I had a chillin’ out session with five 20-something guys this afternoon.
I captured some of their concerns about COVID-19 Vaccines in this brief.
1. Are COVID-19 vaccines good for the womb?
Questioner: Fasehah Binti Ali (27 YO)
1.1. Dato’, I heard that COVID-19 jab is not good for young women like me because it’ll affect my fertility. Is there any truth in this?
There is no link between the vaccines and infertility
During the clinical trials, several women became pregnant, suggesting that the vaccines don’t cause infertility
Misinformation surrounding COVID-19 vaccines and their ability to impact fertility has been around since vaccine rollout in Dec 2020
1.2. There have been reports of some women experiencing irregular period cycle after COVID vaccination. How do you explain this?
There are reports, mostly anecdotal that vaccines affect your periods.
However, research hasn’t directly linked these changes to the COVID-19 vaccines.
Described as irregular periods, lighter or heavy periods or longer periods after vaccination.
These effects appear to be temporary, most return to normal menstrual patterns within weeks after vaccination
1.3. How about pregnant and breastfeeding women, is it safe for them to get the COVID vaccine?
It was in Feb 2021, at an O&G webinar, that I stuck my neck out and said that the Pfizer vaccine was safe for both pregnancy and breastfeeding mothers.
This was based on good science and the recommendations of the CDC, American College of O&G and Fetal Medicine.
The MOH has more recently agreed.
However, the MOH will not allow the AZ and Sinovac vaccines in both pregnant & breastfeeding women.
Let us look at the data:
A. Pregnant women are at high risk for developing severe COVID-19 disease.
The COVAX Maternal Immunization Working Group found no evidence of safety concerns associated with COVID vaccines in pregnancy.
They support the WHO guidelines that recommend pregnant women to consider the COVID vaccines especially if they are at high risk of exposure or have co-morbidities.
B. The UK has the largest experience with the AZ vaccine, having used it since Dec 2020. Their Joint Com on Vaccination & Immunization has allowed breastfeeding women to have the AZ vaccine.
2. Are COVID vaccines safe for young adults?
Questioner: Ng Xelynn (26 YO)
2.1. People say that COVID-19 vaccines side-effects tend to happen more in young adults rather than older people. I read on the news about a young model in the UK dying after getting vaccinated. As a 20 something female, should I be worried?
White blood cells moves to the injection site causing pain, tenderness and redness.The immune system releases cytokines which causes the fever, headaches, body aches, fatigue and other adverse effects. This triggers the immune system to produce antibodies and memory cells that would protect you against COVID. So it’s a good thing! This inflammatory response is strongest in young adults. It wanes with age. That is why you report more adverse effects more often than me the oldies.
I think you should be more worried about getting COVID than about the rare AEFI. Life is about a balance between risks and benefits. The benefits of the COVID vaccines far outweighs the rare adverse effects.
2.2. What if these rare side-effects happen weeks after vaccination? What are some of the signs that I should look out for?
Swelling of the heart (myocarditis) appears to be a very rare adverse effect that occurs in young people under 30 years old after the Pfizer vaccine
16 cases for every 1 million people who got a second Pfizer dose
Presents with chest pain, shortness of breath, and fever within 4 days of second dose of the Pfizer vaccine
The other rare adverse effects are blood clots in a large vein in the brain or the large veins around the liver.
It occurs in 5 per million doses of the AZ vaccines.
The risk of a blood clot if you get COVID is 8X higher
The symptoms appear 4 days – 1 month after having the vaccine. Most were after the 1st dose. They include:
· A severe headache that is not relieved by painkillers – Blurred vision
· Persistent vomiting – Problems speaking – Drowsiness – Seizures
· Shortness of breath – Chest pain
· Leg swelling – Persistent abdominal pain – Rash small bruises or bleeding under the skin
2.3. If I suspect that I might be having these rare side effects, what should I do?
You should seek immediate medical help. Most cases of myocarditis improved rapidly with treatment. For blood clots the quicker you are diagnosed and treated the better is the outcome
3. Is COVID-19 vaccination safe for my parents?
Questioner: Prahashini Galadaran (28 YO)
3.1. Dato’, my parents are old and they have chronic illnesses. They are scared that the COVID-19 vaccine will worsen their health. What should I tell them?
One my twitter friends wrote. My 81 yr old grandmother refused to take the covid vaccine despite being advised by everyone in the family. Our family GP had a chat with her and soon afterwards, she agreed to take the vaccine. He even arranged for her registartion on MySJ. Your family doctor, your parents friends who have had the vaccine maybe able to convinve them to take the vaccine.
3.2. My parents are on a lot of medications. Will the COVID-19 vaccine react with the medication?
Most of the drugs which our parents or grandparents take for their hypertension, diabetes, heart disease, strokes and chronic bronchitis are not contraindictaed with the covid vaccines. In certain conditions like auto-immune disorders, cancer and transplant pateints, they are on immunosuppresants, cytotoxic drugs and/or steroids which may interfere with the effectiveness of the vaccines. Your doctors will review their medicines and your parents can still get your covid vaccines.
