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.  

I'm now 5 days from getting my 2nd dose and my whole body feels... weird.  Extreme fatigue in my arm and leg muscles along with aches and cramps in my buttocks and legs, the latter symptoms lasting only a day thank goodness.  I have NO idea if this is linked to the vaccine in any way but I doubt it since it was over 2 weeks ago.  My menstrual period was difficult and I had my first real migraine in over a year, which is expected after hearing reports of women having heavier/worse periods after the shot.  It's possible I have a mild case of COVID since my (vaccinated) brother was exposed to students in his class who had it, or possibly the flu.  Just today news broke of 7 NY Yankees and Bill Maher--all of whom were fully vaccinated--testing positive for the virus, so it's possible I contracted a mild version after my 1st shot.  I've been more lax about wearing my mask at home.  

In any case, just recording my symptoms here for future reference.


Dose Two:  The Big-Big Day

(Side effects underlined)

I'm feeling fine on the day of my 2nd shot.  I went through all the same preparation as before, the only difference was I didn't take any Xanax this time as I didn't want to feel tired afterward.  But the tiredness was INSTANT after the 2nd dose; it hit within 5 minutes just as the "sludge" sensation started to spread throughout my arm.  It's definitely the vaccine causing the fatigue, which is to be expected as that's a normal immune response to any stimulus.  And my throat is a bit sore which lasts through the day and night.  I popped 1,000mg Tylenol (with codeine) and lay down the minute I got home, trying not to snooze as I didn't want a repeat of the nightmares I had last time.  Plus I slept 9.5 hours the previous night and oversleeping is just asking for bad dreams.  

More about the "sludge" (aka arm pain).  It feels like heavy industrial waste, for lack of a better description.  Definitely get the shot in your non-dominant arm because you won't be able to use it for a couple days.  The injection itself is almost painless (at least the Pfizer one, that is) but its contents spread out over several hours until your muscle feels like it's rotting away.  And then the pain is gone as suddenly as it started.  As are the other symptoms.  

Eric Clapton, ardent anti-lockdown protester, made a huge stink about how the vaccine is "not safe for everyone" because he experienced side effects that were extremely unpleasant & scary, though temporary.  Welcome to the world of the vaccinated.  EVERYONE experiences that, sir.  It doesn't mean it's not safe.  And if you got that sick from the first shot, why go back for the 2nd?  Yet he did and lived to tell about it, and is now protected from the deadly COVID virus.  This is why you must consider the source when dealing with reports of adverse reactions.  They're a real phenomenon & must be considered but people are also using them in bad faith to bolster their anti-vax, anti-science agenda.  If social media and partisan news outlets existed in the 1940's, polio and smallpox would still be rampant.  That's a terrifying thought.  

On the eve of my 2nd dose I start to feel a bit more discomfort in the arm as well as a vague malaise consisting of a bad mood and fatigue as the sun sets around 8:00 p.m.  Also, I'm freakin' STARVING which I experienced after my 1st shot but chalked up to PMS--that's definitely not the case this time.  I Googled a bit and saw that appetite changes in both directions have been reported, though increased appetite has no biological explanation.  I'm just grateful not to be nauseated.  I pop an ibuprofen with my Ramen noodles around 8:30 and lie down after putting some frozen peas on my shoulder to ease the pain.  The ibuprofen definitely cleared the brain fog.  

I slept like shit:  only 6.5 hours, but no nightmares/fever dreams thankfully.  Woke up at 6:30 a.m. and popped a Tylenol/codeine for the arm pain which was moderately severe but no worse than with the first shot.  My neck (left side) and throat are also sore but that's it.  Taking meds and staying hydrated really does offset the worst of the side effects, I think, as does not over-exerting yourself physically.  I expected to feel much worse after the 2nd dose as that's what the lady at the clinic told me and what everyone's reporting, but so far it's identical to the first shot--maybe a little LESS severe.  Or I'm just used to it & know what to expect.  Feeling decent by the end of night 2 (24 hours in, give or take) & hoping to sleep better.  Hunger has died down significantly.  

Rounding out the 3rd day after my 2nd vaccine (48 hours post vaccine), I feel about the same:  achy arm and neck, brain fog, general malaise & bad mood.  But now there's a new symptom--lower back pain on both sides.  I had this shortly before getting this shot but didn't think it was related due to the timing being so delayed after the 1st one; now I'm not so sure.  No idea what muscle group or organ system is right there but the pain is pretty bad despite all the codeine & Tylenol I've taken.  Sort of feels like bowel or endometriosis-type pain but can't be sure.  It's not worrying enough to call a doctor but thought I'd include it here anyway.  Also, the spot where the injection went in is somewhat hot and hard to the touch as of May 22nd (3 days after the shot).  The arm pain finally resolves entirely by May 24th.  

 

Final Thoughts

Overall I'm glad I ended up getting the Pfizer shot over the Johnson & Johnson one.  My fears turned out to be overblown and the added protection this brand provides is worth it.  Since I started this article 3 weeks ago, experts have recommended that women in their 30's (i.e. me) opt for the mRNA shots over Johnson & Johnson due to the small risk of blood clots if they have the option.  Maybe the universe was trying to guide me in this direction all along.  In the end I'm just grateful to have not one but three vaccine options in this country.  Not everyone is so lucky.  We're already seeing dramatic decreases in virus cases in my state and the country.  The CDC said it's safe for fully vaccinated people to go maskless in most indoor settings now.  I'll continue wearing mine in most situations until more of the population is vaccinated but I do feel a great sense of relief that I'll soon have 95% protection from severe SARS-COVID-19.  

Keep in mind that, as someone with severe health anxiety, I'm overly conscious of every little sensation in my body and thus super dramatic in reporting all of these symptoms.  They may sound more serious than they really are.  Please don't let anything I've said scare you.  On a scale of 1-10, none of my vaccine side effects were worse than a 5.  This was more about recording everything as accurately as possible for my own future reference as well as being upfront about my experience.  

Thank you to all the scientists, medical professionals & volunteers who made this breakthrough possible.  If you have any questions, leave them in the comments below.





Here are some general 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.  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 to prevent stiffness & aid mobility.  Avoid strenuous exercise or injury--simple neck rolls & stretches will do.

- 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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