more than 100,000 people.

Hub providers will be published Sunday, January 10. Please check back.”

• The goal of this plan is to provide more people the vaccine and a simpler way to sign up for an appointment.
• Providers will focus on vaccinating areas and populations hardest hit by COVID-19.”

The differences between vaccine distribution systems between states is beginning.
California - 1A eligible
Texas - 1A & 1B eligible

Texas seems to be redirecting vaccines to Hub suppliers. The existing hospital/pharmacy process wasn’t delivering jabs due to restrictions.

Turns out residency isn’t a requirement. Got a call from San Diego relatives. Turns out a Vaccine Road Trip is planned if they can snag appointments for 1B slots. Their logic was simply a drive is pretty equivalent to the restrictions in California. Why not try to get vaccinated?

Just a new twist.

[Orthodoc]

I had the moderna vaccine approximately 45 days after having Covid. The next day I felt awful. Chills, myalgias, fatigue, headache. On day 2, I had milder fatigue. Just at 48 hours post-shot, I felt like I was back to normal.

We've also had a few folks develop redness around the injection site approximately 1 week after the shot. Not sure if that's the type IV hypersensitivity kicking in or something else.

[Lordosis]

I had the moderna vaccine approximately 45 days after having Covid. The next day I felt awful. Chills, myalgias, fatigue, headache. On day 2, I had milder fatigue. Just at 48 hours post-shot, I felt like I was back to normal.

We've also had a few folks develop redness around the injection site approximately 1 week after the shot. Not sure if that's the type IV hypersensitivity kicking in or something else.

We had a few people get the redness a week after the moderna shot as well. I am curious to see if it is there next week.

My wife had the moderna shot and did not get that reaction. Just a very sore arm for a couple days.

[molar roller]

Our state's rollout to 1B has been very slow and haphazard. Everything is supposed be done through special links, which are broken within a day or two.
Was supposed to get the vaccine Thursday... came down with covid on Wednesday. Very pissed that I worked non-stop through the whole thing, and was only short a few weeks.

[Hatton]

We had a few people get the redness a week after the moderna shot as well. I am curious to see if it is there next week.

My wife had the moderna shot and did not get that reaction. Just a very sore arm for a couple days.

I had a large red reaction that lasted close to a week after the second pfizer shot. I also noted a couple of mosquito bites that had a larger than normal reaction that lasted a couple of months. My dermatologist did not think this was related to the pfizer shot but I think it was some type of hyper immune response.

[nephron]

I feel bad for everyone who has contracted the virus post vaccine discovery. I think that there are two major problems in the vaccine roll out: strict criteria for who to give the vaccine to, and lack of incentives to administer the vaccine to anyone but yourself. This is a classic example of where good intentions created in the government actually ends up harming the people that they were trying to help. By having strict criteria (health care workers, then front line workers, then people with 2 medical conditions, confirming age, etc), you create an extra barrier to administering the vaccine. Hospitals can't just let anyone walk up and get the vaccine because they have to ensure that they have clinical duties or do or do not have facetime with covid patients. This creates extra uncompensated work for vaccine administrators. Second, although I appreciate not having to look up a copay or having any financial barrier to having anyone get the vaccine, they probably should consider charging everyone some small amount of money to make administering the vaccine profitable. That's why hospital systems have no incentive to vaccinate local primary care physicians and their front line staff. Why should they be responsible for the documentation burdens and paying staff to administer the vaccine to people with whom they have no affiliation with? That's on top of the burden of confirming that the unaffiliated people fall within the state mandated administration tier. If you allowed people to charge some nominal fee, likely maybe a flat 10 dollar copay regardless of insurance status that could be waived if the person just signed some form stating that it was a hardship, setting up an administration system would become profitable and the market would find some way to administer the vaccine rapidly to maximize profits. That's why there are large bottlenecks in the system right now with some 75% of dosages sitting in freezers while front line workers have not received the vaccine.

I feel guilty for having received the vaccine while my 80 year old with every medical risk factor in the world is still some months away, but obviously they would not have gotten it any quicker had I deferred my dose. I would have rather they use the batch they used to vaccinate congress go to a dialysis unit I round at but that's obviously not going to happen. They are just going to have to accept that those who are highly motivated, have better connections, or have more resources are going to end up getting the vaccine before those more "deserving" if they want to speed up this process. You can't have news articles shaming systems that are misappropriating vaccine usage and trying to profit from them while threatening fines and not expect that to slow the process for everyone as they have to look over their shoulder and dot their i's to make certain they are following the prescribed process. If this vaccine is like most vaccines, there is likely going to be a benefit for vaccinating everyone in terms of preventing the spread of the virus. As distasteful as it may seem to some, by vaccinating your 50 year old multimillionaire who donated money to his hospital to cut in line to get the vaccine, you may prevent him from spreading the virus to his housekeepers mother who would die from the infection if she contracted it.

[Panscan]

Surprised system let that happen. Glad he got through it.

