Assessment And Documentation Of Pain
Assessment and documentation of pain during vaccine injections are important aspects of providing quality care. These processes allow determination of the effectiveness of analgesic strategies employed and planning for future vaccine injections.
In preverbal children, various behavioural cues signal the presence of pain, including crying, facial grimacing and writhing body movements. Older, verbal children may express pain through similar behaviours but can usually supplement the behaviours with a verbal report, which is considered the primary source for pain assessment. In all age groups, pain may be accompanied by physiologic changes , but these are neither specific to pain nor clinically feasible and therefore are not recommended for monitoring pain in practice.
Will I Feel Pain Only Around The Injection Site
Most of the time, the pain or discomfort you feel after a vaccination is limited to the area where you received the shot. But muscle aches are also a possible vaccine side effect. These might feel similar to what you feel shortly before getting sick with a cold or the seasonal flu. This is different from injection pain, as this side effect usually affects your whole body instead of just your arm.
These aches are a sign your immune system is responding to and learning from the vaccine and can also be alleviated with your over-the-counter pain reliever of choice.
When Is Arm Pain After A Vaccine A Sign Of Something More Serious
For most people, arm pain after a vaccine is generally mild and a quick-passing problem. But there are some times when you should contact your provider. Keep in mind that these reactions are rare and are not necessarily signs you cannot receive future vaccinations.
If the person giving you a shot inserts the needle too high, you can develop shoulder problems, including nerve pain and limited range of motion. When this happens, arm pain will start within two days of your vaccination, continue longer than what is typical for that vaccine, and will not feel better if you take pain relievers. This issue is preventable, needs to be treated by your provider, and should be reported to the Vaccine Adverse Event Reporting System .
While true allergies to vaccines are rare, painful rashes after receiving a shot are more common. It is not unusual for these reactions to happen several days to weeks later. This type of side effect is not always a sign of an allergy, but it could be. If you notice a rash or hives where you received a vaccination, you should be seen by your provider.
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Why Your 2nd Dose Of Covid Vaccine Is Likely To Feel Worse
His second COVID-19 vaccine shot wiped Dr. Greg Poland out.
Poland, 65, said he suffered five hours of shaking chills, fever up to 101 degrees, severe headache, nausea, ringing in his ears and a sore arm after getting his booster dose of the Moderna vaccine.
“I’ve never had a reaction to a vaccine like that,” said Poland, director of the Mayo Clinic’s Vaccine Research Group. “Ironic that it would happen to me.”
The second dose of the two COVID-19 vaccines has gained a reputation — initially from clinical trial data and now from the personal experience of millions — that it tends to cause harsher side effects than the first dose.
That’s because the second dose is amplifying the lessons of the first dose, which taught your body how to recognize the coronavirus as an enemy, Poland explained.
“We should stress it doesn’t mean that anything’s going wrong or that something bad is happening. It is an expected reaction to the vaccine, and it will be different between different people,” Poland said.
“It is evidence of a really vigorous immune response, which doesn’t mean that people who have less of a response are not developing an immune response. They are,” Poland added. “But for some of us, for whatever reason, our immune system sees this and really reacts to it.”
Allergies And/or Reporting Adverse Events
Who should not get the Pfizer-BioNTech or Moderna COVID-19 vaccine?
According to the FDA, children should not get the Pfizer-BioNTech or Moderna COVID-19 vaccine if they:
- had a severe allergic reaction after a previous dose of the vaccine
- had a severe allergic reaction to any ingredient of the vaccine.
Is it possible for my child to have an allergic reaction?
There is a remote chance that the Pfizer-BioNTech COVID-19 or Moderna COVID-19 vaccine could cause an allergic reaction. People can have allergic reactions to any medication or biological product, including vaccines. Most allergic reactions occur shortly after a vaccine is administered, which is why the Centers for Disease Control and Prevention recommends that persons with a history of anaphylaxis are observed for 30 minutes after vaccination, while all other persons are observed for 15 minutes after vaccination. All vaccination sites must be equipped to ensure appropriate medical treatment is available in the event of an unlikely allergic reaction. The CDC recommends anyone with an allergy to “any component” of the vaccine not get the vaccine.
What are the signs of a severe allergic reaction to the Pfizer-BioNTech or Moderna COVID-19 vaccine?
The chance of a severe allergic reaction is remote. Severe allergic reactions usually occur within minutes after getting a dose of the Pfizer-BioNTech or Moderna COVID-19 vaccine. Signs of a severe allergic reaction can include:
- Difficulty breathing
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Why Does The Second Coronavirus Vaccine Shot Have Worse Side Effects
As anyone who received a COVID vaccine sourced from Pfizer or Moderna can attest, the flu-like symptoms that can occur post-injection typically manifest after the second dose. More often than not, the only symptoms people experience after the first injection are limited to minor swelling and pain around the point of injection.
