Practice Management Alert
Make Transparency Around Vaccine a Priority
Know that your day-to-day practice won’t change much for a while. The various vaccinations for SARS-CoV-2, the virus that causes COVID-19, that are being distributed and administered are a ray of hope. However, with many people increasingly less information-savvy, it’s crucial to be up front about expectations with anyone who receives a vaccine. One immediate takeaway: Don’t cross the extra personal protective equipment (PPE) off of your budget just yet. Don’t Mistake These Post-Vaccination Symptoms for COVID-19 One worry that nonclinical people may have is whether they risk getting COVID-19 from the vaccination itself. This fear is exacerbated by potential — but totally normal — side effects from the vaccine. Vaccinations sometimes cause an immune response in recipients, and the COVID-19 vaccination is no different. However, the symptoms of a response to the vaccine will not mirror COVID-19 symptoms. The signs and symptoms people may experience after receiving the vaccine are systemic and can include fever, fatigue, headache, chills, myalgia, and arthralgia, said David T. Kuhar, MD, a member of the healthcare infection control team for COVID-19 Response at the Centers for Disease Control and Prevention (CDC) in Atlanta, in a recent Clinician Outreach and Communication Activity (COCA) call. Most of these signs and symptoms would be mild or moderate, would present in the first three days after vaccination, and should resolve within a day or two after onset, Kuhar said. More adverse reactions have been reported after the second dose, and more in people 18-55, rather than older than 55. Symptoms and signs that can be the hallmarks of COVID-19, like cough, shortness of breath, runny nose, sore throat, and loss of taste or smell would be attributable to something else besides the vaccine, Kuhar said. It’s important to be transparent with staff, especially, about what they should expect after vaccination. “Let them know what to expect and what to do as symptoms develop. Also, developing a strategy to provide timely assessment of healthcare personnel who present with symptoms, including providing or identifying options for SARS-CoV-2 viral testing, so it’s readily available if indicated,” Kuhar said. One helpful thing to note when planning vaccination of staff and patients is that the COVID-19 tests will still be accurate. “Positive nucleic acid and antigen testing for SARS-CoV-2 should not be attributed to the COVID-19 vaccine, as the vaccine does not influence the results of these tests, and this is important, because we can still test vaccinated persons for acute disease when indicated,” Kuhar said. Build this consideration into your vaccination protocols, along with monitoring the timing of any symptoms or signs. Keep following the same protocols for symptomatic and asymptomatic staff, too, with a special eye on fevers. “If symptomatic personnel return to work and symptoms are not improving or persist for more than two days, which is more than you’d expect from postvaccination signs and symptoms, then pending evaluation, they should be excluded from work and considered for viral testing. Personnel with fever should ideally be excluded from work, pending evaluation, including consideration for SARS-CoV-2 testing,” Kuhar said. Make Sure You’re Using PPE Unfortunately, getting vaccinated is not yet a golden ticket to stop wearing a face mask or other PPE — or for your organization to stop purchasing it or keeping a stocked inventory. There’s not enough information available yet for definitive proof that the vaccine is effective enough to preclude PPE usage. “It’s really important to remember that because information is lacking on vaccine effectiveness in the general population, resultant reduction of disease, severity, or transmission — even the duration of protection ... healthcare personnel should continue to follow all current infection prevention and control recommendations to protect themselves and others from SARS-CoV-2 infection regardless of their vaccination status,” Kuhar said.
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