@ our GRounds, the ID team did warn about the 2nd shot and is making general recommendations to have either a day off after or lighter schedule planned.

That's simply not going to work for the general public and recommending something like that will probably make people less apt to get it.

[StarTrekDoc]

This is why california is still at 1A - to learn with a finite group of people how to walk before we run. It's exceedingly frustrating to have my patients wait while the county still has 100k healthcare staff to get it done; but it's only going to get harder with the larger populations to make it orderly. Our county fell extremely behind and have no resources to lift on this. They finally reached out to us to lend our expertise and we coordinated with the county to stand up a mass vaccination site starting monday to complete the lift of finishing off 1A. We clearly don't have the actual staff to do this; so county medical society did that recruitment outreach coordination and we had the know-how to coordinate a labor pool.

50k a week site going active Monday. Got my cousin's dentist office recruited and vaccination appointment monday already.

This makes sense and then allows us to maintain and expand these super sites for 1B along with existing health systems doing their own 1B established patients -- all funding flowing through the county-state-federal-taxpayers

[Tim]

The flaw in your logic is that the hospital systems were given “huge” quantities disportionately, 9000:100 week after week and the pharmacy chains as well. If they don’t want to serve the public distribution priorities, that is fine. Then the allocation for their internal needs goes through the allocation process. They participate getting supply for their needs and come up short as well. The $10 isn’t the issue. It’s taking an extremely scarce supply under false pretense.
Second shot minimums:
•Pfizer 21 days
•Moderna 28 days
What is the maximum?

The distribution plan was premised on reserved quantities for the second shot. Any data on
maximum wait times? Why is this important?
In a couple weeks the supply chain rules will be changed. At what point will you need to start over? Follow the science. I doubt we have any studies to support this. We have a lot of political and healthcare and pharmacies making up self interest distribution plans with self interest.
All for $10.

Just a reminder, this pandemic has huge impacts and the hospitals, pharmacies and politicians are looking out for their own interests and it will have tremendous costs. Rather than expand ED’s and ICU’s and suspend electives,
vaccinate!

I have no opinion on the priorities, simply a desire to distribute available vaccines according to guidelines developed.

[molar roller]

I feel bad for everyone who has contracted the virus post vaccine discovery. I think that there are two major problems in the vaccine roll out: strict criteria for who to give the vaccine to, and lack of incentives to administer the vaccine to anyone but yourself. This is a classic example of where good intentions created in the government actually ends up harming the people that they were trying to help. By having strict criteria (health care workers, then front line workers, then people with 2 medical conditions, confirming age, etc), you create an extra barrier to administering the vaccine. Hospitals can't just let anyone walk up and get the vaccine because they have to ensure that they have clinical duties or do or do not have facetime with covid patients. This creates extra uncompensated work for vaccine administrators. Second, although I appreciate not having to look up a copay or having any financial barrier to having anyone get the vaccine, they probably should consider charging everyone some small amount of money to make administering the vaccine profitable. That's why hospital systems have no incentive to vaccinate local primary care physicians and their front line staff. Why should they be responsible for the documentation burdens and paying staff to administer the vaccine to people with whom they have no affiliation with? That's on top of the burden of confirming that the unaffiliated people fall within the state mandated administration tier. If you allowed people to charge some nominal fee, likely maybe a flat 10 dollar copay regardless of insurance status that could be waived if the person just signed some form stating that it was a hardship, setting up an administration system would become profitable and the market would find some way to administer the vaccine rapidly to maximize profits. That's why there are large bottlenecks in the system right now with some 75% of dosages sitting in freezers while front line workers have not received the vaccine.

.

nephron,
I agree with all of this. Which is why I don't understand why after spending hundreds of billions on this amazing breakthrough, a very small portion of this amount could not be allocated to make delivery centralized and organized. I don't blame hospitals for being reluctant to roll it our to everyone - with their resources strained as is. The fact that they were placed in that position is terrible.

[G]

Our state's rollout to 1B has been very slow and haphazard. Everything is supposed be done through special links, which are broken within a day or two.
Was supposed to get the vaccine Thursday... came down with covid on Wednesday. Very pissed that I worked non-stop through the whole thing, and was only short a few weeks.

Ugh. Hope you get well soon.

[molar roller]

Ugh. Hope you get well soon.

thanks. so far the symptoms have been quite mild... this is Day 5 and just very low grade fever for now, seems to be getting better too. Hopefully it's winding down.
But I did have a gut feeling I won't be getting the vaccine on Th. I told EVERYBODY about it .. jinx..

[jhwkr542]

Just got my 2nd dose. Will update with sx's if they show up. Definitely agree with nephron. I'm pretty low risk but when offered, I accepted. I don't understand the prioritized approach. Outside of nursing homes getting doses, just push to get the shot out. Front line workers will figure out a way to get it. But while they're at high risk of getting it, they're not at greatest risk of dying usually. Even in limited data, the first dose looks effective. Just get shots out there.