Coronavirus (covid-19) Information and updates

What you need to know from DIFF Medical Centre

From DMC

During the coronavirus pandemic, DIFF Medical Centre continues to take the utmost measures in caring for our patients and collaborating with our communities. Please utilize this site to learn more about COVID-19 patient care, testing, immunizations, and other related topics.

An Overview

The COVID-19 is an infectious disease that is caused by the SARS-CoV-2 virus which belongs to the family of coronaviruses. People who get infected with COVID-19 may experience mild to moderate respiratory illness. This infection may resolve on its own without requiring special treatment. Some people with underlying illnesses like cardiovascular disease, chronic respiratory disease, cancer diabetes etc are more likely to develop serious symptoms of COVID-19. However, anyone can become sick with COVID-19, be seriously ill and die irrespective of the age of the individual.

How Does The Virus Spread?

The virus spreads from the nose or mouth of an infected person to the surroundings when they breathe, sneeze, speak, sing, talk, cough or sneeze. These respiratory particles could be in form of large droplets or small aerosols.

How Do We Slow Down The Transmission Of The Virus?

  • Information – The general public should be properly informed on the effect of COVID-19 and intensive health education should be propagated within the society
  • Physical distancing – Endeavour to maintain a one metre distance from others while conversing, sitting, walking or standing.
  • Mask- up – wear a properly fitted mask at all times
  • Hand disinfection – Wash your hands frequently with soap and water for at least 20 seconds and use an alcohol-based hand sanitizer when you’re not able to wash your hands.
  • Get vaccinated – Get vaccinated as soon as you can and follow local guidance.
  • Respiratory etiquette – Cough into a flexed elbow or into a clean disposable napkin and discard immediately in a responsible manner.
  • Self- isolation – Stay at home and isolate yourself if you feel unwell.
  • Ventilation -Choose well-ventilated open spaces over closed doors for events and meetings.

Symptoms Of The Virus

  • Common symptoms:

    • fever
    • cough
    • tiredness
    • loss of taste or smell.

    Less common symptoms:

    • sore throat
    • headache
    • aches and pains
    • diarrhoea
    • a rash on skin, or discolouration of fingers or toes
    • red or irritated eyes.

    Serious symptoms:

    • difficulty breathing or shortness of breath
    • loss of speech or mobility, or confusion
    • chest pain.

    Seek immediate medical attention if you have any symptoms.  Always call DIFF Medical Centre before visiting if you experience any of these symptoms.

    On average it takes 5–6 days from when someone is infected with the virus for symptoms to show, however it can take up to 14 days. 

Why Should I Get Vaccinated?

  • You should get vaccinated to protect yourself and your loved ones
  • Keep my colleagues and residents safe
  • Set the example for others including residents, families, co-workers and community at large

COVID-19 Variants

    • Omicron -B.1.1.529 – This was first identified in South Africa. It may spread more than other variants. persons who have been fully vaccinated may still experience breakthrough of infections but vaccines help to prevent severe illness, hospitalizations and death.
    • Delta- B.1.617.2- was first identified in India, spread more easily than other variants, may cause more deaths. Persons who are fully vaccinated may contract the virus and can spread the virus to others.

     

    The vaccine is currently received all over the world, and many are asking what side effects to expect and if there are differences between the side effects of the vaccine, the honest answer is YES

COVID-19 VACCINES

  • THE FIRST TWO COVID-19 VACCINES

    Both are mRNA vaccines

    • Pfizer (BNT162b2)
    • Moderna (mRNA -1273)

     

    *They do not contain covid-19 virus

     

    WHAT IS COVID-19 mRNA vaccine

    • mRNA technology is a new vaccine production but is already being used in cancer treatment. It has been studied for more than 10 years.
    • vaccines give instructions for our cells to make a harmless piece that looks like a “spike protein”. The spike protein is found on the surface of the COVID-19 virus. This is what happens typically with mRNA vaccines.
    • Our bodies recognise that this protein should not be there, so they build antibodies that will remember how to fight the virus that causes COVID-19 if we are infected in future.

    Question?

    Can mRNA vaccine give me covid-19? An mRNA vaccine cannot give you COVID-19 or change your DNA.

HOW EFFECTIVE ARE THE mRNA VACCINES?

Pfizer (BNT 162b2)

  • Their trial used 152 sites around the world
  • Majority trial of 130 sites were in the US, trial sites were also located in Brazil, Argentina and South Africa.
  • More than 43000 were involved in the trial
  • The vaccine was found to be 95% effective in preventing moderate to severe COVID-19.
  • The second dose is scheduled between 4 and 12 weeks after first dose
  • The vaccine is stored frozen (ultra-low temperature ULT) between -80degrees Celsius and -60 degree Celsius with shelf life of 6months.
  • Once thawed the vaccine cannot be re-frozen

Moderna (mRNA-12730)

  • This vaccine was developed by Moderna in partnership with Niaid.
  • Their trial involved about 99 sites across the US
  • The vaccine was found to be 1% effective in preventing moderate to severe COVID-19.
  • This vaccine is also stored at a relatively low temperature (sub-zero temp) until they are ready to be used.

