Dose 2: Side Effects But Worth It

Dear Andrea,
I heard you got the second dose of the COVID-19 vaccination and you had some side effects. What happened?

Sincerely,
Individual Living with NMD

Dear Individual Living with NMD,
Dose 2 of the Pfizer and Moderna vaccinations both have a reputation for causing side effects, even for those who had no side effects from the first dose.

"The most common side effects are injection site pain, fatigue, headache, muscle pain, and joint pain. Some people in the clinical trials have reported fever. Side effects are more common after the second dose; younger adults, who have more robust immune systems, reported more side effects than older adults." Reference: https://www.statnews.com/2021/02/02/comparing-the-covid-19-vaccines-developed-by-pfizer-moderna-and-johnson-johnson/​

I personally know some with neuromuscular conditions who had nothing more than injection site soreness after dose 2, but I also know those who had fatigue and muscle aches. I "prepared for the worst" but was not expecting the symptoms to shift direction and begin so many hours after vaccination. That caught me off guard. 

My Dose 2 of the Pfizer vaccine was during another late Thursday afternoon appointment. The shot was fast and painless. We went straight home after my 15 minute waiting period.  Within minutes, my arm was already sore, a faster development of soreness than I had experienced with the first dose.  I awakened earlier than usual that morning, so I was more than ready for a nap when we got home. I got into bed and used my assisted ventilation to relax and watch TV.  Within an hour, a slight headache began. I slept for about two hours. While eating our carryout supper an hour later, I began to feel as if I had not even napped. I was very fatigued. It was the kind of fatigue that made eating and holding one's head up a lot of effort. I wasted no time and got ready to return to bed. 

I took ibuprofen because that mild headache was getting more noticeable.  I had a rough night and experienced what I will call "temperature regulation issues." One minute I was hot, the next I was cold, and then soon after I was hot again. The heat was a strange sensation that didn't seem like a hot flash. It radiated over most of my body, just under the surface of my skin.  This symptom went on for hours and made it difficult to get comfortable. Throughout the night, I woke up a couple of times feeling hungry enough to eat a large meal, but I stayed in bed.

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The Day After
I got what I am guessing was five hours of sleep, and when I signed on for work the next morning, I was quite tired.  It was hard to tell if that was from lack of sleep or the vaccination causing fatigue. During my lunch break, I was feeling less tired, but within minutes of deciding I would work my full shift, I began to feel those "temperature regulation issues" starting again. At this point, it had been about 20 hours since my vaccination. Chills were more pronounced and got increasingly worse over the next two hours along with new joint and muscle aches.  That strange heat sensation under the surface of my skin was back too, and it was worse. 

​By the time my work day ended, I was bundled up in jackets and blankets and feeling miserable. It took everything I had to focus and get through the last hour of my work day. I checked my body temperature to find it was only slightly elevated above my usual temperature and not high enough to be considered a fever.  I took more ibuprofen, went straight to bed, and I slept on my assisted ventilation for nearly four hours.  ​

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​​The Night After
At 30 hours post vaccination, I was a whiney, achey mess and had not improved much. The aches were from the soles of my feet to the top of my scalp.  Thankfully it was not a constant ache, and I would alternate from aching in one body part to aching in another. At times, it felt like my wrists and ankles were broken. If ibuprofen was helping the pain, I don't know how I would have felt without taking it.  

Ibuprofen perhaps kept my body temperature from never exceeding 99.9 degrees Fahrenheit, however.  Slowly the muscle and joint aches eased off.  The one symptom that remained constant was that hard to describe sensation that felt like my blood or tissues were hot under the surface of my skin.  

I got up briefly around midnight and discovered my arm was more sore than it had been and had a swollen red mark at the vaccination site.  My entire arm was slightly pink and itching.  I applied an over-the-counter hydrocortisone cream that helped.  While up, I felt like I was finally starting to feel less achey.  I began to have hope that this was going to pass the next day.  

Day Two
​I slept very soundly for eight hours, unlike the night of the vaccination. I woke up to discover the arm that had been vaccinated felt different, almost like I couldn't fully hold it against the side of my body, like there was something obstructing it. When I got up and looked closer, I could see my armpit and the areas surrounding it were swollen, and it was really sore.  After a few minutes of reading online, I realized this was likely a swollen lymph node in my armpit, something that can happen after any vaccination and is a normal immune system response. It's a documented side effect of both the Pfizer and Moderna vaccinations (for either dose 1 or 2) and has been in the news.                                                         

Within a couple of hours of getting up (now 45 hours post vaccination), I felt mostly back to normal, other than the slightly itchy and sore arm and armpit.  Over the next two days, at times I felt a bit sluggish, almost as if the vaccine fatigue is still somewhat there.  This symptom had little to no impact on my activity though. You may be asking, "Was the second dose of the vaccine worth these annoying side effects?!" To that I resoundingly say, "Absolutely!" These side effects and the inconvenience were minor compared to contracting COVID-19 and risking a severe outcome.

Tips
​In closing, my advice is to prepare yourself for a day or two of lying around or simply being less productive after dose 2.  That might mean missing work or feeling unable to do certain activities of daily living. For me, it meant I could not prepare meals until the day after vaccination, nor did I feel capable of safely taking a shower independently.  I also spent significantly more time lying in bed.  

My hope is that your experience is less annoying than mine and that you will quickly see what a blessing it is to get vaccinated and feel the sense of hope it gave me that life can slowly begin to return to some degree of normalcy and be more safe.  I will continue to double-mask, socially distance, wash my hands thoroughly and frequently, but I will feel safe enough to go to necessary appointments and interact briefly with others from outside my home. I am ecstatic about being able to do some of the more mundane tasks of life again, once my immune system has had a couple of weeks to finish building immunity.  

Wishing you all the Best,
Andrea

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