Checking Up On Health: April 19, 2021

Medical Monday: A weekly post of healthcare- and technology-related policy news, views and commentaries.

Cat Stevens first sang, “The First Cut is the Deepest.” But last week’s second COVID-19 vaccination suggested the first shot’s not the hardest. In fact, as it did many other Americans, the second Moderna shot knocked me for a loop.

It’s not just Moderna that has such an effect, of course. Others have been hit hard by the Pfizer vaccine. Both shots, as I have mentioned in an earlier post, are messenger RNA (mRNA) vaccines. A Sacramento Bee article explains the most-reported after-effects of each vaccine. There no “standard” reaction; it varies. You may feel one, all, none or different after-effects.

The nurse who injected the first shot told me younger patients tended to have stronger reactions: Their stronger immune systems fight back hard, making many feel more ill. Stay away from NSAIDs, she said; have acetaminophen (Tylenol)  instead if you hurt so the vaccine can do its job without suppression.

The nurse who injected the second vaccine explained the likelihood of a strong reaction. She described the first shot as a “primer,” so that the body recognizes the attack with the second vaccination and fights back. She suggested no acetaminophen for the first 24 hours if I could tolerate the pain. And she reminded me, importantly: It takes about 14 days for the vaccine to take full effect, during which time you may still be infected.

It took about 24 hours for the dam to burst: The vaccination was at noon Wednesday; by noon the next day I was fading fast. Cold, achy, tired and feverish (100.4 F temperature), I climbed under the blankets and tried to warm up. I didn’t get out of bed until Friday morning, awakening with what I described as a “cottonwool” headache: a feeling of fuzziness. By Saturday, I felt painful, swollen lymph nodes in my armpit. It was Sunday by the time I noticed a huge red spot on my painful left arm.

How, I wondered, can such a tiny needle cause so much pain? An article in explains why and shares a “hack” on how to reduce the arm pain. According to infectious disease specialist Dr. Peter Chin-Hong, your arm is sore because the vaccine is being injected into your arm muscle, not the bloodstream.

“It remains local,” he says, “so the first thing your immune system is going to say is, ‘Hey, there’s this foreign invader in here.’ … It’s going to start being trained, which is a good thing, which is what you want. So that inflammation happens at the muscle area.”

But in order to diffuse the vaccine away from the muscle, and let the immune system begin developing immune cells elsewhere, you need to increase your arm’s blood flow.

(That’s also the reason why experts advise getting your vaccine in your dominant arm, as it’s the one that you end up moving around more.)

The hack? Swinging your arm in a circle, windmill-style, like this viral TikTok video shows, limits the pain after your vaccination. Do it as soon as you’re released from your 15-minute waiting period (if not sooner). Chin-Hong says that swinging your arms sooner, and in effect dispersing the vaccine sooner, could help reduce soreness as opposed to waiting to get home to do any arm exercises.

My advice? Take this suggestion to heart, no matter how foolish you look. Anything that reduces the soreness is worth it. The assistant at the Habersham Aquatic Center who demonstrates arm movements to patients during the 15-minute waiting period deserves special recognition for her wise counsel!

Air, air: Commentaries in the British Medical Journal, The Lancet and the Journal of the American Association (JAMA) demonstrate that researchers “have all concluded that aerosols are the dominant mode of transmission” for COVID-19, according to an article in Medscape. They cite the increase in COVID-19 cases in the aftermath of so-called “super-spreader” events, its spread to people across different hotel rooms, and the relatively lower transmission detected after outdoor events.

“It was only just last week that CDC pulled back on guidance on ‘deep cleaning’ and in its place correctly said that the risk from touching surfaces is low,” Joseph G. Allen, associate professor of exposure assessment science at the Harvard T.H. Chan School of Public Health in Boston told Medscape Medical News. “The science has been clear on this for over a year, but official guidance was only recently updated.”

As a result, many companies and organizations continued to focus on “hygiene theatre,” Allen said, “wasting resources on overcleaning surfaces. Unbelievably, many schools still close for an entire day each week for deep cleaning and some still quarantine library books. The message that shared air is the problem, not shared surfaces, is a message that still needs to be reinforced.”

Rocketing rate: More than half of all American adults over 18, or almost 131 million, have received at least one dose of the COVID-19 vaccine, and 33%, or more than 85 million, are fully vaccinated, according to CDC data. An average of 3.2 million doses are being administered per day, compared to the about 1.7 million given last month.

Eligibility: As of today, the federal government has announced, anyone over age 16 is eligible to receive a COVID-19 vaccination.

Paused again: First, use of the one-dose Johnson & Johnson COVID-19 vaccine was paused because of concerns about very rare blood clots. Now, there’s a manufacturing pause ordered at the embattled Emergent BioSolutions plant in Baltimore pending a completed inspection. The U.S. Food and Drug Administration is continuing its investigation into quality control issues at the plant that ruined 15 million potential doses of the vaccine. Source:

Compiled by Benita Dodd, vice president of the Georgia Public Policy Foundation.

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