Sunday, May 2, 2021

Getting the Vaccine With Severe Health Anxiety: A Diary

This article will serve as an ongoing log of my experience with the 2-dose Pfizer COVID-19 vaccine.  Will update after the first and second dose and as needed.  Hopefully it helps someone out there who's on the fence about getting the shot, which shot to get or how to manage the side effects.  For specific questions about your health condition or other details unique to you, ask your doctor.  




As someone who lives in rural shithole America, I was unable to get the Johnson & Johnson shot I so desperately wanted.  You know, the one that's less effective overall but only requires one dose and tends to cause less severe side effects.  That's a fair trade based on my age and low-risk status:  I'm a shut-in who doesn't mind wearing a mask and washing my hands a lot so my overall COVID risk isn't as high as some.  But alas, my multiple attempts to get it failed before it was paused for causing blood clots in 6 people, so I had to choose between the two remaining shots:  Moderna and Pfizer.  (It's recently been "unpaused" but there's no telling when it'll be available in my area again so I'm not waiting).  

Now, I know it's not cool to "vaccine shop" and we're supposed to be grateful for whichever one we get, and I am.  But my situation is a bit different.  I was in therapy for severe germophobia and health anxiety for 2 years before COVID even hit, so this was a huge and terrifying decision for me.  I know if the first dose makes me sick I'll be hard pressed to go back for the second one.  Meaning I probably won't.  Then I'll be left with about 80% protection against COVID that possibly wears off sooner than if I was fully vaxxed.  Too many variables.  Also, living out here miles from a hospital, if things go awry in the night I will have to call an ambulance because it's too far for my housemates to drive.  What to do?


The Big Decision

It was a hard decision full of backpedaling and arguing with my mother, who tried to convince me on the night before my shot that it was a bad idea based on something a chiropractor told her sister.  Yes, a chiro-quack-tor.  That sealed the deal.  I was now determined to get the jab come hell or high water.  

On a deeper level, I decided to have the shot because the worst vaccine outcome is better than many of the best COVID outcomes.  Even the asymptomatic cases are leaving people with all kinds of damage, and this virus isn't going anywhere.  Meanwhile my mental health can't take another year of wearing a mask in my own house because my family members are anti-maskers who sneeze and cough into the air, and I need to do things like going to the dentist that could result in infection because the mask has to come off there.  To be clear, I'll still be wearing it in public places and in larger group settings after the shot.  But this paranoia can't go on.  This virus is too contagious and harmful to gamble with any longer.  

After extensive Googling I decided on the Pfizer shot.  I had a hunch that it was less prone to causing side effects which was then validated by this article (Moderna recipients reported slightly higher rates of side effects like headache and fatigue in trials).  The only real difference between the two are the inactive/carrier ingredients and the timing of the 2nd dose.  A few factors increase your risk of side effects:  Being under 55, being female or having had COVID previously.  I have at least 2 of those 3 risk factors.  Unfortunately I have no way of knowing whether I've had the virus at all.  I could have it now for all I know but it's best not to focus on that... right?  😨

It would be cool if they administered rapid tests and antibody tests at vaccine sites to be sure people weren't infected, as getting any vaccine while sick can result in adverse effects and COVID is so often asymptomatic.  If nothing else, they should take temperatures on site.  These are the types of details that need more investigation--not necessarily the vaccines themselves.  Coronavirus jabs have been studied since SARS arose in 2003 and are not "brand new" despite the proclamations of anti-vax fearmongers.  These are the first mRNA shots to be deployed in the real world though, so that's kinda exciting and scary.  

Here are the rates of side effects reported in clinical trials after the first and second doses of the Pfizer shot, which was administered to people of all ages from many different health backgrounds.  Notice how much the side effect rates go up after the 2nd dose:

1st shot:  Fatigue - 30%  Headaches - 25%  Fever/Chills - 9%
2nd shot:  Fatigue - 54%  Headaches - 54%  Fever/Chills - 30%


The Big Day

I make sure not to pre-load with my usual Tylenol with codeine, as acetaminophen is said to suppress the immune system & fever response which you need for the vaccine to work.  You should also avoid taking ibuprofen or other NSAIDs before the shot (they're fine to take afterward however).  And I skip my daily Benzedrex to keep my blood pressure down.  Not a very fun morning.  To ensure a robust immune response, I take 2 Vitamin D3 pills (2,000 IU) and a Prenatal multivitamin before heading in.  All things recommended by WebMD though completely optional.  And I have everything I need at home to control side effects should they occur:  Zofran for nausea, codeine/Tylenol for pain & fever, Xanax for anxiety & blood pressure, Imodium for diarrhea.  Yeah, I'm overthinking the hell out of this but that's what anxiety does.  

Before heading in I eat a full meal, drink plenty of water and do my best to stay calm as I know anxiety and vasovagal response are the most likely thing to affect me--I've passed out while giving blood samples which was embarrassing.  To seal the deal I take 1/4th of a Xanax... a microdose if you will.  The nurse debriefs me on possible side effects which I covered above & I ask a few questions, like whether they have an EpiPen on site in case I spaz out.  They do.  She also said it's cool to take any meds or supplements I need later.  The shot itself is incredibly painless compared to every other shot I've taken--much less so than the Hepatitis A & B or flu shots.  I wait the mandatory 15 minutes with my family members who are already at the clinic (I told you it was a small town) and then head home to take my codeine tabs immediately.  

That was easy!


