Severe allergic reactions are rare for the two covid-19 vaccines in use now. But sometimes uncomfortable side effects are common.
Here's what to expect after the first and second injections of Pfizer or Moderna vaccines, according to two Arkansas experts.
State epidemiologist Dr. Jennifer Dillaha and Dr. Robert Hopkins, professor of Internal Medicine and Pediatrics at UAMS and chairman of the national Vaccine Advisory Committee, answer questions below. Their responses are edited for brevity and clarity.
Q. As more people get vaccinated, what is the range of typical reactions we're seeing to the shots?
Hopkins: Typical reactions are similar to what we see with many vaccines -- arm pain, fatigue, low grade fever. There have been a few with swollen lymph nodes in the underarm after vaccination.
Dillaha: For the most part, people are having mild to moderate side effects ... such as pain, redness, swelling at the site of the injection and swollen lymph nodes on the side the shot was given. Systemic side effects are likely to include fever, tiredness, sore muscles and sore joints.
Q. Are there estimates of what percentage have no reaction to either shot? Mild reactions? Life-threatening reactions?
Hopkins: About half of those receiving the vaccine have a sore arm. In the studies that led to vaccine approval, around one-fourth had mild systemic symptoms (headache, fatigue, nausea).
Side effects enough to miss work are probably less than 1 in 10. Life threatening effects are rare.
The most common severe reaction reported to date is anaphylaxis. Current estimates are that this occurs about five times for every million doses, and those reported were treated promptly and all survived.
Q. Are reactions more likely with the second shot? Why?
Hopkins: Yes, the local and systemic reactions are more common with the second dose and generally resolve in about a day. Those who have allergic reactions to the first dose should not get second dose. Fortunately this is rare.
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Dillaha: People are more likely to have side effects with the second shot.
In addition, younger people are more likely to have side effects than older people who receive the vaccine. Because you already have partial immunity [from the first dose], you mount a more vigorous response to the second dose. And younger people are likely to have a more vigorous response to the vaccine than older people because our immune systems wane as we get older.
Q. What should a person do if feeling achy and feverish after a vaccination?
Hopkins and Dillaha recommend acetaminophen or ibuprofen (Hopkins mentions naproxen if health permits.) Dillaha also suggests rest.
Q. Are any of the more usual reactions serious enough to deter anyone from getting vaccinated?
Hopkins: I would recommend that anyone who has not had an allergic reaction to a previous dose of covid vaccine be vaccinated (pregnant women should speak to their obstetric provider before being vaccinated).
I do not know of any common reaction seen with these vaccines that would dissuade me from being vaccinated, and I have been.
Dillaha: The expected side effects, while troublesome, will not be nearly as troublesome as being admitted to the hospital with covid-19. So we encourage people to lower their risk of covid-19 by getting the vaccine.
