Each week, we answer “frequently asked questions” about life during the coronavirus crisis. If you have a question you’d like us to consider for a future post, email us at email@example.com with the subject line: “Weekly Coronavirus Questions.”
I hate shots. Tell me the truth: How much is this vaccination going to hurt?
The honest, and short, answer appears to be: Not much! That’s according to people who have already been jabbed including Vice President Kamala Harris, who said she “barely felt it,” Dr. Anthony Fauci, who didn’t flinch when he got his inoculation on live TV, and my needle-averse son, who is in Moderna’s adolescent trial and says the poke hurt way less than any other he’s gotten.
“From my own experience, I didn’t even feel the needle go in,” says Dr. Jill Weatherhead, assistant professor of adult and pediatric infectious diseases at Baylor College of Medicine.
Experts say the coronavirus vaccine should feel about the same as any other intramuscular vaccine shot when the needle pierces your skin en route to your deltoid, a muscle that has been deemed an easy target. But there’s some evidence to back up the anecdotal accounts that the Pfizer and Moderna vaccines hurt less: There is a range in the CDC’s guidelines for needle size, and vaccine administrators may be opting for the smallest length and diameter within those limits in order not to waste any amount that clings to the needle, says Dr. Abinash Virk, co-chair of the COVID vaccination allocation and distribution for the Mayo Clinic in Rochester, Minn.
Previous research has shown that smaller needles are more tolerable, Weatherhead says. And in case you’re a numbers nerd, the diameter range, which likely matter more than length in terms of potential pain, is 25-28 gauge— skinnier than a pencil point.
“I’ve heard people say, I didn’t feel it!'” Virk says. “But it is a needle piercing through your skin, inserting a little bit of liquid into a spot that normally doesn’t have [liquid], so your body has to adjust: ‘What do I do with this .3 ml ?’ So it just causes a little bit of pain.”
Of course, people’s perceptions of pain vary widely.
“There’s so much individual variation,” Virk points out. “I’ve seen kids who don’t blink and others who bring the house down. Interestingly, I ran the trial clinic at Mayo Clinic for 17 years, and it was usually the young, very fit guys who were not doing well. For the most muscular, tough guys, here comes the needle and you hold on to them to make sure they don’t fall off the table.”
So what can the needle-phobic among us do to ease the experience? We asked Drs. Virks and Weatherhead for tips:
If you’re not a fan of needles, don’t watch, Weatherhead says. “Many do not like the look or feel of needles, so look away to quell fears and anxiety related to needles.”
Of course, it’s fine to keep your eye on things if you tolerate shots well. “My 5-year-old loves to watch,” Weatherhead says. “It’s all personal. Whatever makes you feel more comfortable and confident to get this done, do it.”
Don’t take a pain reliever beforehand (but afterward is fine if needed)
Some research on other vaccines suggests there could be “a slight blunting of the immune response” in kids who took Tylenol before their shots, Dr. Virk says. Even though a different study of older adults did not back that up, most experts are erring on the safe side and recommending not to take any pain relievers beforehand.
“You don’t want to be taking medicine you don’t need,” Weatherhead says. “If you develop symptoms afterward, then at that point it’s certainly OK to take some sort of pain relief to help control symptoms.”
Be honest with jittery offspring
If it’s your child who is nervous, the best strategy is honesty, Weatherhead says.
“Be honest with kids upfront that you’re going to get a vaccine that’s a shot in your arm, that it may hurt initially, but it’s helping your body get stronger to protect you from illnesses,” she says. “Give children honest answers. When they’re empowered around their own health, it’s really helpful.”
In terms of potential pain, you don’t need to worry too much about whether your arm is tensed or relaxed, Weatherhead says, but “just being relaxed in general is helpful,” she says. If you relax your arm by your side, you’re less likely to flinch it or move it during the jab. That means the vaccinator can get the needle in and out in a flash.
Trust in nurses
Doctors are the first to admit that experienced nurses are expert at delivering painless jabs.