At first glance, its a bit curious why the first vaccine dose yields minor symptoms while the second dose can sometimes leave people completely knocked out for a full 24-hours. In fact, one volunteer who participated in Pfizers clinical trial likened the side effects from the second dose to a severe hangover that caused headache, fever, chills, and severe fatigue.
Naturally, theres a perfectly cogent and scientific explanation as to why people tend to react more strongly to the second dose than the first.
As Dr. William B. Greenough III of Johns Hopkins explains, the first vaccine dose starts revving up the bodys immune system. And seeing as how Pfizer and Modernas COVID vaccines are built around Messenger RNA technology, the first dose essentially informs the body how to prepare for and defend against the coronavirus.
That being the case, Greenough notes that by the time the second dose is administered, the immune system is already primed to react and brings out the big guns.
Stanford Professor Dr. Grace Lee adds:
A More Surprising Reaction
Soon after the Moderna vaccine was approved in December, allergist and researcher Kimberly Blumenthal began receiving photographs of arms from colleagues at Massachusetts General Hospital in Boston. The photos showed large red splotches around patients injection sites. Some people had a second rash below the first. Some had red marks shaped like ringed targets. Some rashes appeared on elbows and hands.
After accumulating a dozen images, Blumenthal wrote a letter for the New England Journal of Medicine with the goal of alerting physiciansand reassuring themabout the potential for delayed reactions to the vaccine. Some doctors were prescribing antibiotics for suspected infections, but the pattern she saw suggested that antibiotics were not necessary.
Unlike the rare and dangerous anaphylactic reaction that can happen immediately after injection, delayed rashes dont usually require treatment, Blumenthal says. In a biopsy of one patient, she and colleagues found a variety of T cells, suggesting a type of hypersensitivity. Delayed rashes are known to show up occasionally after other vaccines too, she adds, and they can be a sign of hypersensitivity or a normal part of the immune response. Researchers don’t yet know which is happening with the Moderna vaccine. In this case, they may appear especially common because so many people are getting vaccinated at once.
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Know The Difference Between Vaccine Side Effects And Covid
If you experience cough, sore throat, shortness of breath, or loss of taste or smell, stay home. Those symptoms are not known to be side effects associated with the vaccine. It may be difficult to distinguish between some side effects of the vaccine and symptoms of COVID-19 or other illnesses. When in doubt, speak to a provider virtually. You can view virtual care options at LVHN.org/VirtualCare.
Myths And Facts About Covid
CDC has updated its recommendations for COVID-19 vaccines with a preference for people to receive an mRNA COVID-19 vaccine . Read CDCs media statement.
Accurate vaccine information is critical and can help stop common myths and rumors. It can be difficult to know which sources of information you can trust. Learn more about finding credible vaccine information.
Below are myths and facts about COVID-19 vaccination.
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What Is Covid Arm
You may have heard of COVID arm and are concerned it will happen to you. This reaction doesnt happen to many people and usually resolves on its own, even if its not fun to experience. COVID arm is a local reaction by your immune system, meaning it occurs around the injection site. You may experience:
- A painful and/or itchy rash that can get very large
- A firm bump under your skin where you received your shot
According to the Centers for Disease Control and Prevention , COVID arm can start a few days to a week or more after getting your shot. Its not caused by the coronavirus itself, since both the Moderna and Pfizer vaccines are MRNA vaccines that dont contain the virus.
According to Phase 3 trial results in the New England Journal of Medicine, this rash affected 0.8% of participants after the first dose, and 0.2% of participants after the second shot. In both cases, a very small number.
Age can play a role in who has a higher chance of having COVID arm. It seems as if younger patients have more arm pain compared to older patients looking at a study that was done using the Pfizer vaccine, Dr. Palli says.
If you do notice a rash after your first COVID-19 vaccination, inform your healthcare provider before you get the second one. A rash may not be a reason you shouldnt get your second dose. However, your healthcare provider may advise you to get the second injection in your other arm. Other things that can help treat the rash include:
How To Reduce Pain After Vaccination
There are a few things you can do to help relieve arm pain after receiving a vaccine:
Keep your arm moving in the hours following your shot.
Apply a cool compress or ice pack to help reduce swelling and redness. If you use an ice pack, only apply it for 20 minutes at a time with at least a 20-minute break before applying it again.
Experts do not recommend taking pain relievers before receiving a vaccination. Doing this isnt always helpful, and theres concern that it could interfere with your immune systems response to the vaccine.
