What Are Our Healthcare Workers Who Have Completed Their Vaccines Are Saying?

Barriers to healthcare Coronavirus Covid-19 Disease Control Emerging Infectious Diseases Global Pandemic Herd immunity immunization SARS-CoV-2 SARS-CoV-2 Vaccine vaccine safety

This post is my attempt to bring the vaccine experience to a larger audience. To do this I polled about 500 vaccine recipients over about 24 days. A prior survey that I conducted suggested that many individuals were taking a wait-and-see attitude with Covid-19 vaccinations. This is not surprising to me; in my experience every community has individuals who like to take their time to adopt new ideas. The fact that our current vaccines use a new technology may be aggravating this situation. Some of us may feel frustrated by these late adopters, or laggards, as some are known to call such individuals. To help these groups we need to learn to exercise some patience. For some of these persons, the answer to the question; “would those who have received the Covid-19 vaccine recommend it?” may be useful.

How New Innovative Ideas Change Societies

New ideas always take time to be adopted. In most societies about 1 in 7 of the population will fall into the wait-and-see group. These individuals like traditions and are very wary of any change or new ideas. Such late adopters are more likely to respond to friends and close family. They have a strong need for asserting their autonomy. A friendly gentle attitude is the best way to help them in their decisions. Late adopters are really looking for data and they will slowly look through the data to make their decision eventually. They may also respond to someone who has received the vaccine recommending it to them.

In these times with so much misinformation we should not confuse late adopters with conspiracy theorists and anti-vaxxers. These two groups are entirely different groups. At this time I have no specific suggestions on how to handle conspiracy theorists and anti-vaxxers directly. I do however suggest countering their misinformation with good, clear and well-researched information without engaging them. These groups (those spreading misinformation) should not be your target; your target is the population they seek to misinform.

My Polling Population

This post is mainly to provide more data for our late adopters to help them make their minds. Many states in the US and many other countries have started to roll out their vaccine programs. Over 3 weeks from 1/17/2021 to 2/9/2021 we collected information from recent Covid-19 vaccine recipients. This information was collected using an anonymous online poll on SurveyMonkey. The link was shared widely on social media using WhatsApp and Facebook. Overall 516 individuals completed the survey. The survey was primarily for individuals who had completed the two doses of the available vaccines. There were 17 respondents who only had dates for the first dose; they were excluded from the analysis. The total analyzable sample is therefore 499.

Demographics and Professional Background of The Polled Population

The respondents were all healthcare workers ages 18 – 74 years. One hundred and eighty-five individuals (37.1% of all respondents) were in the 35 – 44 year age group. Almost all respondents (94.6%) were female, and on average were younger. Male respondents, who form only 5.4% of our audience were on average older. Individuals above age 55 years made up 22.2% of all male respondents compared with 14.5% among females. The sample was mostly white (about 80.3%) with 6.6% self reporting Asian heritage, 6.4% African American and 5.2% Hispanic or Latino.

Most of those who responded worked in hospitals or similar acute care settings (52.9%). Ambulatory care workers made up 38.1% and nursing homes and other long-term care facilities contributed 7.2%. This social media sample was very much US-biased; 494 (99%) US residents with 3 individuals resident in Canada and one each from Israel and the UK.

Most of the respondents in this survey were nurses, 218 (43.7%) of all respondents. There were 126 (25%) physicians, 44 (8.8%) nurse practitioners and 14 (2.8%) physician assistants. Other healthcare workers with good representation include 16 social workers or counselors, 12 certified nursing assistants, 10 radiology technicians and 8 physical therapist and 7 respiratory therapists. In this sample all the nurses self identified as female. Among the physicians who responded and provided information on gender 109 (87.2%) self identified as female and 16 (12.8%) as male. This sample is thus gender skewed towards females which is the norm among healthcare workers in the US and many other developed nations.

The Vaccines and Experience

Our respondents reported vaccine first doses as early as August 19th 2020, suggesting a few individuals may have received vaccines in the phase 3 clinical trials. Majority of individuals however got their first doses between December 12th, 2020 and January 22nd 2020. With the exception of 2 individuals who got their second dose in September 2020, most had their second doses from December 30th, 2020 to February 8th 2021.

The interval between doses ranged from 17 – 50 days. There were a few individuals whose dates suggested dosing intervals of 10 – 14 days. It is unclear if these individuals were dosed that closely together or if these were errors in data entry. On closer look though, all of these were individuals who got the Pfizer vaccine which is recommended for a 21 day interval. Most of the respondents received the Pfizer vaccine 308 (61.7%) and 189 (37.9%) got the Moderna vaccine. Only one individual reported receiving the AstraZeneca vaccine.

