COVID-19 Update from Dr. Michael McLoughlin 1/12/21

A couple of updates this week regarding COVID-19 vaccination:

Most importantly, the state of Iowa has started to clarify which individuals will be able to receive vaccination next (stage 1b). This will primarily be people over 75 and those in certain occupations with a higher-risk of exposure (notably, teachers, first responders, and meatpacking plant workers). Vaccinations in these groups are expected to start around February 1st.

The full criteria are below:

Persons aged > 75years, OR the following populations vulnerable to high risk of exposure or severity of illness:

• Individuals with disabilities living in home settings whom are dependent on attendant care staff, and their attendant care staff, if not otherwise vaccinated under Phase 1a.
• Correctional facility staff and individuals incarcerated, including state and city or county operated facilities.
• Staff of and individuals living in congregate settings, not covered by the first two bullets, including shelters, sober living homes, behavioral health treatment centers, and detention centers. College dormitories shall not be included as part of Phase 1B.
• Where public health data indicates outbreaks or clusters of disease among food, agriculture, distribution and manufacturing workers whom work in or live in congregate settings that do not allow for social distancing. For example, working in a meatpacking or manufacturing production line or migrant workers whom live in bunkroom style housing.
• PK-12 school staff, early childhood education, and childcare workers. Sub-prioritization should consider persons who work with younger and at-risk children in care, to better ensure child-wellbeing and mitigate impact to parent workforce.
• First responders (e.g., firefighters, police officers, and dependent adult abuse and child welfare social workers).

Iowa Specialty Hospital and Wright County Public Health will be working on plans to ensure we can get appropriate individuals in our community vaccinated as expediently and safely as possible.

Also, as we start to have employees who are receiving their second dose of vaccine at the end of this week, I want everyone to be aware that systemic side effects (this would include fever, chills, headache, muscle and joint aches, nausea) are significantly more likely with the second dose than the first. They also are more likely to affect younger individuals than older individuals. The graphs below are taken from the study of the Moderna vaccine, recently published in the New England Journal of Medicine, and give a good idea of how many people had each side effect with the first or second dose of the vaccine (and of placebo). When these effects occur, they typically will improve on their own within 1-3 days. Grade 1 and 2 side effects (gray and blue) typically don’t affect a person’s ability to go about their usually activities. Grade 3 side effects (red) are the type that are significant enough that a person may check with a medical provider or take time off work because they feel poorly. The moral of the story is that we should expect some people to have these symptoms after the second dose. These are symptoms that occur when the immune system is working and they occur more with the second dose because the immune system has already been taught by the first dose how to respond effectively.