Johnson and Johnson COVID-19 Vaccine

  • The trial included more than 40,000 people across 19 geographic regions
  • Importantly, this included South Africa, where the vaccine was found to be slightly less effective against the B1351 variant
  • The FDA found this vaccine more than 66% effective at preventing moderate to severe COVID-19.
  • While the efficacy rate is lower than the Pfizer-BioNTech and the Moderna vaccines, it still gives protection against hospitalization and death.
  • This vaccine requires just one dose and has a generally lower rate of side effects.

Oxford Astra Zeneca Vaccine Composition and Presentation

Oxford Astra Zeneca vaccine

  • The university of Oxford partnered with British-Swedish company Astra Zeneca to develop and test a coronavirus vaccine known A2D1222.
  • A large clinical trial showed the vaccine offered strong protection with an overall efficacy of 97% after the second dose.
  • Dozens of countries have authorised the vaccine for emergency use.
  • In March 2021, some countries paused use of the vaccine over concerns about possible rare blood clots.
  • The Astra Zeneca vaccine unlike the Pfizer and Moderna vaccine which store instruction in a single stranded RNA, use double stranded DNA

Oxford Astra Zeneca vaccine composition

  • The Astra Zeneca COVID-19 vaccine contains recombinant, replication deficient chimpanzee adenovirus vector encoding the SAR-CoV-2 spike(S) glycoprotein.
  • It also contains
  • L-Histidine
  • L-Histidine hydrochloride monohydrate
  • Magnesium Chloride Hexahydrate
  • Polysorbate 80
  • Ethanol
  • Sucrose
  • Sodium chloride
  • Disodium Edetate Dihydrate
  • Water for Injection

Presentation of the Oxford Astra Zeneca vaccine

  • The vaccine is presented in a multidose vial containing a solution which should be colourless to slightly brown, clear to slightly opaque and free of particles.
  • The two different presentations are:
  • 80 dose packs (ten 4mls vials with at least 8doses/vial
  • 100 dose packs (ten 5mls vials with at least 10 doses/vial
    • Once the vial is punctured, vaccine must be used within 6 hours of first puncture (during which time it can be stored between 2 degree Celsius to 25 degree Celsius.
    • A single dose is 0.5mls
    • Two doses are required with minimum of 28-day interval between doses.
  • Operationally, it is recommended that the second dose of the vaccine be routinely scheduled between 4-12weeks after first dose.

WHAT SHOULD I EXPECT WHEN I GET THE VACCINE?

  • You can have short-term discomfort, fatigue, headache, muscle pain, chills, fever, and pain at injection site after vaccination
  • These reactions can last between 3 to 7days and are typically more pronounced after the second dose
  • It is very important to note that side effects mean your body is doing its job and making antibodies (IT IS A GOOD THING)
  • These side effects are normal, common and expected.
  •  

What Causes The Side Effects?

  • Side effects are a sign the vaccine is prompting your body to mount an immune response.
  • They may be uncomfortable, but can also be a sign the vaccine is working as intended
  • They are caused by the release of chemicals in the body which signals the immune system ‘it is time to mount a response’
  • These naturally occurring chemicals are called cytokines and
  • Side effects are expected as they are part of the process.
  • It is important to note that if you have a history of severe allergic reactions not related to vaccines or injectable medicines; you may get a COVID-19 vaccine.
  • You should be monitored for 30 minutes after getting the vaccine, if an immediate or severe allergic reaction occurs after getting the first dose of a COVID-19 vaccine, DO NOT GET A SECOND DOSE
  •  

Regimen for mRNA vaccines

  • The mRNA vaccines uses a two dose regimen.
  • The Pfizer BNT162B2 is spaced 21days apart
  • While the Moderna mRNA-1273 vaccine is spaced 28days apart.

 

YOU MUST GET THE SECOND DOSE!!! Because the vaccine will not protect you if you get only one dose.

  • It is important to get the same vaccine as the first dose

Are covid-19 vaccines safe

  • COVID-19 vaccines are safe, as safety is the most important priority in vaccine approval.
  • The FDA (Food and Drug Administration) and Centres for Disease Control and Prevention (CDC) continue to monitor vaccine safety data including side effects after the vaccines are authorized.
  • These are sometimes referred to as phase iv trials.
  • These ongoing studies can help identify the rarest of side effects, and pinpoint people who may have special sensitivities to the vaccine, such as potential for allergic reactions
  • To asses safety FDA typically advises that a minimum of 3,000 participants are included in the trial. The current COVID-19 vaccine trials include 30,000 to 50,000 participants.

