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On December 27, when Araceli received her first dose of Pfizer in Guadalajara, the vaccination was an exciting and emotional act: it
was the light at the end of the tunnel
. Five months later, this same act has become a nightmare for many citizens who are afraid of the excess of information and the comings and goings of institutional decisions. Citizens who are now charged with the responsibility of deciding what to vaccinate with. The immunologist, professor and science
communicator Alfredo Corell
has called this situation "death by transparency". Is it really up to the citizen to decide what vaccine to get? Since our authorities have decided yes, we have turned to Dr. Corell to help us solve the ten questions
trending topic
on vaccination against coronavirus.
1. I am under 60 years old and I am vaccinated with one dose of AstraZeneca: do I vaccinate the second dose or better "I stay as I am"?
The main thing is that whoever received the first dose of AstraZeneca completes the immunization schedule.
The desirable interval between doses is 10-12 weeks, but do not tear their clothes if the vaccination comes later, at 14-16 weeks or even later.
The important thing, we insist, is to complete the immunization schedule
.
2. I'm going to get the second dose: is it better to do it with AstraZeneca or with Pfizer?
The European Medicines Agency (EMA), in the light of scientific evidence, recommends
completing the regimen with the second dose of AstraZeneca
.
Despite this, in our country the last decision that has been adopted is to vaccinate primarily with Pfizer.
If someone wants to be vaccinated with AstraZeneca they can do so, but must sign an informed consent.
Logically, this decision has generated a lot of fear and uncertainty among the population.
3. What is the real risk of blood clots after vaccination with AstraZeneca?
Thrombi have an
incidence of 1 / 100,000 after the first dose and this falls to one-tenth with the second.
We are talking about one case in a million after the second dose.
It is something that is accepted by signing the consent.
It should be noted that 75% of thrombi are controlled and do not trigger death: for this, the detection of symptoms is very important (they occur between 5 and 15 days).
One of the most characteristic is an
excruciating headache that does not subside with pain relievers
and worsens when lying down.
4. If I get the first dose of AstraZeneca and the second dose of Pfizer ... am I a guinea pig?
No. "Mixing vaccines" is something that has been researched for years.
It has been tested in vaccines to prevent malaria, HIV, Ebola, and even COVID-19.
Yes, they read that correctly.
The
Sputnik
vaccine
is heterologous (each dose is one preparation) and combines two different adenovirus carriers.
"Mixing vaccines" is probably equal to or better than putting two equal doses.
The problem is that, although the data from the studies carried out in Spain (Combivacs) and the United Kingdom are not bad, the mixture is not sufficiently proven.
5. What can happen if I decide to stick with just one dose?
Staying with a dose
is a mistake from two angles: the selfish and the supportive.
The selfish, because not all those vaccinated with a dose have good immunity (and its duration is not known) and because the immunity conferred may not respond to the new variants.
And it is also a solidarity error because a person "half vaccinated" can be
the perfect breeding ground for the appearance of new variants.
6. Is it advisable to stop taking contraceptives if I am going to be vaccinated with AstraZeneca?
Do I get vaccinated if I am pregnant or breastfeeding?
No,
it is not recommended to stop taking oral contraceptives by getting vaccinated with AstraZeneca
.
They are two separate risks and they do not multiply.
For pregnant and lactating women, we already have a fairly advanced trial in the United States on the safety of modified RNA vaccines (Pfizer and Moderna) in these groups.
In fact, although it is not concluded, due to its health interest the Ministry has included in the latest update of its vaccination schedule that pregnant or lactating women are vaccinated when they are due by age with Pfizer or Moderna.
Therefore, those in this situation having received the first dose of AstraZeneca might consider taking the second dose of Pfizer.
7. What do we know about the possibility of a third dose of Pfizer or Moderna as it is being talked about lately?
The announcement of a possible third dose by Pfizer and Moderna is probably based on the fact that after a few months after vaccination the concentration of antibodies falls. This could happen, but we must not forget that we also have lymphocytes (T and B cells) in our blood, which act as memory and last for a very long time.
We do not yet know how long the immunization of vaccines will last
(unless the companies know information that they have not published). On the other hand, an article in
Nature
points out that a third or fourth long-term dose of both RNA and adenovirus may not be particularly beneficial and does generate more side effects or less specific responses to SARS-CoV2.
Everything remains to be seen.
What does this leave us?
Maybe because mixing is probably the future, although the best combination has yet to be described.
8. If I have passed the coronavirus, do I have to take both doses or with one "okay"?
At first the authorities administered the two doses even to those who had passed the disease.
At least two studies show that natural infection plus one dose protects more than two doses of vaccine.
The latest guideline from the Ministry is that, under 65 years of age, if you have had the infection, just one dose is enough to consider the complete vaccine.
It is even advisable not to get vaccinated until half a year after having passed COVID-19.
Above 65 years it is recommended to do the complete guideline as a precautionary principle.
9. Will we get to the famous herd immunity?
Spain is a country with good vaccination coverage and everything indicates that, as long as there is supply, there will be no problems reaching 70% of the population.
It would be interesting to identify more risk groups (lung diseases, autoimmune, obesity, etc.), but it has been decided to establish the order by age ranges.
People in their 30s and 40s need not worry about when the vaccine will arrive - it will arrive.
10. When in doubt, consult your doctor.
If you have a history of blood clots or any other disease that worries you ... If the first dose left you "wrecked" and now you fear repeating the experience ... consult your doctor!
All our cases seem different and special to us, but the truth is that everyone has their experience with vaccination and only the doctor who knows all your medical history and the drugs you are taking will be able to assess individually which is the best option.
Conclusions:
You have to get vaccinated.
The important thing is to complete the guideline.
The option with the most evidence is AstraZeneca + AstraZeneca, but it is always better to wear AstraZeneca + Pfizer than none.
On specific cases, medical advice should be sought.
According to the criteria of The Trust Project
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