Australia AstraZeneca and Pfizer COVID vaccine shots lead to missed work days, survey reveals

23:56  16 june  2021
23:56  16 june  2021 Source:   abc.net.au

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Leonard Cronin said he was "totally surprised" by how unwell he felt after his first dose of the AstraZeneca vaccine.

"I get my flu shot every year and don't normally get any reaction at all," Mr Cronin said.

"It was not a mild cold or fatigue.

"It was nasty flu symptoms: I was really ill."

Mr Cronin, 72, said he was "first in line" to get vaccinated two months ago when he became eligible.

He had his vaccine around 11:30am and felt fine until about 2:00am the next morning.

"There was just this terrible flu feeling," Mr Cronin explained.

"I spent most of the day in bed."

Mr Cronin said symptoms disappeared when he woke up after a second nights' sleep, roughly 45 hours post-vaccination.

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And although Mr Cronin still encourages all eligible Australians to have their vaccine as soon as they can, he is urging people to plan a recovery day.

"You might have a fairly nasty flu reaction and should be prepared to take the following day or two off," he said.

"Make sure you don't have any big commitments."

AusVaxSafety shows common symptoms

Mr Cronin's experience is far from unique.

The National Centre for Immunisation Research and Surveillance (NCIRS) is conducting an ongoing vaccine study, called AusVaxSafety, which monitors the safety data of all Australia's COVID-19 vaccines

Around three days after you get vaccinated, you will be sent a text message or be contacted from your GP or health service asking about whether or not you've experienced any symptoms.

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Altogether, 183,543 Australians who have participated in the national survey reported an adverse event (most of which were very mild symptoms) after dose one of AstraZeneca.

The figure represents 56.4 per cent of people vaccinated with AstraZeneca who took part in the survey following their first dose.

After their first AstraZeneca jab, nearly one in five (17.7 per cent) people said they missed work, study, or other routine tasks because they felt unwell.

The most common symptoms were fatigue, followed by a headache and muscle or body ache.

Overall, Australians were more likely to take a day off work to recover after their second Pfizer vaccine than either the first or second dose of AstraZeneca.

Nearly one in four people (22.9 per cent) who had their second dose of Pfizer in Australia reported missing work, study, or other routine tasks.

Nick Wood from the University of Sydney's faculty of medicine and health, said it wasn't clear why so many people felt unable to work.

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"What was the thing they were most worried about that meant they couldn't go to work?" Dr Wood said.

"Right now, we're interviewing people to find out."

What causes vaccine side effects?

Griffith University virologist Johnson Mak said it was normal to feel sluggish or unwell post-vaccine.

"Discomfort is part of the immune response," he said.

"The good thing is that any discomfort induced from COVID-19 vaccine generally disappears within 24 hours."

According to the NCIRS, people can expect most side effects to resolve within one to three days after they've been vaccinated.

There are two main types of adverse reactions our bodies have to vaccination: local side effects (such as redness or swelling at the injection site) and systemic ones (such as headaches and fever).

Professor Mak explained local adverse effects were caused by the body sending immune cells to the location of the "injury" to fight off invaders.

And systemic effects happened after the vaccine had begun prompting the body to have an immune response to the spike protein.

Dr Wood said this included the production of proteins called cytokines,  which cause inflammation and side effects such as headaches and muscle aches.

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"It's pretty amazing when you think about it. You're getting 0.5 mL injected ... and this inflammatory response happens," he said.

Professor Mak added that a headache was one way the body could tell us we should take it easy to help the recovery process.

He said considering vaccine side effects were under the spotlight, it was normal for someone to feel concerned about symptoms.

"The fact that all of us have been bombarded by SARS-CoV-2-related news, it is only natural that we might have unintentionally magnified our responses and concerns," he said.

An extremely rare side-effect of the AstraZeneca vaccine is a condition called thrombosis with thrombocytopenia syndrome (TTS).

"We do not yet know enough about the cause of this blood clotting side effect," Professor Mak said.

But he said as time went on, doctors were learning more about how to detect and treat the condition.

Why do some feel worse than others post-vaccine?

Professor Mak said several factors were at play: including our genetics, how healthy we are, how sensitive our immune system is and stress levels.

"The same vaccine will impact on people differently simply because we are all different," he said.

Katherine Gibney, an infectious disease physician and medical epidemiologist at the Doherty Institute, said some broad patterns had started to emerge with COVID-19 vaccines.

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"People who are younger seem to have more side effects following the vaccine, women have been reporting more side effects, and people who have had COVID [infections previously] seem to have more side effects," she said.

Dr Gibney said younger people had a more robust immune system, which could explain why they had a stronger response to the vaccine itself.

But, she added that there was no evidence linking the seriousness of side effects with how well a vaccine worked.

Why effects after different doses?

AusVaxSafety data reflects findings from clinical trials, which show people report more side effects to the first dose of AstraZeneca and the second dose of Pfizer.

"The AstraZeneca vaccine has an adenovirus vector, which is what they use to deliver the genetic cargo which makes the spike protein," Dr Wood said.

Scientists chose a chimpanzee adenovirus, not a human one, to ensure the body had not seen it before and would mount a strong immune response.

"The first time you've seen this adenovirus you're getting a pretty strong immune response but then when you get the second one, your body says 'Hey, I've seen this before.'" Dr Wood said.

It's not yet clear why people report more side effects after the second dose of Pfizer, but Dr Gibney hypothesised the first dose may prime the body to react strongly to the second dose.

Experts urge Australians to get vaccinated

Dr Wood said instead of being concerned about the AusVaxSafety data, Australians should feel reassured that health experts were gathering data in real time and reporting it transparently.

He encouraged people to use the information as a guide, and plan their vaccinations around quieter days, in case they felt unwell afterwards.

If you have symptoms, you can participate in the AusVaxSafety study by replying to the text message, or you can report your symptoms directly to the TGA.

All three experts, plus Mr Cronin, said Australians should get vaccinated with whichever vaccine they were eligible for as soon as possible.

Mr Cronin said he was looking forward to his second dose of AstraZeneca in about four weeks. Despite how poorly he felt, he said he wouldn't hesitate to do it all again.

"As far as the community is concerned, we need to consider not only our individual needs, but the community's needs," he said.

"It's very important."

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