In the last few days, I have received a lot of messages from folks back home with various questions on the COVID-19 vaccine. So, I thought of compiling this FAQ – and hope it helps.

FAQ on AstraZeneca COVID-19 vaccine, or Covishield in India.

  1. What is the AstraZeneca COVID-19 vaccine?

COVID-19 Vaccine AstraZeneca stimulates the body’s natural defences (immune system). It causes the body to produce its own protection (antibodies) against the virus. This will help to protect you against COVID-19 in future. None of the ingredients in this vaccine can cause COVID-19.

2. What is the effectiveness of the vaccine?

Preliminary findings showed that neutralising antibodies were induced at day 14 and 28 after the first vaccine dose and levels increased after the second dose. Specific T cell responses were also induced after a single immunisation and were maintained after the second dose. Final data showed that IgG spike antibody responses and neutralising antibody 28 days after the second dose were similar across the three age cohorts (18–55 years, 56–69 years, and ≥70years).

3. What are the common side effects?

Like all medicines, this vaccine can cause side effects, although not everybody gets them. In clinical studies with the vaccine, most side effects were mild to moderate in nature and resolved within a few days with some still present a week after vaccination. If side effects such as pain and/or fever are troublesome, medicines containing paracetamol can be taken.

Very Common (may affect more than 1 in 10 people):

Tenderness, pain, warmth, itching or bruising where the injection is given, generally feeling unwell, feeling tired (fatigue), chills or feeling feverish, headache, feeling sick (nausea), joint pain or muscle ache.

Common (may affect up to 1 in 10 people):

Swelling, redness or a lump at the injection site, fever, being sick (vomiting) or diarrhoea, flu-like symptoms such as high temperature, sore throat, runny nose, cough and chills.

Uncommon (may affect up to 1 in 100 people):

Feeling dizzy, decreased appetite, abdominal pain, enlarged lymph nodes.

4. How to store AstraZeneca?

DO NOT use the AstraZeneca COVID-19 vaccine after the expiry date, which is stated on the carton. The expiry date refers to the last day of that month. Store in a refrigerator (2°C to 8°C). Do not freeze. Keep vials in outer carton to protect from light.

The vaccine does not contain any preservative and should be administered by a healthcare professional. After the first dose is withdrawn, the vaccine should be used as soon as practically possible and within 6 hours. During use it can be stored from 2°C to 25°C.

5. Dosing and Schedule?

The dose of AstraZeneca COVID-19 vaccine is 0.5ml.

Based on good evidence of higher clinical protection, ideally, an eight week minimum interval should be observed for this vaccine. An interval of 28 days may be observed when rapid protection is required. If an interval longer than the recommended interval is left between doses, the second dose should still be given (preferably using the same vaccine as was given for the first dose if possible). The course does not need to be restarted.

6. What are the Contraindications (where you must refrain from taking the vaccine) and precautions to be observed?

There are very few individuals who cannot receive the AstraZeneca COVID-19 vaccine. Where there is doubt, rather than withholding vaccination, appropriate advice should be sought from the relevant specialist, or from the local immunisation or health protection team.

The vaccine should not be given to those who have had a previous systemic allergic reaction (including immediate-onset anaphylaxis) to:

● A previous dose of the same COVID-19 vaccine

● Any component (excipient) of the COVID-19 vaccine e.g. polyethylene glycol (PEG).

Minor illnesses without fever or systemic upset are not valid reasons to postpone immunisation. If an individual is acutely unwell, immunisation may be postponed until they have fully recovered. This is to avoid confusing the differential diagnosis of any acute illness (including COVID-19) by wrongly attributing any signs or symptoms to the adverse effects of the vaccine.

There is no evidence of any safety concerns from vaccinating individuals with a past history of COVID-19 infection, or with detectable COVID-19 antibody. Vaccination of individuals who may be infected or asymptomatic or incubating COVID-19 infection is unlikely to have a detrimental effect on the illness. Vaccination should be deferred in those with confirmed infection to avoid confusing the differential diagnosis.

As clinical deterioration can occur up to two weeks after infection, ideally vaccination should be deferred until clinical recovery to around four weeks after onset of symptoms or four weeks from the first confirmed positive specimen in those who are asymptomatic.

Having prolonged COVID-19 symptoms is not a contraindication to receiving COVID-19 vaccine but if the patient is seriously debilitated, still under active investigation, or has evidence of recent deterioration, deferral of vaccination may be considered to avoid incorrect attribution of any change in the person’s underlying condition to the vaccine.

Disclaimer: I am not a scientist or an epidemiologist but have run vaccine programmes as a clinical lead for one of North Central London vaccination hubs.

(Ashila Wangdi is a COVID warrior and works with the National Health Service in the United Kingdom. She has her roots in Sikkim and is a clinical specialist neuro-physiotherapist working at the North Middlesex University Hospital in London.)

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