Eighty percent of respondents reported some form of reaction to the vaccine. Those who received the Moderna vaccine were 2.6 times as likely to report a reaction compared to those who got the Pfizer vaccine. This difference was significant with a p-value < 0.001. Females were more likely to report reactions compared to males 80% of females, compared to 74% of males). This difference was not significant however. Participants 55 years and above were also less likely to report a reaction 71.6% compared to 81.2% in younger respondents. This difference did approach statistical significance with a p-value of 0.06. Two out of three of respondents reported that the intensity of their reactions was greater with the second dose as compared to the second. Only 40 respondents 8.1% believed the 1st dose had a more intense reaction, 24% judged the reaction to be similar the 2 doses.

What Interventions Did Those Who Had Reactions Get?

For both vaccine doses, 362 (72.5%) of individuals said they needed to have some medication or treatment for their reactions. Ninety-six percent of these respondents reported taking over the counter (OTC) medications like Tylenol or Motrin. One female in the 35 – 44 year age group reported going into hospital for enlarged lymph nodes in the neck and armpit. Twenty-one 4.2% of individuals reported requiring care in an emergency department (ED) or urgent care for vaccine related reactions. Below are the categories of complaints for which our respondents received ED or urgent care evaluation. Similar reports are considered together.

Nature of reaction reportedFrequency
Slow heart beat (Bradycardia)2
Rapid heart beat (Tachycardia)5
Some form of allergic reaction4
Cellulitis2
Shoulder bursitis2
Migraines1
Lymph node swelling1
Lightheadedness2
Acute Appendicitis1
Worsening of pre-existing back pain`1
Multiple symptoms1
Hypertensive crisis1
These report do not suggest these were due to the vaccine received. This poll is not capable of making that judgement. If respondents reported multiple symptoms or concerns the one most likely to determine need for medical attention was chosen.

Conclusions of Our Healthcare Worker Vaccine Recipients and Other Recommendations

Out of the 499 healthcare workers who have received both doses of the COVID-19 vaccine, 478 (96.0%) will recommend the vaccine to friends and family. Only 12 (2.4%) of these prior vaccine recipients will not recommend the vaccine to friends and family. It is not clear why these 12 would not recommend the vaccine. Among these 12 though, 4 (33.3%) reported reaction that required medical attention. One of these reported no reactions at all and majority 7 (58.3%) only needed OTC medications for their complaints.

Unedited Responses of Those Who Were Unsure Whether To Recommend Vaccine or Not

1st but maybe not the 2nd
Everyone is different and I don’t push controversial views
High risk only
 I will not encourage or discourage
It’s everyone’s self decision
 Maybe. It is pretty rough
Wouldn’t want to say either way. I felt horrible pry should of went to hospital but didn’t
   depends on their situation

Based on these responses it appears healthcare workers who responded to our survey favored recommending vaccination to friends and family. Only 2.4% will not recommend the vaccination with the available Covid-19 vaccines. Overall 8 out of 10 individuals had some reaction to vaccination but most where reaction expected from vaccination. Most individuals either did not need medications or just took OTC medications. Older individuals in this sample ie those aged 55 years and above were less likely to report reactions. This difference was not really significant.

If you are yet to get the vaccines this is the combined voices of those who have already been vaccinated. Overall this suggests that these vaccines are safe. Vaccine reactions were common, but this is expected. The reactions were mostly discomfort that responded to OTC medications. Only 4 out of a 100 participants reported requiring some medical attention. It is therefore not a surprise that 96% of all those who responded to the survey will recommend vaccination to family and friends.

I have also received Covid-19 vaccination and will recommend it for my friends and family.

So please take account of these experiences of these almost 500 individuals and make your decision.

By Dr. Leonard Sowah an internal medicine physician in Baltimore, Maryland

Feature photo: Picture collage of several healthcare workers displaying their Covid-19 vaccine credentials. Much gratitude to; Hazel Jones-Parker, Michael Mensah, Naana Atsina, Norma-Clayton McKinley, Otha Myles, Zureena Curlees, Rachael Reynolds, Rachita Navara-Patel & Kunj Patel for allowing me to use their photos.

holisticphysician

A physician providing primary medical care to patients across the lifespan

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