Hesitant about your 2nd dose of COVID-19 vaccine? Here’s why local health officials say you still need it, how to manage fears

DeKALB – It’s been nearly 500 days since the COVID-19 pandemic first began in Illinois, and Dr. Bob Manam said he gets “upset, angry and then literally sad,” seeing patients hospitalized still with the virus, especially now that there’s a viable vaccine out there.

“When you’re looking at the [patient] chart, you’re really kind of upset and angry,” said Manam, an infectious disease specialist at Northwestern Medicine Kishwaukee Hospital in DeKalb. “Then you walk into the room, and you’re literally just sad. There’s no point in being angry because this guy is suffering.”

According to recent data published by the Centers for Disease Control, millions of Americans who’ve received either Moderna or Pfizer vaccine are not showing up for their second dose appointments. The two vaccine providers are the most common offered in the country, and require a second shot about a month after the first: a recommended 21 days for Pfizer and 28 days for Moderna. Pfizer is the only vaccine currently approved for 16 and 17-year-olds, and Moderna is for those 18 and older.

The second dose skips so far don’t appear to be much of a problem in DeKalb County however, said Lisa Gonzalez, public health administrator with the DeKalb County Health Department.

“At this point, we have not identified a significant issue with individuals skipping the second dose,” Gonzalez said Tuesday. “Our second dose appointments are filling and show rate has been consistent.”

For both Pfizer and Moderna, two doses are required to achieve optimal protection, Gonzalez said. And then an additional 14 days until the vaccine’s full effect comes into play.

“Fully vaccinated status is achieved two weeks after the second dose is received,” she said. “We currently assist individuals with scheduling the second dose appointment at the time of the first dose.”

Second dose appointments can be scheduled at the DeKalb County Health Department’s website: events.juvare.com/IL-IDPH/0fd3d046-fd58-495f-bf18-b5b6fd68c4a6/.

According to Illinois Department of Public Health vaccine data, 82.63% of DeKalb County residents 65 and older have received at least one dose of the vaccine, and 72.22% are fully vaccinated.

As of Tuesday, there are 4,620 doses of Moderna in the health department’s inventory and 5,640 of the Johnson & Johnson vaccine, which is a single-dose vaccine.

Manam said unlike the beginning months of the pandemic, when hospitalizations were spread amongst mostly the 65 to 70-year-old crowd, this new round, compounded by new COVID-19 variant strains, is majority young people in their mid-20s.

“We’re seeing a fair number of people in hospitals now,” Manam said. “And the ones who are hospitalized now far and away, 98% have not been vaccinated.”

Manam said his own cases he’s treated through Northwestern Medicine lately are often those in their mid-20s or some of the older crowd who were hesitant to get the vaccination.

“And when we discuss it after they’re sick, they said ‘I didn’t realize it was going to be serious’,” Manam recalled. “They really are surprised, shocked. I think it’s like if you have a 100-car pileup, and it’s still snowing, and there’s ice on the road, police are flashing their lights. And then we’re seeing the 110th car crash into it.”

Second dose doubts

Manam said he understands some may have issues scheduling a second dose for a variety of reasons, be it transportation or work and scheduling conflicts, but fear of side effects or vaccine effectiveness shouldn’t be a factor.

“It’s a double-edged sword,” Manam said. “Because we’re so transparent [about the side effects] and we should be. But the misinformation or disinformation crew is out there exaggerating the problems.”

Common side effects reported in those who’ve received the second dose of COVID-19 vaccine vary, according to the CDC. Some side effects may affect your ability to go about your daily activities, but should subside within a few hours or at most, a few days. Some report no side effects. If you do experience side effects which persist, its recommended to contact a medical provider.

While it’s not recommended you take ibuprofen, acetaminophen, aspirin or antihistamines before a vaccination; according to the CDC’s guidance, you can take them to relieve post-vaccine affects as long as you have no medical reasons which would normally prevent you from taking them.

The takeaway is that side effects are a normal sign, however. It’s your body’s way of telling you it’s building protection against the virus, according to the CDC.

