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  • Dr. Jeff Livingston

    You Got the Second Dose of the Covid-19 Vaccine. Now What?


    Celebrate your success and keep your mask on

    Photo: Drazen Zigic/istock by Getty

    As Covid-19 vaccines arrive in American cities, we are moving into a new phase of the pandemic. The vaccination rollout continues to improve, with the U.S. now vaccinating over one million people per day. Though millions still wait in line for vaccination, over 100 millions have received one dose and many have completed the two dose series.

    Hope is on the horizon.

    But Covid-19 is a novel virus with new vaccines and treatments, so it is not a surprise that many people have questions, especially about what to do after getting vaccinated. My mother, who qualified for vaccination in category 1B, prompted this story the morning after her second vaccine dose when she sent me this text:

    Author's image

    Like millions of senior citizens, my mother is anxious to get out of the house and hug her grandchildren. Many others may be feeling the same way: Senior citizens and those with medical conditions are classified as 1B. Qualifications vary state by state but generally include those greater than 65 years old or with chronic medical conditions.

    One important thing for vaccinated people to understand is that immunity does not come immediately after vaccination. It takes time for your body to build up protection. The two mRNA vaccines approved in the U.S. both require two doses. The first shot primes the immune system to produce protective antibodies. The second dose kicks it into high gear.

    Here is what we know about post-vaccine immunity with the two Covid-19 vaccines currently available in the U.S.: In phase 3 clinical trials, the Pfizer vaccine showed a 95% efficacy seven days after the second dose. The Moderna vaccine offers 94% immunity at least 14 days after dose number two.

    Two weeks after completing the vaccination course, recipients can breathe a sigh of relief. Their risk of severe disease from Covid-19 is very low. But we must remember that the risk is not zero.

    The Covid-19 vaccine protects us from getting the disease, but we do not yet know if the vaccine prevents transmission. There is a growing amount of encouraging evidence regarding the protective effect of the vaccine against transmission, but at this moment, we don’t currently know whether a vaccinated person can still transmit the SARS-CoV-2 virus to others.

    No vaccine is 100% effective, and according to the current data, 5% of those getting a Covid-19 mRNA vaccine may still be at risk. Vaccine recipients should continue to wash their hands, wear a face mask in public, and practice social distancing.

    At your vaccination appointment, you will receive a copy of your vaccination record. Apps and digital documents are coming, but for now, your safest move is to keep the vaccine record in a safe place where it won’t get lost. I recommend taking a picture for storage on your phone.

    Here is what a vaccination record looks like:

    Author's image

    The waitlists for Covid-19 vaccination vary across the country. The Centers for Disease Control and Prevention provide an up-to-date resource to help people find a vaccine hub here. The waitlists are long, even for those who currently qualify. I recommend taking proactive measures and signing up now.

    All three FDA-Approved Covid-19 vaccines are safe and effective.

    Janssen Pharmaceutical Companies is the vaccine arm of Johnson & Johnson. The Janssen vaccine is now approved for use in people 18 years and older. It only requires a single dose to be effective and is not burdened by the cold storage requirements, which slowed the distribution of the two previously approved vaccines from Moderna and Pfizer.

    Like the Moderna and Pfizer vaccines, the Jansen vaccine does not contain a live virus. One cannot catch Covid-19 from these vaccines. Each approved vaccine has different efficacy rates. The Janssen vaccine is 72% effective at preventing infection and 86% effective at preventing severe disease. Pfizer and Moderna quote a 95% efficacy rate. All three vaccines prevent death from Covid-19.

    These efficacy rates were not performed as direct head-to-head comparisons. Scientists performed the clinical trials for each vaccine in different parts of the world at various pandemic stages.

    On March 8, the CDC issued updated guidelines for fully vaccinate people. These recommendations apply two weeks are the single dose Janssen vaccine or two weeks after the second shot from Moderna or Pfizer.

    The CDC guidelines for fully vaccinated people are:

    • Visit with other fully vaccinated people indoors without wearing masks or physical distancing
    • Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing
    • Refrain from quarantine and testing following a known exposure if asymptomatic

    For now, fully vaccinated people should continue to:

    • Take precautions in public like wearing a well-fitted mask and physical distancing
    • Wear masks, practice physical distancing, and adhere to other prevention measures when visiting with unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease
    • Wear masks, maintain physical distance, and practice other prevention measures when visiting with unvaccinated people from multiple households
    • Avoid medium- and large-sized in-person gatherings
    • Get tested if experiencing COVID-19 symptoms
    • Follow guidance issued by individual employers
    • Follow CDC and health department travel requirements and recommendations
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