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Coronavirus and the missing answers: An expert answers 15 difficult questions about vaccination

2021-06-15T16:16:04.194Z

The infectologist Javier Farina provides details on the combination of vaccines, intervals and immunization after being infected.



Paula galinsky

06/13/2021 1:55 PM

  • Clarín.com

  • Society

Updated 06/13/2021 4:26 PM

The long-awaited moment arrives, that of receiving the coronavirus vaccine, and questions arise.

The pandemic confronts us with new situations, a sore throat or fever lines can already make us doubt.

Do I go to the shift with symptoms?

Do I reprogram it?

What if it's the flu?

What if I am incubating Covid?

Is it useful to do a rapid test before getting immunized?

Javier Farina, member of the Argentine Society of Infectology and head of Infectology at Hospital Cuenca Alta de Cañuelas,

answers some of the difficult questions about which we still lack details.

1- They say that 15 days must pass between the Covid vaccine and the flu vaccine, what should be done if the turn comes earlier than expected and there is no margin to meet the interval?

The coronavirus vaccines received emergency approval.

For this reason and with the intention of being prudent, the interval was insisted upon.

There were two central doubts: one related to the possible adverse effects of one vaccine being overlapped on the other, the second had to do with avoiding interference in the immune reaction of the vaccines.

That is, the goal was not to overload the body so that it could correctly develop the antibodies.

Today we already have real-life data analysis, it is known that there are no problems of this type because millions of people in the world have already been vaccinated.

Also, adverse effects are rare.

2- But is the recommendation still valid?

What to do?

The CDC (Center for Disease Control and Prevention) of the United States has already suspended this recommendation, although in Argentina it remains in force.

Surely they will modify this point shortly.

There is an exception for which it is still important to maintain the interval, which is when one of the vaccines is attenuated virus.

This is not the case with any of the Covid vaccines available in Argentina.

Do not confuse attenuated virus with inactive.

The Sinopharm contains the inactivated virus.

3- Are there vaccines on the national calendar that contain attenuated virus that we have to pay attention to in order to maintain the interval with that of Covid?

Yes, that is the case with rotavirus and chickenpox immunizations.

The same thing happens with the triple viral, the yellow fever and the Argentine hemorrhagic fever.

In those cases, it is key to defer the applications.

4- After having coronavirus, do you have to wait to get vaccinated?

How much and why?

I recommend that my patients allow 10 days to pass after being discharged for Covid 19. On the one hand, to have a safety margin and thus avoid contagion when they leave.

On the other hand, so as not to confuse or overgenerate symptoms.

5- And what happens with the indication to wait 3 months?

At one point there was talk of waiting that time although the indication has more to do with the fact that after the disease the person has certain levels of immunity and the intention was to prioritize the application to people without antibodies against the coronavirus.

6- What effect can the vaccine have on a recently infected and recovered person?

The infected person generally begins to develop antibodies after seven days.

The first dose of the vaccine in those who have already been infected will have the effect of booster (reinforcement-accelerator), which in those who did not have the disease is usually achieved with the second dose.

7- In those cases, should the second dose be given?

Yes, the vaccination schedule must also be completed, although it is likely that the significant jump in antibodies will be obtained after the first dose and not the second.

8- If the day of the application the person is having a flu picture, should they be vaccinated the same?

Vaccination against acute infection is not advised.

In principle, it can generate more symptoms.

Also, if the body is trying to fight a pathogen, it is not convenient to make it react to something else.

In these cases, the effectiveness of the vaccine may be less.

Likewise, it is a relative contraindication.

Not absolute.

9- What happens if instead of the flu the person's condition is Covid and they are vaccinated while being infected without knowing it?

Getting vaccinated while infected can generate more fever or longer fever, for example, but it will not aggravate the disease.

In other words, it does not generate severe adverse effects and it will not be the cause of complications such as bilateral pneumonia.

Yes, it can further weaken the patient.

It is important to clarify this because after the case of the journalist Mauro Viale, who died from Covid and is believed to have been vaccinated already infected, there were those who thought that immunization had had to do with the complications that led to his death.

It is not like this.

Likewise, if there is a suspicion of Covid, the person must remain isolated.

10- What should be done if the person who was assigned a shift had close contact with an infected person?

You must remain isolated for 10 days and reschedule the shift.

I have patients that it happened to.

You can call the vaccination, notify and modify the date.

Getting vaccinated in this situation is not recommended because close contact may be incubating the disease and, in addition, it can infect others.

11- Is it useful to take a quick test before vaccination?

If the person is asymptomatic, it is not worth it.

Most likely, it will test negative even though the disease is incubating.

If there is a suspicion of Covid, the indication is to isolate yourself for 10 days.

12- What care should be taken the days after vaccination?

The usual.

Vaccines are not magic and there are no immediate results.

Antibodies are generated after three or four weeks and even at that time you don't have to relax either because no vaccine prevents infection 100%.

Protection will be achieved with herd immunity when 70% of the population has antibodies.

13- Can a person who received the first dose in Argentina and is going to travel to the United States add a dose of Pfizer?

Is it possible to combine vaccines?

On the combination of vaccines, the general experience is scarce.

There is a small study of 600 people with the combination of the Pfizer and AstraZeneca vaccines with positive but preliminary results.

I also believe that in the future it will be a very interesting strategy.

14- Is it known what happens with the other vaccines available in the country: Sputnik V and Sinopharm?

Outside of the Pfizer and AstraZeneca report, I don't know of any other published study on this.

15- Should immunosuppressed people get vaccinated?

Is there a vaccine that is more recommended for these cases?

There is no general answer.

It depends on the pathology and the patient, who should consult his or her doctor yes or yes.

In some cases, medication can be interrupted -when it is the cause of immunosuppression- or replaced, although in others it is not necessary.

In most cases, the advice is usually to get vaccinated because it is precisely a population with more risk, so it is essential that it is immunized.

There is no difference in relation to the vaccines available.

GS

Look also

Covid: Argentina reaches 20 million vaccines received and the City has the highest percentage of the population immunized with one dose

AstraZeneca study in Brazil: is half a dose enough to generate protection against the coronavirus?

Source: clarin

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