Mild and common side effects include pain, redness and swelling at the injection side, and for others, tiredness, headache, muscle pain, chills, fever and nausea.

Manam said some may even feel emboldened to perhaps not get the vaccine if they’ve “gone this long without getting infected.”

“There are some people that feel they do not need the vaccination,” Manam said. “What I tell my patients who are concerned and haven’t gotten it yet is, when a virus is so common and it is literally everywhere, prevalence in such large numbers, it is really hard to escape it, even by being indoors and doing everything you can.”

He said some may be willing to take their chances, but those with fears about the vaccine should trust the science, considering hundreds of millions have already received it around the world.

“I believe it is safe,” Manam said. “I believe it is effective, so I think it’s a good thing.”

Hesitancy history

Multiple-dose vaccine hesitancy isn’t new in the medical world, Manam said, and in fact many long-existing vaccines have always required more than one shot. Tetanus, Hepatitis B and Shingles vaccines all require multiple shots for inoculation, Manam said.

Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus which is spreadable through blood, sexual contact or from mother to baby at birth, according to the CDC. The first HepB vaccine was licensed in 1986, nearly four decades ago, according to the CDC. Most parents elect to have their baby vaccinated young, which most commonly requires a three-dose regimen.

Shingles is a viral infection which creates painful rashes on the body, is caused when the varicella zoster virus, most commonly known for causing chickenpox, reactivates, usually in those 50 or older who once had the chickenpox. And it’s also prevented through a two-dose vaccination, according to the CDC, with the first vaccine licenses in 2006.

Cost is a big factor in preventing people from getting their boosters for those vaccines, Manam said. But the COVID-19 vaccine is free in the U.S.

For something like COVID-19 and its quickly-spreading variants, booster shots and multiple-dose vaccines are likely going to have to be the norm, Manam said.

Although the COVID-19 virus still is in pandemic-mode, its viral prevalence means it could live on in endemic-mode beyond this moment, similar to the Ebola virus or other diseases.

“A pandemic is worldwide spread, it’s everywhere in high numbers,” Manam said. “Endemic means it’s existing in certain areas. Let’s say two years from now, we’re traveling to some place in rural Idaho, maybe there’s a little bit of a flare. If we have the possibility of endemic spots domestically, and you had one vaccine, the problem is you took it two years ago.”

There exist other coronaviruses around the world that medical researchers check annually, such as the common cold. But COVID-19 can’t be treated like the common cold medically.

“When the risk of infection and the severity of infection is there, and you have a vaccination, it is worth getting it,” Manam said.

COVID-19 vaccine vs. variant

“We’re racing to vaccinate everybody so the virus can’t get them,” Manam said. “But the virus is also racing to get people. It literally has changed and it’s racing to get as many people that are vulnerable.”

According to the most recent IDPH data, there are 2,622 confirmed variant cases. The majority of variant cases are the B.1.1.7 variant, commonly called the United Kingdom variant. Variants occur when the COVID-19 strain coronavirus mutates, according to the CDC.

“They get sick faster, they require assistance in a fast way than the older virus,” Manam said. “It seems to be more easily spread, and we’re seeing several members at a party or a full family sick.”

Compared with other country’s vaccine rollouts, the U.S.’ efforts are “pretty good,” Manam said. But a look to the east would show what happens when the virus spreads more quickly than vaccinations can get out, Manam said, such as in India.

Hospitalization mitigation is the key to managing a viral outbreak. If hospitals become overloaded, the virus becomes unmanageable, he said. And the vaccination reduces COVID-19 transmission that greatly reduces hospitalizations because of COVID-19.

“Remember, this was the original reason for the shutdown,” Manam said. “To get people away from each other, slow this thing down so hospitals could not get overloaded. Now we have to manage it, use our masks, vaccinate, slow down a little bit. Common sense. If you’re not vaccinated, don’t take a lot of risks right now.”

And share your vaccine experience with others, to encourage them to take the step, Manam said.

“There should be a series of public service announcements by people that are trusted in the community, saying I’ve got the vaccine, my family got it, the reason I made this decision is to lower my chance of getting sick.”