A sense of eagerness, apprehension, suspicion, a dash of hope—they say you never forget your first. How do you prepare and what can you expect? Prof Dr James Koh Kwee Choy, Head of Division of Medicine, School of Medicine, International Medical University (IMU) helps to answer these questions as he recalls his first date…with the COVID-19 vaccine.
He arrived early. It was half an hour before his appointment. The usual SOPs were followed—QR code scanned, temperature taken, hands sanitised, mask checked and social distancing adhered to. He joined the others who were already there waiting and soon he was called up. His identity was checked and verified. Then it was time for a briefing and a ten-minute counselling session with an assigned doctor. A short medical history was taken—covering medical conditions and medications. He was given time for any questions he might have. When the doctor was satisfied that it was safe for him to receive the vaccine, he was given a consent form to sign. With everything in order, it was time for his jab. “It was quite a long process,” says Prof Dr James Koh Kwee Choy as he recalls his first ‘date’ with the COVID-19 vaccine. “But the injection itself was very fast and painless, just a very small nick that you don’t really feel at all,” he assures. All in all his appointment took about two hours, including a half an hour post-jab observation. “They will observe you to ensure that you do not have any severe reactions such as an anaphylactic shock,” explains Prof James.
|On The Side|
|According to Prof James, side effects vary widely but it is very rare that you will experience severe reactions. For him, he experienced pain and swelling at the injection area and was tired for about three days. “I slept a lot,” he says, while some of his colleagues had fever and chills. It was the second jab though that hurt more. “The effects were more pronounced for me with the second dose. The pain was more intense, my left shoulder was more swollen and I really felt very, very tired and sleepy,” he says. He also had swollen lymph nodes and the side effects lasted more than a week. “This time I took some paracetamol to ease the pain,” he adds. Taking mild pain relief such as paracetamol is fine but not Non-steroidal anti-inflammatory drugs (NSAIDs), he advises. “There is no need to worry about the side effects because these are expected reactions to a vaccine. It shows that your body is working to produce antibodies,” he explains. On the flip side, he says that we need not worry if we have no side effects. “That does not mean it is not working. In fact, you should consider yourself lucky!” You are of course advised to immediately seek medical help if you experience breathlessness or extreme dizziness.|
Most Malaysians are still waiting for our appointments, and some of us are going the extra mile to sleep more, eat well and exercise regularly. But is this necessary? Prof James answers with a laugh, “We should always be cultivating good healthy habits!” He adds, “Yes, be well rested because when you receive the vaccine, the body is at war. So if you are well rested, your body will be better at fighting than if you are overly tired. But there really isn’t much we need to do to prepare.” Similarly, after you have received the vaccine, he says: “If you are feeling tired, rest. Don’t immediately return to strenuous workouts or start an exercise regime if you hadn’t been doing it before. But there are no hard and fast rules. Just listen to your body.” There is also no need to specifically eat or fast before going for your appointment. “But if you are like me and you get hungry easily, please eat something before you go,” he says. You might even want to bring some snacks with you just in case. “If you are feeling a bit under weather you don’t have to be worried. You can still get the jab,” he adds.
The Second Date
The second dose comes within three weeks after the first. If you can’t make the stipulated date and time, you can reschedule it. “Just don’t leave it for too long. Although all is not lost if you miss your second dose—some studies have shown that one dose still offers some protection—it is important to have both doses to ensure maximum efficacy,” he says. In his experience, the second appointment was much faster than the first, taking just a bit more than an hour. “There is no briefing and counselling session and no forms to fill for the second dose,” he explains. Your body will build up protection to the virus in about two weeks after the second dose. This does not mean that you are no longer susceptible to the virus. “You can still get infected. The vaccine does not protect you from the virus. What it does is to prevent you from getting a severe case of COVID-19 that can lead to death,” he says. At this point many people might start to question the need for vaccination if this is the case. But Prof James explains: “After you are vaccinated, if you get infected, the infection will not be as severe. If the infection is mild, the virus load is less. This means you are less likely to spread it and if you do, it will also be milder.”