Why should we trust the covid -19 vaccine

  • The FDA is using the same strict standards that it has for decades
  • No steps are skipped
  • Two independent advisory committees are reviewing the results.
  • Members and experts of these committees have no conflict of interest and are not associated with any vaccine manufacturers.
    • The Vaccines and Related Biological Products Advisory Committee (VRBPAC) that advises the FDA. The Advisory Committee on Immunization Practices(ACIP) that advises the CDC.

Emergency Use Authorization(EUA)

  • An Emergency Use Authorization (EUA) for a vaccine is based on the need to use a vaccine quickly to save lives during a public health emergency.
  • EUA is a shorter process but no steps are skipped in the safety evaluation process
  • The FDA will assess if the vaccine known and potential benefits outweigh the known and potential risks
  • The two separate advisory bodies (VRBPAC and ACIP) will also review the data and make recommendations
  • An EUA does NOT imply that the authorization was done too quickly or that the vaccine is not safe
  •  

How Was The Vaccine Developed So Quickly?

  • Major reasons these vaccines were developed so quickly than usual include;
  • Global effort with the world’s leading scientists focused on a single task
  • Nearly unlimited resources (money, knowledge, manpower, technology
  • A large pool of diverse adult volunteer trial participants
  •  

When and how long will I be protected by the covid-19 vaccine

  • Most of the vaccines are 2 doses, 3-4 weeks apart
  • Protection occurs 1-2weeks after the second dose
  • It’s not known how long the vaccine will be protective once received. More will be known as time passes in the current research
  • We may need to have vaccine shots for COVID-19 on a regular basis (like the flu shot).
  •  

Vaccination FAQs

It is not currently recommended to take pain killers such as ibuprofen, asprin and paracetamol before your COVID-19 vaccine to prevent side effects.

No pork or other animal derived ingredients are contained in the Pfizer-BioNTech or Oxford Astrazeneca vaccines. The Oxford Astrazeneca vaccine has etanol listed as an ingredient, but this is in amounts lower than found in natural foods.

There is no evidence that the immune response to coronavirus in animals or in humans, and there is no biological mechanism that has been shown result in an impact on fertility. Regulations have looked at data carefully from the clinical trial and have not recommended any precautions for individual planning to become pregnant.

The currently available data do not indicate any safety or harm to pregnancy, there is currently insufficient evidence to recommend the use of COVID-19 vaccine during pregnancy, however it is advised that vaccination in pregnancy should be considered where the risk exposure to SARS-COV-2 infection is high and cannot be avoided or where a woman has underlying conditions that put them at very high risk of serious complications of COVID-19.

There is no research on the safety of COVID-19 vaccine in breastfeeding women. However, there is no known risk associatedwith giging non-live vaccine while breastfeeding.

 There is no COVID-19 Vaccine for children younger than 16. Several companies have begun enrolling children as young as 12 in COVID-19 vaccine clinical trials. Studies including younger children have also begun.

Because reinfection is possible, and COVID-19 can cause severe medical complications it is recommended that people who have already had COVID-19 get a vaccine. If you’ve had COVID-19, you might delay vaccination until 90 days after your diagnosis. Reinfection with the virus that causes Covid-19 is uncommon in the 90days after infection.

Keep in mind that one can get infected after taking the vaccine as it takes a few weeks for the body to build immunity after getting the vaccine. It is advised to continue to maintain the COVID-19 guidelines.

Whilst the Pfizer-BioNTech and Oxford Astrazeneca vaccines technologies both use genetic code to reduce the spike protein inside the body, this code cannot be in-coporated into the body’s DNA, this is because;

  • mRNA vaccines like the Pfizer-bioNTech vaccine cannot reach the part of the cell that holds the DNA, called the nucleus.
  • mRNA cannot be translated back into DNA.
  • Both mRNA and adenovirus vaccines do not contain the specialised tool needed to copy or edit DNA

These vaccines cannot replicate inside the body and only stay in the body for a few days. After helping the cells to produce an immune response against the spike proteins, then the vaccine is removed by the body.

None of the currently approved vaccines are using a live SARS-COV-2 virus in them, so you cannot get COVID-19 from them. It is common to get symptoms that feel the same as an infection for a few days after you have a vaccine (eg. feeling “fluey”). This is a sign that your immune system is responding to the vaccine, not that you have got a real infection.

It is not clear how long the vaccine can protect against COVID-19, further studies are being carried out on whether a booster dose will be needed.

  • Everyone has to do their part and get vaccinated to get back a normal life

 

  • CDC:https://www.cdc.gov/vacines/hcp/covid-conversations/answering-questions.html
  • CDC:About COVID-19vaccines:https//www.cdc.gov/coronavirus/2019-ncov/vaccines/about-vaccines.html
  • CDC:Provider Resourses for COVID-19 vaccine conversations with patients and answering patients’ questions:https://www.cdc.gov/vaccines/hcp/covid-coversations/
  • WHO Target production profile for covid-19 vaccine
  • WHO Guidance on ethicsof vaccine allocation