Tennessee Nurse - May 2021
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Page 20 <strong>Tennessee</strong> <strong>Nurse</strong> <strong>May</strong>, June, July <strong>2021</strong><br />
COVID-19 Vaccinations:<br />
Knowledge vs. Myth to Get Back to A New Normal<br />
Erin Morgan, DNP, FNP-BC<br />
In <strong>Tennessee</strong>, the COVID-19 virus has infected 826,371<br />
people, and 12,022 individuals have lost their lives as of<br />
April 13, <strong>2021</strong>. The virus has become the third leading<br />
cause of death in the United States for 2020. Now<br />
that multiple vaccinations are more widely available,<br />
nurses can educate the public about their options and<br />
dispel the myths surrounding these important tools<br />
to decrease future COVID-19 infections and deaths.<br />
<strong>Nurse</strong>s have remained the most trusted profession<br />
throughout the pandemic, and therefore, must use this<br />
position to inform the public about their vaccine options.<br />
Understandably, individuals may remain hesitant to Erin Morgan<br />
obtain a new vaccine when they still have unanswered<br />
questions. <strong>Nurse</strong>s have always provided detailed education to allow individuals<br />
to make the most informed choice for their health. Information surrounding<br />
COVID-19 vaccination is no different.<br />
Vaccine Options<br />
Currently, there are three COVID-19 vaccines approved for emergency use<br />
authorization (EUA) in the United States, two-dose Pfizer or Moderna Vaccines<br />
and the single-dose Johnson and Johnson-Janseen vaccine. <strong>Nurse</strong>s should<br />
recommend individuals receive any vaccine that is available to them. The<br />
FDA has deemed all of the vaccines safe and effective to prevent infection<br />
and severe complications from COVID-19. This recommendation applies to all<br />
individuals, not just those who have co-morbidities. As more individuals are<br />
vaccinated against the virus, the number of available individuals COVID-19 can<br />
reside continues to decrease.<br />
mRNA Vaccines<br />
The Pfizer vaccine was first approved for use in December 2020, with the<br />
Moderna vaccine approval following shortly after. Both vaccines require two<br />
doses; 21 days between Pfizer doses and 28 days between Moderna doses.<br />
These two vaccines use messenger RNA to provide COVID-19 immunity. This<br />
mRNA technology has been studied for years and has already been used in<br />
some cancer treatments. These vaccines use mRNA to instruct cells to make<br />
a ‘spike protein’ similar to that of the COVID-19 virus. The recipient’s immune<br />
system responds to these new proteins by making antibodies. These new<br />
antibodies remain with the recipient to recognize the similar ‘spike protein’ if a<br />
COVID-19 infection occurs. The mRNA does not change the vaccine recipient’s<br />
DNA; instead, it trains the immune system how to respond if the virus is<br />
encountered.<br />
Side effects for the Pfizer and Moderna vaccines include pain or swelling at<br />
the vaccine site, fever, muscle aches, fatigue, or headache. These symptoms<br />
may occur after the first or second dose. Individuals who have had COVID-19<br />
may have more side effects with the first dose. However, many individuals who<br />
have not had COVID-19 report more side effects after a second dose.<br />
Viral Vector Vaccine<br />
The Johnson and Johnson-Janssen vaccine is the most recent to receive<br />
approval. This vaccine is a single-dose injection that offers convenience and<br />
expediency compared to the other two vaccine options. This vaccine was<br />
tested later during the pandemic resulting in differing effectiveness data that<br />
should not be compared to the Pfizer or Moderna vaccines. Additionally, the<br />
Johnson and Johnson-Janssen vaccine was tested in locations where variants<br />
of COVID-19 were already circulating, affecting results of the study. The use<br />
of this vaccine was paused to examine six blood clotting events in women.<br />
Nevertheless, the Johnson and Johnson-Janssen vaccine has already been<br />
received by millions of individuals to date.<br />
The Johnson and Johnson-Janssen vaccine provides immunity through a<br />
viral vector instead of mRNA. Viral Vectors, non-infectious harmless viruses,<br />
are used to transmit information to the recipient’s immune system. The vector<br />
instructs the recipients’ immune system how to produce antibodies for the<br />
‘spike protein’ recognizable on the COVID-19 virus. While considered effective<br />
after two weeks per the CDC, immunity increases up to 28 days past the single<br />
dose. Viral vector vaccines have already been used to treat cancer and the<br />
Ebola virus.<br />
Side effects are similar to the previous two vaccines and include pain or<br />
swelling at the vaccine site, fever, muscle aches, fatigue, or headache. The CDC<br />
recommends that women between the ages of 18-50 who receive the Johnson<br />
and Johnson-Janssen vaccine should be aware of the rare but increased risk of<br />
thrombocytopenia syndrome. Any individual who feels uncomfortable with this<br />
risk is recommended to obtain one of the other two vaccine options.<br />
Vaccine Hesitancy<br />
Many patients and fellow nurses have questions and concerns about<br />
these new vaccinations. These apprehensions are valid and may take time to<br />
overcome. One way to dispel myths and answer questions surrounding these<br />
vaccines is to provide evidence-based education from trusted sources and then<br />
let the patient or nurse choose for themselves.<br />
The process was rushed<br />
All medications and vaccines must go through an approval process with the<br />
FDA. All three vaccinations currently approved have undergone this process<br />
and received emergency use authorization (EUA). This approval does not mean<br />
that the steps for approval were shortened or skipped; instead, it provides<br />
approval for widespread use in the pandemic when benefit is demonstrated.<br />
Scientists were able to accelerate the development of these vaccines<br />
due to several factors. Scientists shared information between countries and<br />
between companies in an unprecedented effort to roll out multiple COVID-19<br />
vaccine options at once. Cooperation occurred in the scientific community<br />
using methods that were already in progress, such as viral vector and mRNA<br />
technology, developed for a new purpose. Moreover, governments provided<br />
funding to help cover costs for the development of vaccines locally and abroad;<br />
in the United States, this was titled “Operation Warp Speed.” Additionally,<br />
many volunteers of varying ages and races enrolled in the vaccine trials<br />
decreasing the time to find participants. Finally, vaccine developers were able<br />
to move through the phases of vaccine development promptly. Phase 3 trials<br />
were completed relatively quickly due to the infectious and widespread nature<br />
of COVID-19, when many participants were exposed, proving effectiveness. All<br />
of these factors allowed multiple vaccines to be developed in a time of great<br />
need.