No walk-ins allowed: Health officials review what to expect for 1st COVID-19 vaccine dose

For those who now are eligible to get the COVID-19 vaccine but may still be a bit unsure of what that will look like, Shaw Local spoke with Illinois health officials and specialists who explained the ins and outs of the vaccine and what to expect when you go in for your first dose.

First, a check-in

Every vaccine clinic mostly has the same process, starting with a check-in with a health official, Lisa Gonzalez, public health administrator for the DeKalb County Health Department, said late last month. The check-in process uses a list of people that have have registered for their appointment for that clinic.

“That’s really our clinic roster of who should be coming,” Gonzalez said. “And it also, at the end of the clinic, shows us who actually showed up so we make sure that, anyone who didn’t show up, we can offer them another time.”

Will I be turned away if I don’t meet the eligibility criteria? Yes.

Cindy Graves, the health department’s nurse practitioner, also made it clear: Yes, clinic staff does turn people away if they are not part of the appropriate vaccination groups receiving doses currently.

“We have had to do that, and we are very diligent and intentional about that,” Graves said.

Clinic staff asks patients for proof of phase eligibility ahead of their registered appointments and tries their best to not let people in when they shouldn’t be coming in, Gonzalez said.

The McHenry County Department of Health invalidates the submission forms of anyone who tries to complete their Phase 1b or 1c online enrollment form if they are not eligible for either of the two phases, according to a notice on its website. Those people are asked to sign up again when the department opens up enrollment to their priority group.

Screening process and symptom check

Following the check-in process, registered patients then undergo a screening process where staff goes through the vaccine administration form.

Questions asked include how patients are feeling the day they’re supposed to receive the dose to make sure they aren’t ill in any way and whether patients are pregnant or breastfeeding, Graves said. Patients also are asked if they are immunocompromised and – if applicable – whether they have received their first dose already, when that was and what type it was.

“The big piece is the anaphylaxis, whether they have had an anaphylactic reaction to anything,” Graves said.

Anaphylaxis is defined as a life-threatening allergic reaction that could include symptoms such as nausea, vomiting, skin rash or hives, shock and difficulty breathing, according to the Centers for Disease Control and Prevention.

These screening questions are more about having conversations about next steps than about excluding someone from getting the vaccine, she said.

For example, clinic staff will ask those who might be pregnant or breastfeeding whether they have already had conversations with their doctors and will remind them that there haven’t been a lot of clinical trials done about that. The conversation with immunocompromised patients might include informing them their body may not have as robust of a response to the vaccine as others, she said.

Post-vaccine monitoring period and vaccine reactions

Once the patient passes the screening section, the screener will determine how long of a monitoring period is required after receiving the vaccine, which could include 15- or 30-minute wait times, Gonzalez said.

Patients who have had anaphylactic reactions to other vaccines in the past likely will be disqualified from receiving the COVID-19 vaccine, she said.

People who have experienced allergic reactions to polyethylene glycol, which is present in the vaccines, should speak with a doctor to weigh the risks and benefits of being inoculated and may need to be monitored for a longer time afterwards, said Dr. Irfan Hafiz, an infectious disease specialist for Northwestern Medicine.

For those who may have a general reaction to vaccines, 95% of those reactions occur within the first week and 99% of reactions occur within the first month, Hafiz said.

The vast majority are local reactions, which could include mild fever, muscle soreness or chills, he said.

These statistics show that long-term, delayed responses to vaccines are very rare, Hafiz said. This allowed researchers to be confident in the long-term safety of COVID-19 vaccines despite only having monitored clinical trial patients for a handful of months.

How COVID-19 vaccines work

The two COVID-19 vaccines currently being distributed in Illinois are made by Moderna and Pfizer and are both classified as messenger RNA, or mRNA, vaccines, Hafiz said.

In the past, “all vaccines, the principle is to produce a protein that the body can recognize to which the body can produce antibodies,” Hafiz said.

Developing an mRNA vaccine, on the other hand, works off of the understanding that all proteins are made by an mRNA molecule, he said.

The coronavirus gets it’s name from “spike proteins” that form the outer layer of the virus, creating a sort of crown. Vaccine developers knew that if they could figure out which mRNA molecule would be needed to make those spike proteins, then that molecule could be used to help people’s bodies produce the antibodies necessary to protect them from a COVID-19 infection, Hafiz said.

Using this method, rather than the lengthy process of extracting a protein from a virus and then trying to replicate or inactivate it for vaccine use, allowed for the two current vaccines to be developed more quickly and to be produced in larger quantities, he said.

Messenger RNA vaccines do not have any impact on a person’s DNA, Hafiz said, debunking a common myth.

Should I be nervous to receive the vaccine?

The timeline of the development of these two COVID-19 vaccines moved more quickly than ever before, but Hafiz said this does not mean they are unsafe and rather reflects the immense amount of resources put behind producing a vaccine candidate and modern advancements in vaccine technology such as the mRNA method.

“A lot of the years that it would have taken to develop this were compressed because of the tools that we currently have,” he said.

The vaccines have now been distributed to tens of thousands of people through clinical trials and well over a million doses have been administered to Illinois residents. Throughout this distribution, the vaccines have proven to be safe and effective, Hafiz said.

Looking to be vaccinated through your local hospital?

Northwestern Medicine is holding appointment-only vaccine clinics for patients who are 65 years or older and are registered with the health system. Established patients who have a MyNM account will receive an email inviting them to schedule, according to a recent news release. Those who do not have a MyNM account will be contacted by phone, text message or email.

Vaccinations are scheduled on a week-by-week basis dependent on vaccine availability, a spokesperson for Northwestern Medicine said Thursday.

“We started by sending invitations to community members age 79 and older in high-hardship ZIP codes and will send invitations to other individuals as more vaccines become available,” Northwestern Medicine Media Relations Manager Michelle Green said in an emailed statement.

Mercyhealth also will be making appointments for its vaccine clinics by invitation only based on eligibility and the available supply of doses, a spokesperson said Thursday.

“We will be coordinating appointments from a central location and will be contacting patients via email and MyChart as well as direct phone calls to notify of eligibility,” Mercyhealth Public Relations Specialist Trish Reed said in an emailed statement. “We will also be expanding notification through other outreach methods as our vaccine supply allows.”

Advocate Aurora Health is taking the same approach, offering vaccines by appointment only and prioritizing patients by age and risk factors, a spokesperson for the hospital group said Jan. 25.

Eligible Advocate Aurora Health patients will be notified by email and, subsequently, by text or phone call and will be provided with a vaccination code, spokesperson Kelsey Sopchyk said in an emailed statement.

Patients who wish to be vaccinated should download the LiveWell app, which has instructions on how to schedule an appointment using their vaccination code, she said. She encouraged patients to visit the app regularly as new appointments are added whenever the supply of vaccine doses allows.

Vaccine phases in Illinois

Phase 1b includes: first responders, day care workers, corrections officers and inmates, food and agriculture workers, postal service workers, manufacturing workers, grocery store workers, public transit workers, educators and support staff, shelters and adult day care workers and those age 65 and older. Priority groups are designated by health departments in accordance with federal government protocols.

The Illinois Department of Public Health lists Phase 1c as “possibly” including those ages 16 to 64 with high-risk medical conditions and other essential workers, such as those in the transportation, food service, housing, finance, information technology, energy, media, legal, public safety, water and wastewater and public health industries.

Individuals who didn’t fall under any of the previous groups are part of Phase 2 vaccinations, which has also not yet been defined by public health officials, but could include the general public age 16 and older or more essential workers.