Anticipating common discomfort, some people are taking over-the-counter pain relievers, like ibuprofen or paracetamol, before going to the COVID-19 vaccination appointments. But doing so raised concerns about the inadvertent weakening of the immune system and the loss of some protection from the vaccine.
The recent buzz may revolve around a study on the subject published on Jan. 19, although the research has only examined immune responses in mice and human cells growing in petri dishes. In addition, as more and more people take their second doses of the COVID-19 vaccine, you may hear about some mild side effects, such as nausea, fatigue and low fever. These symptoms are more common after the second injection than the first, and doctors say this discomfort usually goes away in a day or two.
Until now, people rarely experience severe allergic responses to COVID-19 vaccines. A recent study by the Centers for Disease Control and Prevention found 10 cases of anaphylactic shock associated with the Modern vaccine in more than 4 million doses administered in December and January. A previous study found 21 cases among the first 1.8 million doses of the Pfizer-BioNTech vaccine. Most of these adverse events occurred shortly after people were inoculated, so the standard protocol is to keep everyone for 15 minutes of observation.
Gothamist asked Dr. Adam Berman, a toxicologist and head of emergency medicine at Northwell Health’s Long Island Jewish Hospital, to explain why self-medication before an injection is not a good idea for most people – but probably also not it’s terrible. Their responses were edited for brevity and clarity.
Some research suggests that common anti-inflammatory drugs can inhibit the immune response that the body boosts. Not much, but maybe a little. Is that something that worries you?
This is something I’ve heard a lot about – from my coworkers, my patients and even my own family. I thought about it myself when I was getting the COVID-19 vaccine.
But I don’t think there is any good evidence in real humans that they inhibit their immune response. There is only one study on this.
If there was good evidence that taking anti-inflammatory drugs is detrimental to your immune response, we would have problems with all types of vaccines, which last our entire lives without any problems of effectiveness. This applies to taking anti-inflammatory drugs before or after these injections. More research is needed, but I’m not too concerned with that right now.
Even in the absence of evidence, there is the Precautionary Principle – the idea that we should play it safe. Isn’t that an argument against taking these drugs until we know more about any potential impact on the immune system?
The truth is that if you think you can handle your symptoms and you don’t need to take any medication at all, it is always better not to take any medication at all. If people are concerned about weakening the response to the vaccine and don’t want to take a painkiller out of caution, then that’s fine. But there is probably not enough evidence to advise against using the drug when the arm is sore from the vaccine.
So leave your medications on hold, wait to see if there are any bad symptoms, and then decide whether to take Advil or Tylenol. But don’t you accept in advance?
Exactly. Now, if people know they have a history of reactions to vaccines, it’s a different story. If someone says that they usually swell after having an injection and are so concerned about the difference between getting the vaccine, I would feel comfortable if they took a pain reliever before receiving the vaccine. Then again, if they are so concerned, they may want to talk to their doctor in any case, before going to get the vaccine.
Okay, so ‘wait and see’ and ‘less is more’. What should guide people’s decisions about taking these drugs?
We are talking about the same symptoms that you would experience if you had any type of mild viral illness, such as a cold. And if people feel very uncomfortable after receiving the vaccine, they should take a drug instead of resisting.
We hear that these side effects are your body developing an immune response. Public health people say, “It’s just your body doing what it should be doing.” That’s true? Rather than the reaction being a sharp metal object, a syringe, invading muscle tissue?
Arm pain is most likely related to irritation from a volume of fluid injected into a muscle. This is painful. The full-body symptoms that people experience within hours of receiving the vaccine are likely due to the actual immune response to the injection.
And are these the types of symptoms that respond well to anti-inflammatory drugs?
In general, yes. They can make you feel a lot better. After my second dose of the vaccine, I had a headache for a few days. At first, I didn’t think about it at all. It was not an unpleasant headache. But after a few days, I said to myself, ‘Maybe it’s the vaccine’, so I took some Aleve. After a few more days, he left.
Of course, he may have disappeared alone at that point. Or maybe you have had a small placebo effect?
This can be. I am totally in favor of the placebo effect!