COVID-19

COVID-19 is caused by a coronavirus, which is the same family of viruses that causes the common cold. Because COVID-19 is caused by a new strain of coronavirus, it can cause severe illness in some patients, especially those with underlying health conditions like heart disease, lung disease and diabetes.

Symptoms of COVID-19 can include symptoms that are commonly associated with other illnesses, so it’s important to know the difference so you can protect yourself and others.

Common symptoms are:

• Fever and/or chills
• Cough (usually dry)
• Shortness of breath or difficulty breathing

 
These symptoms are occasionally or rarely accompanied by:

• Tiredness/Fatigue
• Aches and Pains
• Headaches
• Sore throat
• Loss of sense of taste or smell

The common cold is an annoyance for all of us, but tends to be milder than COVID-19 or seasonal influenza. Symptoms normally onset gradually and usually last for less than 10 days, whereas a flu can come on fast. Headaches, difficulty breathing, and a loss of taste or smell are not commonly cold symptoms, and a cough will usually be mild. Sneezing is not a common symptom of COVID-19 and is an indicator that you may have a cold or seasonal allergies.

Common symptoms are:

• Runny or stuffy nose
• Cough (mild)
• Sneezing
• Watery eyes
• Aches and pains

 
These symptoms are occasionally or rarely accompanied by:

• Fatigue
• Headaches

Seasonal influenza is a common respiratory infection caused by a virus and symptoms generally come on fast. Many of the common and occasional symptoms are consistent with COVID-19, so it is important to talk to your doctor to determine whether you should be tested for the flu and/or COVID-19. Most people with the flu get better without treatment, and getting an annual flu vaccine can help reduce your symptoms if you do get the flu.

Shortness of breath and loss of taste and/or smell are not symptoms of seasonal influenza. Runny or stuffy nose are not typically symptoms of COVID-19.

Common symptoms are:

• Fever and/or chills
• Cough (usually dry)
• Fatigue
• Aches and pains

 
These symptoms are occasionally or rarely accompanied by:

• Runny or stuffy nose
• Sore throat
• Diarrhea

Seasonal allergies can closely mimic a cold, but have some unique symptoms as well, and are the result of an underlying trigger or reaction that a specialist can help resolve to provide lasting relief.

Where shortness of breath can be a symptom of both seasonal allergies and COVID-19, loss of taste and/or smell and a runny, stuffy nose are not typically symptoms of seasonal allergies.

Common symptoms are:

• Itchy nose, eyes, throat, ear canals, and sinuses
• Sneezing
• Runny or stuffy nose
• Cough (usually dry)
• Water eyes
• Shortness of breath

 
These symptoms are occasionally or rarely accompanied by:

• Runny or stuffy nose
• Headaches

If you think you may have COVID-19, stay home, isolate yourself from other household members as much as possible, and call your healthcare provider, who will give you guidance on the best next step to protect yourself, others, and the process of getting tested. The CDC offers guidance on the steps to take when you are sick, including a self-check tool.

1- Effectiveness – Vaccine should be able to stimulate a strong fast immune response to eliminate it before it gains a foothold in the population. It should also be able to produce memory T cells and a B cell immune response so protection is conferred on the individual receiving the immunization. The vaccines can elicit a high effectiveness rate of 94-95 % among the two new mRNA technology vaccines. ( Pfizer -BioNTech and Moderna- NIH/NIAID. 2020). The Oxford University-AstraZeneca vaccine elicits a greater than 90% effectiveness by using an adenovirus as a carrier of virus genes to trigger an effective immune response.

2- Safety – A vaccine must first be established to be safe and NOT cause the disease in the individual . Side effects of the vaccine should be tolerable and must be disclosed after pre-clinical trials on cell cultures or animal models and clinical trials on human volunteers to gain successful acceptance.

3- Pathogen features – This pathogen is novel and we are still trying to understand some of its innate characteristics. It may cause acute or chronic disease leading to severe disease and long recovery or even death. Many patients (about 30-40%) may have no symptoms or very mild symptoms like a “cold”. The question about its ability to mutate is still not clear and is undergoing studies. We do know that it currently does not attack the human immune system. This current form of virus has a reservoir in the species of bats. It also has the ability to exist in humans without any symptoms for up to 21 days. Therefore these humans may be able to transmit the aerosolized virus through many pathways such as talking, sneezing, coughing and also by touching surfaces.

After the Pfizer and Moderna COVID-19 vaccines were approved for use, Dr. Buddiga shared information and guidance in his article. With the recent resuming of the administration of the J&J vaccine, Dr. Buddiga is providing an additional resource with answers to some of the top questions he has received from patients, doctors, community leaders, and members.