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Adenovirus Vector Vaccines Arent New
Janssens phase three clinical trial included more than 40,000 participants. In addition, Janssens viral vector platform is supported by an even larger body of evidence, including an Ebola vaccine that’s already been tested in pregnant women and children and approved in Europe, said Dr. Fryhofer. More than 193,000 peopleincluding patients of different ages and conditionshave been vaccinated with various investigational vaccines using this adenovirus platform.
The adenovirus vector vaccine uses a modified cold virusan adenovirus called Ad26as the viral vector and several genes have been removed from this virus, she explained. Its replication deficient, so it cannot multiply in the body.
This means that it cannot give someone COVID-19, said Dr. Fryhofer. The company says this safety sign imbalanceblood clots and low plateletsdid not show up in the phase three trial or with their research on other Ad26 based viral vector vaccines.
However, in the phase 3 trial, one patient, a 25-year-old male, did suffer CVST, had low platelets and also had PF4 antibodies, she added.
/6soreness In The Arm Can Be A Good Thing
The tenderness and soreness are directly linked to how inflamed your arm is. Put simply, the more inflammation you have, the more swollen and probably painful your arm could be- signifying the reason why some people experience more intense, or longer-lasting pain at the site of injection than others.
However, many experts also add that extreme soreness in the arm, or tenderness could also be a prime sign that your vaccine is working just as well, as it is supposed to be. A vaccine is supposed to prompt inflammation in the body and create antibodies. If you do experience high levels of inflammation, it probably is a good sign that your vaccine is doing its job well and working to provide ample protection.
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What Can You Expect After An Additional Or Booster Dose
There’s been a lot of expert advice about planning to take it easy after your second dose of the COVID-19 vaccine, and doctors say it’s probably not a terrible idea for your third dose, just to be safe.
“It’s sensible to take it easy afterward,” Dr. Schaffner said. “Don’t plan to do anything strenuous the day after your shot.”
Dr. Adalja said you can expect to have a similar reaction to your second dose of the mRNA vaccine. “However rough it was, use it as your baseline to see if you need to take any special precautions,” said Dr. Adalja.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it’s possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
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Read The Latest On Covid
Get reliable information on developments in the authorization, distribution and administration of COVID-19 vaccines.
J& Js one-shot vaccine for adults was another major step toward vaccinating millions of people across the country. While its single-dose, easy-to-store logistical advantages make it an attractive option, its important to understand what to expect with the Johnson & Johnson COVID-19 vaccine and the need for a booster shot.
The AMAs What Doctors Wish Patients Knew series provides physicians with a platform to share what they want patients to understand about todays health care headlines, especially throughout the COVID-19 pandemic.
In this installment, two physician experts took time to share what patients should know about the J& J vaccine. They are:
- Mira Irons, MD, president and CEO of the College of Physicians of Philadelphia. In a prior role, Dr. Irons served as chief health and science officer at the AMA.
- Sandra Fryhofer, MD, an Atlanta general internist who serves as the AMAs liaison to the Centers for Disease Control and Preventions Advisory Committee on Immunization Practices . Dr. Fryhofer also is a member of ACIPs COVID-19 Vaccine Work Group.
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/6are There Ways To Minimize Pain And Soreness
Soreness experienced with the vaccine injection can be highly discomforting and take a while to recover from. In some cases, it could almost render the arm immovable for at least a couple of days.
That being said, there are definite ways to minimize or alleviate the intensity of your arm soreness and recover from the side-effect speedily. Most experts recommend people use therapeutic measures such as an ice pack, warm/hot water compress at the site of injection to minimize soreness and inflammation. Taking Epsom salt baths could also help relieve pain.
Some pain relievers can also be taken to fight inflammation and pain, post-vaccination. However, taking them preemptively, or before your scheduled vaccination may not be so helpful, and not really advised by doctors.
Apart from this, there are also some other ways to combat this side-effect. Exercising, basic stretching and incorporating movements to reduce stiffness in the arm can definitely help. However, do remember to not overdo your efforts and go slow.
How To Treat A Sore Arm After Vaccination
Although a sore arm after COVID shots is temporary, there are a few things you can do at home to help treat a sore arm after your vaccine:
- Use a cold compress on the injection site
- Move your arm around frequently throughout the day
- Take over-the-counter pain medications, such as Advil and Tylenol if approved by your provider
- Use antihistamines such as Benadryl if you experience itchiness
Unless you have a health condition that prevents you from taking certain OTC pain relievers, such as a bleeding condition or liver or kidney problems, you may find relief from arm soreness as well as certain other vaccine side effects such as headache or fatigue.
However, you want to avoid taking OTC pain medications before your vaccine in anticipation of side effects. While it may decrease your arm soreness, the local inflammation is beneficial to the development of a vigorous immune response and anti-inflammatory drugs may reduce this beneficial response, Dr. Anderson explains.
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