The Big Why

Now for a short tangent.  I know I'm not gonna convince any hardliners to get the shot if they've convinced themselves it's unsafe, unnecessary or some combination of the two.  That's not my goal here, nor am I narcissistic enough to think I can undo the loads of anti-vax material you've consumed to arrive at your foregone conclusion.  It's a big decision and shouldn't be taken lightly.  Be very skeptical of anyone trying to push you into something before you're ready, such as a profit-driven boss or controlling spouse; at the same time, make sure you're not working from the Appeal to Nature fallacy or similar flawed thinking patterns.  In this case, "nature" is very deadly and can leave you with permanent damage even if you're otherwise healthy.  You can also infect others without feeling sick yourself as up to 80% of COVID cases are asymptomatic or cause only mild symptoms (but are still capable of causing long-term organ damage & infecting others who may get very sick).   

Vaccination vs. COVID are really your only choices here.  It's not like the flu where you can go 20+ years or your whole life without catching it.  You WILL contract COVID at some point if you haven't already, and even if you've survived it once you are subject to catching it again.  Like the seasonal flu or stomach virus, coronavirus is going to be with us forever; constantly mutating in an attempt to outwit our immune systems.  Unlike those things, it's extremely infectious and spread via aerosols that are expelled just by talking or singing, not to mention coughing or sneezing.  It can affect any organ in the body from the brain to the toes and has killed 574,000 Americans in a little over a year at the time of this writing.  There are currently 400,000 new cases per day in India.  Turning your nose up at the vaccine is not only ignorant but privileged, offensive & deadly to people who are unable to access it.  


Don't fall prey to the COVID "infodemic".


There are unknowns about the vaccines to be sure, but millions around the world have already received them with very few problems compared to those who have died or been maimed by the virus.  Nobody likes to feel crappy, least of all people with severe health anxiety like myself, but the other alternative is infinitely worse: feeling crappy indefinitely or even dying on a ventilator.  I haven't had a flu shot since age 10, for reference.  Flu shots are about 60% effective at best; the J&J shot is 72% effective against COVID & the other two given in the States are 94-95% effective after dose 2.  That's an amazing feat of science.  The fact that people are so indignant & ungrateful about this lifesaving technology is embarrassing and just proves how much our public education systems have failed.  When the smallpox & polio vaccines came out, they were hailed a miracle of modern science and people lined up without hesitation.  Those diseases were all but eradicated as a result.  What changed?

For all the good it's done, the internet has given people a false sense of expertise in subjects they are completely ignorant about, also known as the Dunning-Kruger Effect.  This total inability to grasp that some things aren't up for debate--that facts are concrete, provable and not subject to opinion--is also an outgrowth of the partisan 24-hour news cycle on channels like FOX News and MSNBC.  This vaccine actually has some possible benefits aside from preventing COVID.  In patients with long-COVID, it's showing promise in eradicating or reducing their lingering symptoms like loss of smell and fatigue.  I've even seen a few scattered reports of Chronic Fatigue/fibromyalgia patients feeling better shortly after their shot.  (Long COVID and Chronic Fatigue Syndrome are thought to be caused by a similar post-viral immune response).  This is all anecdotal at this point but as someone with Chronic Fatigue of unknown origin, I must admit it was alluring for that reason. 

But back to my vaccine experience.  

I received my shot at 1:30 & took a short nap after getting home but it was probably just from the Xanax wearing off.  The immune system is most active after sunset (ever notice how fevers and other sickness symptoms get worse at night?) so I prepare by taking an ibuprofen around 5:45 p.m.--something I haven't done in ages due to my chronic gastritis--and drinking a ton of water to offset any headaches that may arise.  My side effects 7 hours after the 1st dose include:  mild-moderate arm pain, left-sided neck soreness & the most minor brain fog.  But again, I took a microdose of Xanax so who knows if that's clouding my head to some degree.  

The next day I feel slightly worse.  I had graphic fever dreams which I won't get into here but let me say they were worse than my worst opiate withdrawal nightmares.  And my arm HURTS, though admittedly less than after the Hepatitis shot or some of my worst flu jabs as a kid.  I'd say a 6 on a scale of 1-10.  Beyond that, I'm fine on the day after my 1st dose.  I go back to my regular codeine/Tylenol and Benzedrex dose on this day as I don't feel my heart or other organs are acting weird in any way.  And I keep guzzling water.  


Dose Two:  The Big-Big Day

(TBA in 3 weeks - check back!)




In the meantime, here are some tips for reducing vaccine side effects:

- Eat a good meal before your shot.  Low blood sugar is no bueno when doing something like this.  Breathe deeply and avoid looking at the syringe during your injection, especially if you're prone to fainting.  

- Stay hydrated before and after.  Don't overdo it but increase your intake of water a bit from whatever you normally drink.  Your urine should be light yellow/straw-colored for reference.  This will help majorly with headaches and fatigue.  

- Take Tylenol (acetaminophen) or an NSAID (ibuprofen or naproxen) shortly after your vaccine, but not before.  Don't wait until the middle of the night when symptoms are at their worst to take these meds--before bed is best if possible to head off fever & inflammation.  Follow the directions on the bottle and don't exceed the safe daily limits.  

- Move your arm as much as comfortably possible after your shot while avoiding strenuous exercise or injury.  Simple stretches & neck rolls should do.  This helps prevent stiffness.

- Do not exercise vigorously or take hot baths/showers for 4 hours following your shot as this can increase your risk of anaphylaxis, a very rare but serious side effect.  

- Use a cool, wet wash cloth or ice pack on your sore arm to reduce swelling and inflammation if the pain gets severe.  

Notice I said "side effects".  For severe adverse reactions like throat swelling, hives and wheezing, call 911 immediately.  If you have any question about whether your symptoms are serious, call your healthcare provider.    



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