The CDC and the FDA both recommend vaccination with the J&J Vaccine resume among people 18 years and older, as the potential benefits of the vaccine outweigh its known and potential risks. Women who are younger than 50 years old should be aware that they may have an increased risk of TTS (Thrombosis with thrombocytopenia syndrome), which is a blood clot condition with low platelets, but it is very rare. The other COVID-19 vaccines (Moderna & Pfizer) do not have an increased risk of this complication.

The FDA and CDC paused the administration of the J&J Vaccine to investigate the causal relationship between the vaccine and TTS after the VAER system (Vaccine Adverse Event Reporting System) picked up on reports of new blood clots in women within the age group of 18-49, which was statistically significant and not a random event. This adverse event is rare, occurring at a rate of about 7 per 1 million vaccinated women 18-49 years old. It is even rarer in patients older than 50 and men 18 years and older.

The pause allowed the CDC time to communicate with healthcare providers, re-emphasize the importance of reporting severe events, and conduct a risk-benefit analysis. The CDC and the FDA, after reviewing the data, have recommended that health professionals begin administering the J&J Vaccine again, as the potential benefits outweigh the potential risks, and because the complication is so rare in the demographic of adult men and women over 50 years of age.

If you received or plan to receive the J&J Vaccine, and, particularly, if you are a woman between the ages of 18 and 49, for 3 weeks following the vaccine, you should be on the lookout for the following symptoms and seek medical care immediately if you develop one:

• Severe or persistent headaches with blurred vision
• Shortness of breath
• Chest pain
• Leg swelling
• Persistent abdominal pain
• Easy bruising or tiny blood spots under the skin beyond the injection site

 
You always have an alternative platform of Moderna or Pfizer if you choose not to risk receiving the Johnson & Johnson if you are a woman.

At this point, the key is to get vaccinated and follow mask protocols until at least 85% of the population is vaccinated. The consensus goal of the US vaccination task force is to vaccinate the American population in a timely, orderly, and equitable method, respecting all ages, and placing higher-risk groups ahead of others. Beyond that, all three vaccines are safe & effective with very low side effect profiles. Women between the ages of 18 – 49 should be aware of the potential for an increased risk of TTS and may opt to get a vaccine from the mRNA platform such as Moderna or Pfizer since a warning label has been issued by the FDA-CDC committee in this age group with the Johnson & Johnson vaccine.

The main difference between these vaccines is the type of vaccine delivery system utilized. The Johnson & Johnson vaccine is an adenovirus vector vaccine, whereas the Moderna and Pfizer vaccines are mRNA vaccines. These mRNA vaccines have been around and in testing for a long time, so adjusting the profile of the vaccine from SARS-CoV-1from 2002 to SARS-CoV-2 in 2020 was relatively quick once we had the genomic structure of SARS-CoV-2. Adenovirus vaccines take longer to complete due to the stability of the adenovirus and the gene segment needed for a successful immunization mechanism.

The Pfizer and Moderna vaccines are 2 doses, taken 3-4 weeks apart and take a total of about 8 weeks to reach peak immunity, and require stringent refrigeration requirements ranging from -70 degrees celsius to -20 degrees celsius respectively.

The J&J vaccine is a 1-dose protocol, with peak immunization at about 2 weeks after the dose, and has a relatively favorable shelf life with minimal refrigeration requirements. This gives it a unique advantage for ease of transport, storage, and the ability to deliver it to every corner of the United States.

No, the J& J vaccine is not less effective – it is an extremely effective vaccine and, in looking at numbers, it is 100 % effective in preventing ICU hospitalization and death. It also, to a significant extent, decreases the chance of developing severe illness due to COVID by 86%.

All three vaccines do an excellent job of preventing severe illness, hospitalization, and prevention of death.

Yes, as long as it is distributed by the County. Vaccine distribution is completely under state and county control. All three vaccines are extremely effective and I am ready and willing to administer any of them as long as I have communicated to them the warning label of Johnson & Johnson that was reauthorized for emergency use on April 23, 2021.

Anyone seeking the COVID vaccine can have the Johnson & Johnson vaccine. It is also a great option for those who have had an allergic reaction to the mRNA platform of vaccine, or who have demonstrated intolerance to Polyethylene Glycol (PEG) or other components of the mRNA vaccines. Women between the ages of 18 – 49 should be aware of the potential for an increased risk of TTS with Johnson & Johnson and may consider the alternative platform.

The bottom line is: vaccinations play the most critical role in building herd immunity and placing eradication pressure on the COVID 19 virus, which is why anyone eligible to get a COVID-19 vaccination should receive one. Once we get infected, our options for treatment are limited and there can be an unpredictable response to the illness and how we will respond to treatments, as well as a possibility and risk of death.

The best offense is a great defense: vaccination and masking until the goal of herd immunity is achieved, which is when 85% of the population has been vaccinated.