“Nurses are definitely the most talented and very valued, especially in the pediatrician world,” Weatherhead says. “It does take some practice to be fluid and quick. There’s a little hand coordination and muscle memory. The faster and smoother you can do it, the less discomfort and more tolerable it will be to the patient.”
This isn’t to say that there is no pain associated with the COVID-19 vaccine, doctors stress. Most side effects, including arm pain, begin hours after the poke – that’s when the actual immune response begins. To prevent as much interference with daily activities as possible, there are a few things you can do:
Offer your non-dominant arm
The vaccine instructs your cells to mimic the spike proteins of the SARS-CoV-2 virus to provoke an immune response. That will occur with equal efficiency in your left or right arm. But arm pain will likely be less annoying in your left arm if you’re right-handed and vice versa, says Weatherhead.
Most people will have some arm pain after getting the shot, Weatherhead stresses, and it’s really up to you which arm you’d rather experience it in.
If you rely on ice to ease other types of pain, you can certainly try it for a shot. There isn’t any data on it, Weatherhead says, but if it makes you feel better, go for it.
If COVID-19 vaccines become an annual event, you can take some comfort knowing that there are oral vaccines in development. (No nasal sprays thus far.) There’s no guarantee they’ll come to fruition, however, and doctors remind us that any pain associated with the vaccine is a fraction of what many people experience with COVID-19.
Of course, many people have never been so excited for a vaccine, and that may outweigh any fear of being poked. Few people are complaining about sore arms in the vaccination clinics Dr. Virk has seen. The word nurses used to describe the scene, she says? Joy.
Sheila Mulrooney Eldred is a freelance health journalist in Minneapolis. She’s written about COVID-19 for Medscape, Mpls.St.Paul Magazine, Science News for Students and TheWashington Post. More at sheilaeldred.pressfolios.com. On Twitter: @milepostmedia
'We need this:' Getting COVID-19 vaccine to remote and urban Indigenous populations – Kamloops This Week
Chief Chris Moonias looked into a web camera as he prepared to get a COVID-19 vaccine just after precious doses arrived in his northern Ontario community.
“I’m coming to you live from Neskantaga First Nation community centre where our vaccines will be administered,” a jovial Moonias, wearing a blue disposable mask, said during a Facebook live video at the start of February.
Moonias was first to get the vaccine in the fly-in Oji-Cree First Nation on the shores of Attawapiskat Lake north of Thunder Bay.
The vaccine had arrived by plane earlier in the day after weeks of planning, and the chief’s video was part of a campaign to get community members on board.
Moonias said in an interview that he had done his own research, had spoken with medical professionals and wasn’t concerned about getting the shot.
About 88 per cent of eligible on-reserve members have since received a first dose of the Moderna vaccine. Second doses are to arrive Monday.
However, earlier this week, the reserve declared a state of emergency due to a COVID-19 outbreak, with some cases linked to the Thunder Bay District Jail.
Moonias said four off-reserve members in Thunder Bay, all under the age of 40 — including his nephew — have died. And he’s worried about the 200 other members who live off the reserve — almost the same number as those on the reserve — and when they’ll get inoculated.
“I even thought about flying my peopleup… to get the vaccine,” said Moonias, who added it’s unlikely to be an option because of cost.
Canada is in the midst of the largest vaccine rollout in its history. The second wave of the COVID-19 pandemic has hit Indigenous populations much harder and Ottawa says they are a priority for vaccinations.
The actual distribution remains complex and varied across the country.
Neskantaga is one of 31 fly-in First Nations included in Operation Remote Immunity, part of the first phase of Ontario’s vaccination rollout. The operation was developed with Nishnawbe Aski Nation and Ornge, the province’s air ambulance service. The goal is to provide mass vaccinations by April 30 and it is having early successes.
There are challenges getting the vaccine to remote First Nations and questions about distribution for urban Indigenous populations.
The Assembly of First Nations says most Indigenous communities haven’t received sufficient supply to extend doses to their off-reserve members. The National Association of Friendship Centres says there is no national vaccination plan for urban Indigenous people.
There’s also concern there is no national plan to tackle decades of mistrust created by systemic racism and experimentation on Indigenous people.
