By: Joseph Mechak, MD
Should I worry about the new Coronavirus variants?
Viruses mutate. This is not new or concerning. however, the viral mutants discovered in the UK and South Africa seem to have made the Coronavirus more contagious. Both strains have now been identified in the United States (and the UK variant has been found in Maryland). Both Moderna and Pfizer remain confident that their vaccines are effective against these mutants, though perhaps slightly less so for the South African mutant. These strains are something that the CDC and other health officials are monitoring very closely but are not cause for panic.
Should I ‘double mask’ or wear an N95?
Dr. Fauci recently said that wearing two masks may provide better protection than one. He cites “common sense,” saying that more layers between you and the virus is a good thing. He felt this may be a good step in light of the new more contagious variants discussed above. There is no robust data to support this recommendation (at least that I could find) and the CDC has not made or changed any formal guidance. However, in medicine we often weigh the risks vs. benefits in a given situation. The risk of double masking is minimal and if there is any potential benefit it seems like a reasonable idea.
Other experts have also suggested that the general public wear N95s or similar masks like the KN95 and KF94 in situations where social distancing is not possible. The CDC, again, has not updated its recommendations on the matter. This idea has been met with resistance by some because, while the situation is much improved from Spring 2020, the supply of N95s available for medical providers remains limited. If you already have one, these respirators are more protective than a cloth or surgical mask, so not a bad idea to wear it in unavoidable higher risk situations.
For the complete recommendations from the CDC about masks, follow this link: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html
Grandma and Grandpa have gotten their vaccine, can they come visit?
Over the next few weeks to months more and more people will receive their COVID-19 vaccine. The vaccine has been proven to do two things: 1) decrease the likelihood of the vaccinated person being infected with COVID-19 (about 95% effective), 2) decrease the severity of illness in those that do get infected. There is not yet enough data to say if the vaccine prevents spread of the virus from a vaccinated person to a non-vaccinated person. Early Pfizer data has hinted that this may be true but there is not currently enough data to make any definitive conclusion.
So, what does this mean for visits from vaccinated family members? The CDC still recommends that vaccinated people wear masks and that social distancing still be practiced when gathering with those outside your household. This means masks, social distancing, outdoor > indoor, and washing hands is still the name of the game regardless of vaccine status. Hopefully, as the data shakes out, it will show that the vaccines also decreases viral transmission but, for now, the same rules apply.
Any updates on vaccines for children? Will Potomac Pediatrics be administering the vaccine?
There have been no significant updates about COVID-19 vaccine approval in children. As of now, the Pfizer vaccine is still only approved for people >16 years old and the Moderna vaccines for those >18 years old. Both companies are in varying stages of recruitment for a randomized-control trial for people 12-16 years old.
In the coming weeks to months, the county will move to Priority Group 1C. The second tier of this group includes people >16(18) years old with specific underlying conditions. Very few of these underlying conditions apply to the pediatric age group. We will send out information very soon about how you will be notified if your child qualifies based on their medical history.
We have not received any additional information on if/when we will be receiving any COVID-19 vaccine. We will update you as we learn more. We are not keeping a waitlist or priority list at this time.
What was your experience with the vaccine like?
Many of us at Potomac Pediatrics have now received both doses of our Moderna vaccine! Here is a glimpse into my experience.
How it happened:
I received an unexpected email from the Montgomery County Health department offering me an appointment at one of the county vaccination sites 2-days later.
I had to pre-register, select an appointment time and location. The electronic system was easy to use and sent a few reminders and visit summaries before and after my appointment.
The Big Day
My vaccine appointment was at a county community center. The center was organized, efficient, and the workers were very friendly and informed. When I arrived, I was asked to show ID that they matched with my appointment slot and pre-registration. I was given information about the vaccine, potential side effects, the V-Safe system for side effect reporting, and what to do if I experienced side effects . I waited in line for about 10-minutes before being ushered to 1 of about 15 vaccination stations in the community center gym. I got the vaccine, took the obligatory selfie, and got my vaccination card. I was then asked to sit in a separate room for about 15 minutes to make sure I did not have an allergic reaction. That was it! It was easy, efficient, and very exciting.\
How did I feel?
More than anything I felt grateful and hopeful for the ‘light at the end of a very long tunnel’ that this vaccine represents. Physically, I had a few side effects…
I was the exception in that I had some side effects after both the first and second dose of the vaccine. Most of our eligible Potomac Pediatrics employees got the first dose around the same time. By my best estimate, only about 10-20% of us had side effects after the first dose. Most had arm soreness, redness, maybe a little fatigue. A smaller number of us, myself included, had more systemic side effect. I had a low grade fever, chills, and muscle aches that lasted less than 24 hours. They all improved significantly with ibuprofen and I felt completely back to normal the next day.
After the second dose the percentage of those with side effects was closer to 75-80% (which is consistent with the study data). My side effects, which were shared by many, included arm soreness, fever, chills, muscle aches, fatigue, and headache. Symptoms were mild to moderate and lasted about 24 hours almost everyone. I was, again, back to normal the next day. All of us agree that the protection was well worth the side effects!
I was pleasantly surprised at the efficiency of the system. I am hopeful that things will go smoothly once more doses are available. The state and county have pleaded for patience and that people not ‘jump the line’ which just slows the process and risks wasting doses. So, please do your part!
The side effects were as billed. They were manageable, short lived, and well worth the protection!
I would certainly recommend that everyone get their vaccine when it is their turn to do so!