The Second Dose

Premier Pulse     February 2021

1134192644By Andre Harris, MD, chief medical officer and vice president of operations, Atrium Medical Center

On January 21, I received my second dose of the Moderna COVID-19 vaccine. Like many people, I heard that the second shot could be a jolt to the system. I can attest that my immune system was in full swing. Because of the second dose jitters, there is hesitancy on receiving the vaccine altogether. I want to encourage and prepare those who are holdouts and preparing second dose recipients. 

It is well-established that vaccine recipients can deal with local and systemic side effects. The local would be swelling, redness, or tenderness at the injection site. I noticed that my deltoid was sore (similar to a good shoulder workout routine). I’ve seen at least one patient with some lymph node swelling as well. The systemic issues seem to be more frequent with the second dose. Systemically, you can notice fever, fatigue, chills, headache, muscle ache, or joint ache. About 12 to 14 hours after my vaccination, I had chills. I fell asleep on the couch and when I awoke at 2 a.m. to go to bed, I noticed the chills. I took 800mg of Motrin and went to sleep. When I woke up, no chills. I had a slight headache and some fatigue issues. By the 24-hour mark, all of my symptoms were gone.

I offer the following advice to second dosers. First, according to CDC guidelines, you should NOT pre-medicate with analgesics. There is a question of blunting your immune response. I would tell you that for most people, if/when symptoms begin, medicating with Ibuprofen (maximum of 800 mg every eight hours, if no kidney issues) or Tylenol (no more than two extra strength tabs every six hours) should be sufficient to manage symptoms. Remember that the symptoms are temporary and much better than an admission to the ICU.

We are all looking forward to seeing family and friends sooner rather than later, and this vaccine, combined with a decline in infections, is setting the stage for this to happen.

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