There are many examples throughout Canadian history of scientists sponsored by the federal government or the government itself doing medical experiments on Indigenous people, including children, who were the subject of a tuberculosis vaccine trial in Saskatchewan that began in the 1930s.
Ontario New Democrat Sol Mamakwa, who represents the electoral district of Kiiwetinoong, said some constituents tell him they are scared to take the vaccine. They don’t trust it.
He has been travelling to communities to help promote it and received his first dose alongside members of Muskrat Dam Lake First Nation.
Community engagement has been key in vaccine uptake, Mamakwa said. Promotion begins weeks before vaccine teams arrive and includes radio campaigns, social media posts and live online question-and-answer sessions.
It’s about giving people information, he said.
“One of the only ways out of this pandemic is the vaccine,” said Wade Durham, Ornge’s chief operating officer, who added it’s key to have Indigenous people involved in vaccine planning.
Each First Nation in Operation Remote Immunity has a community member responsible for answering questions and setting up a vaccination site. Immunization teams are required to take cultural training and, when possible, include Indigenous medical professionals and language speakers.
Indigenous Services Canada said it is aware that a history of colonization and systemic racism has caused mistrust, so campaigns are being developed specifically for First Nations, Inuit and Metis communities.
Michelle Driedger, a Metis professor of community health sciences at the University of Manitoba, said experience has shown that stakes are high when it comes to Indigenous communities.
During the H1N1 pandemic in 2009, the Public Health Agency of Canada prioritized vaccines by geography. A main lesson learned was to increase Indigenous representation at decision-making tables, she said.
At the time, Indigenous people were over-represented in hospitalizations and intensive care stays, as well as in deaths. Those living in remote and isolated communities experienced worse outcomes.
Driedger said the vaccine response is better now, but there is “rational skepticism.” There needs to be a transparent vaccination plan for Indigenous communities — no matter where they are, she said.
The Matawa First Nations tribal council said its four communities reachable by road are not getting the same vaccine access as its five fly-in ones, and more needs to be done.
Provincial officials have said that remote First Nations received priority for the vaccine rollout because of less access to on-site health care and increased health risks. Chief Rick Allen from Constance Lake First Nation has said the vaccine needs to go where the outbreaks are.
Back in Neskantaga, Moonias said he’ll do anything he can to protect anyone he can.
He continues to give updates about his vaccination. In another Facebook video posted soon after he received his shot, the chief gave a thumbs-up and said he had no pain or discomfort.
“We need this. We need to beat this virus.”
This report by The Canadian Press was first published Feb. 27, 2021.
This story was produced through the Journalists for Human Rights Indigenous Reporters Program under the mentorship of The Canadian Press, with funding from the RBC Foundation in support of RBC Future Launch.
One-third of new virus cases in north of province – Winnipeg Free Press
As case counts, hospitalizations and test positivity rates continue to trend downwards across the province, northern Manitoba continues to take on the brunt of the province’s COVID-19 cases, with more than a third of new cases identified in the region.
The province reported 90 new cases of COVID-19 and four new deaths as of Saturday morning.
Of the new cases 37 were identified in the Northern health region, with an additional 34 in Winnipeg, eight cases each in the Interlake-Eastern and Southern Health regions, and three cases in the Prairie Mountain Health region.
The number of confirmed B.1.1.7 variant of concern cases in the province remains at five.
Manitoba’s five-day test positivity rate continues to dip closer to three per cent — the number health officials indicated could lead to looser restrictions — reaching 3.7 percent provincially and 3.2 per cent in Winnipeg.
Public health officials said Thursday loosened restrictions will be considered in two phases as early as March 5, with the second phase to come Mar. 26.
Manitoba completed 1,861 tests Friday, bringing the total number of lab tests since last February to 523,507.
The total number of lab-confirmed COVID-19 cases in Manitoba is 31,809, with 1,208 cases listed as active and 29,708 individuals who have recovered from the virus.
The COVID-19 related deaths reported Saturday include two women in their 80s, and a man and woman in their 90s, all from the Winnipeg health region.