|Not Everyone is a Match|
|There are two groups of people though who should take precaution. Firstly, those whose immune systems have been suppressed for example if you are undergoing chemotherapy or if you are living with HIV/AIDs. Secondly, are those with a history of anaphylactic shock. “If you are in any of these groups, check with your doctor who will monitor and advise you about taking the vaccine as your body needs to be stable before you do,” he says. Others may have to delay their jabs. This is the case if you have received another vaccine, for instance a flu or hepatitis B vaccine, in the two weeks prior to your appointment date. “You will be asked to reschedule your COVID-19 vaccine shot,” Prof James says. “This is to allow the body time to recover from the other vaccines.” Another reason for a delay would be if you have had a COVID-19 infection. “In Malaysia, a 3-month gap between recovery from COVID-19 and vaccination is practised,” Prof James says. This may seem counterintuitive—do we not develop our own antibodies? “Yes, but that’s not enough,” Prof James explains. “Someone who has had the COVID-19 virus will develop antibodies, but studies have indicated that they only last for about 6 months.” “You should therefore still register for the vaccination just like everyone else. You do not need to take any other tests,” he adds.|
To Love and Protect
“All of us who can take it, should do so because we’re the ones who can protect those who are not as strong,” says Prof James. To gain herd immunity, 80 percent of the population needs to be vaccinated. That means most of us need to take the jab. Using a war analogy, Prof James likens it to having a city fortified with able people protecting the very young, the sick and the old. “If we do that, we have a better chance of winning. But if we all start to say that we don’t want to fight, and that we just want others to fight on our behalf, what will happen?” he asks. There is still one big question hanging in the air for many: “Is one vaccine better than the other?” “Some are traditional vaccines that use an inactivated virus to which the body reacts by producing antibodies. The newer methods use something called the messenger RNA (mRNA), that will enter the muscle cells—this is why the muscle becomes very painful. The mRNA causes the muscle cells to make components of the virus, in this case the spikes on the coronavirus, which are displayed on the muscle cell surface for the body to react to it by producing antibodies.” Prof James explains. “While the different vaccines work differently, they are all just as safe and effective.”
Make That Commitment
What about those who want to wait it out? According to Prof James, “There is no point in waiting. Herd immunity needs to happen as quickly as possible as the virus will mutate. The faster we are able to vaccinate people, the less time the virus will have to mutate in the community. This means we cut down the chances that it will evolve into something even more deadly.” Prof James also explains that it is a misconception that the two doses are the only ones we will ever need to take: “That’s not the case. The virus will mutate and you will need to get booster shots regularly.” This means whether you wait or you don’t, booster shots will be part of our life for the foreseeable future. “Get the vaccine because we’re not just protecting ourselves but protecting others,” he says. And if you are still hesitating, heed his words: “If we do not reach herd immunity, it may not take away the personal protection of those who are vaccinated…but what it does mean is that we might live from one MCO to another.”
|On the Day of Vaccination|
|• Turn up early for the appointment. (about half an hour before the appointment time)|
|• Wear loose clothing that allows doctors to easily access your shoulder.|
|• Remember to bring your mobile phone with your MySejahtera ID and your NRIC|
|• A briefing and verification of your identity. You will need to scan several QR codes with your mySejahtera app.|
|• There will be a short counselling session by a doctor who will review your medical history such as past medical problems, allergies, etc|
|• If this is cleared, you will need to sign the consent form saying that you are agreeable to the vaccine. This is only during the first dose.|
|• You can then proceed to vaccination. It is better to be injected on your non-dominant hand, as most people experience soreness and pain at the injection area.|
|• You will need to stay for observation for 30 minutes. You will be monitored for any severe reactions.|
|• You will receive a notification for your second dose (between 2-3 weeks after). The second dose will be much faster as there will be no counselling or briefing session.|
|• After the second dose, you will be given a card to verify that you have received both doses. This card will also be available in your mySejahtera app.|