3.3. From what I understand, MOH advised people with health problems to bring a list of medication or their actual medications during their COVID vaccination appointment. Why is this necessary?
Better still, get a letter from your family doctor or specialist to ascertain that their condition is stable on the various drugs which he has prescribed and that your parents are able to have the covid vaccines. This will surely lessen the burden of the busy doctor at the counselling booth of the Vaccine Center.
4. COVID-19 variants, should we be afraid?
Questioner: Ashwinii (26 YO)
4.1. Dato’, there seems to be more deaths among young adults nowadays. Is this because of the new COVID variants?
There were 309 covid deaths from March 31 to May 4, 2021
21% were 25-to-54 yrs old
3 out of 4 had pre-existing health condition namely Diabetes, Hypertension and Obesity. So we need to do better with the prevention and management of our young adults with Non-Communicable Diseases (NCDs)
We’ve only done 500 genomic studies
That is <0.1% of our cases >50% of the VOC are the B1351 (South Africa-Beta)
About 14% are the Delta or Indian Variant
They, especially the Delta variant are known to be more transmissible and cause more severe form of covid.
These are obviously work place clusters and therefore the MOH and Ministry of Human Resources and MITI must be more smart in mitigating this spread at work (Safety@Work)
4.2. Can the COVID vaccines that are given in Malaysia protect us from the variants?
The most recent real world experience in the UK showed that the 2 shots of the Pfizer vaccines is 96% protective gainst hospitalisation due to the Delta Variant
AZ is 92% protective
AZ-Pfizer combination is more effective than 2 AZ doses and this mix and match is being considered by many European nations.
4.3. Does this mean new variants are going to continue popping up? Would we need booster shots for them then?
That is all the reason why we must ramp up our vaccine covreage to achieve population immunity. This will prevent the new variants from evolving and emerging in the ecosystem. Recent sudies have shown that the neutralising antibodies and memory cells against SARS-CoV-2 are still intact and present after 1 year, suggesting that there is long term immunity. And vaccines are even better at ramping the levels of antibodies and memory cells in our bodies. If there is a need for booster shots, we would by then have developed multivalent COVID vaccines effective against the various Variants.
5. Missing #LifeBeforeCOVID?
Questioner: Izzat Zulhilmi bin Kamaruzaman (26 YO)
5.1. Dato’, most of us young adults are quite happy to get vaccinated. So, when can we start hanging out with our friends, go travelling and basically get our freedom back?
You guys are lucky to be young and healthy duirng this raging pandemic.
I am in my 60s and I am 12X more likely to be hospitalised if I get covid compared to you guys!
And 70X more likely to die from COVID compared to you guys in your 20s.
So count your blessings.
Please allow your parents and grandparents to get their vaccines first to protect them from severe covid and being hospitlaised or dying from covid.
Your turn will come soon enough
Chill out guys!
5.2. Dato’, it seems like COVID will be with us for quite a while, or maybe forever. How are we supposed to cope with this situation?
Yes! These are truly very trying times.
Let’s together build our resilience and coping powers during these difficult times
As the saying goes “when the going gets tough the tough gets going”
First tip: Protect yourself. It is no fun catching covid. It is terribly lousy if you fall sick. Worse still, if you do not fall sick but infect someone else. So go get vaccinated
Second tip: Some of your friends may not trust the covid vaccine, but they trust you, their good friend. So do your part. Get vaccinated and show them that’s it’s cool to get the shot
Third tip: Support each other. That’s what friends do. If you are like going crazy, talk to a friend. Hang out virtually
Better still volunteer for a cahrity. Man! It is a real good feeling helping others, giving away food parcels, helping the elderly. For it is in giving that you receive. It boosts the serotinin levels in your bran which gives you the high- you know what I mean?
Fourth tip: Boredoms kills! So play games preferably outdoors. Badminton, table tennis, cycling. Maybe online games with others. My 30 something daughter and son in law takes a walk around the housing area and brings the kids to the playground. Have fun. Shake your body
Fifth tip: Spend some quiet moments just to chill out. Some find this in prayer. Others in meditation. My 30 something daugther does yoga to speak to her inner self. And speak to God to ask for relief from this crisis and keep us and the nation and the world safe from this pandemic. And trust that this calamity will soon pass.
5.3. For many of us, COVID has affected our studies, jobs, not to mention social lives. We are sick of this pandemic. So, what can we do to make this pandemic end quicker?
Exiting this pandemic requires a smart partnership between the authorities and the rakyat ie You and I
The authorities needs to provide:
Competent and trustworthy pandemic leadership and regain the trust of the rakyat
They must ramp up the FTTIS response
They must rollout the vaccines speedily and widely
They must embrace IR4.0 and share data widely with real time digital solutions.
Despite being fatigued and fed up with the pandemic we must do out part and follow the SOPs
We must follow the 3 Ws – Wash, Wear and Warn diligently and
Avoid the 3 Cs – Crowded, Confined and Close Conversations
Together we can exit this pandemic quickly and safely
Friday
18 June 2021
Dr Musa Mohd Nordin