The total number of virus-related deaths in the province is now 893.
Hospitalizations due to COVID-19 continue to improve, too. The province announced 69 people are currently in hospital with active cases of the virus, with an additional 120 people in hospital who are considered no longer infectious but still require care for a total 189 hospitalizations.
There are 11 people in intensive care units with active COVID-19 and 16 people who are no longer infectious but continue to require critical care for a total of 27 ICU patients, the province said.
Indonesia approves free COVID-19 vaccine drive by private companies – Arab News
JAKARTA: The Indonesian government on Friday said it would allow private companies to run coronavirus vaccination programs for workers and families alongside a nationwide drive to expedite efforts in achieving herd immunity.
The country is aiming to inoculate 181.5 million people out of the total 270 million population by year-end.
“The companies will provide the vaccines for free for workers,” Siti Nadia Tarmizi, health ministry spokesperson for the vaccination program, said during a press conference.
Tarmizi added that the ministry’s revised regulation, which serves as the main reference for the vaccination program, was issued on Wednesday to include articles regulating the private sector’s involvement in the vaccination drive.
“The number of vaccines distributed in the private-run program will match the number that the companies requested, and the inoculations will be conducted at private healthcare facilities or the companies’ own facilities,” Tarmizi said.
Additionally, the vaccines used in the program will be different from the free CoronaVac, AstraZeneca, Novavax and Pfizer vaccines that the government has distributed since mid-January.
While initial population targets included health workers, senior citizens, frontline public workers, teachers and lecturers, athletes, journalists, and lawmakers, the general population or those in their productive age will receive their first vaccine jab in April.
The private scheme, which the Indonesian Chamber of Commerce (Kadin) proposed, will require companies to purchase the vaccine from Bio Farma, a state-owned vaccine manufacturer appointed as the sole importer for all jabs that Indonesia procures.
Bio Farma spokesperson Bambang Heriyanto said the company is in discussions with Moderna and Sinopharm to procure vaccines for the private scheme, which has been dubbed “Gotong Royong,” an Indonesian term for mutual cooperation.
“In accordance with its name, this is a mutual cooperation initiative. The government will provide a space for any members of society that will want to assist the government in the vaccination program,” Arya Sinulingga, a spokesperson for the State-Owned Enterprises Ministry, said on Friday.
He added that the private drive will run in parallel with the government’s program and will not alter the existing schedule or priority groups being targeted.
Kadin said that about 7,000 companies had already registered for the vaccination drive as of Saturday.
“The enthusiasm is really high to take part in this program because it is quite costly for the companies to swab test regularly. It is better for the companies to allocate the cost to vaccinate their workers,” Shinta Kamdani Widjaja, Kadin deputy chairwoman, said at a press conference earlier this week.
She dismissed concerns that the program will commercialize vaccines, saying the government would closely monitor the program to avoid any violations of terms and conditions.
“There are also companies that are willing to vaccinate not only their workers, but also their families. It would be difficult for the economy to recover if we don’t achieve the herd immunity target. The business community is ready to support the government in the vaccination drive and economic recovery program,” Widjaja said.
However, opponents of the scheme said the private vaccination drive will “only enable queue jumpers who don’t really need the vaccine compared with the more vulnerable groups, and disregard the principle of equity for all citizens in a vaccination program.”
Dicky Budiman, an Indonesian epidemiologist, said in an online discussion: “There is also no guarantee that we will achieve herd immunity by inoculating 181.5 million people. This could be misleading the public and making them have the wrong expectation.
“This is also prone to make the government, the companies, and the public relax its compliance to the health protocols, testing, tracing and treatment,” Budiman added.
He said that achieving herd immunity is a long-term goal and that the vaccination drive could not stand alone in battling the pandemic without a comprehensive public health approach.
Pandu Riono, an epidemiologist at the University of Indonesia, agreed and said that the private vaccination program focused mainly on economic recovery targets instead of controlling the pandemic.
“It is clear from the start that the government does not view the vaccine as one of the ways to handle the pandemic, but it has been more about economic recovery,” Riono said.
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