As of today, we have completed 1/6 of our household steps towards vaccinated immunity. With the recent drop in age for the AZ vaccine, my GP’s office had sent out a broadcast email to patients over 40 to say “Come and get it!”, like ringing a dinner bell. But my profile isn’t completely typical, so after reading a bunch of stuff online, I reached out to my GP to check on whether the AZ vaccine was right for me and that my curation had been correct.
Generally speaking, of course, the recommendation is to go with availability over efficacy rates. Currently, the Pfizer and Moderna vaccines are about rated to 90-95% efficacy, while AZ was down at 70%. Those are the initial efficacy rates against contraction, but all three of course are almost 100% effective against serious illness leading to hospitalization or death. In other words, even if you get sick after that initial efficacy number, your second number is generally 100%.
So what’s the issue?
I’m on the cusp of pre-diabetic / diabetic. When the three available vaccines were tested, they had very few people in the sample group with diabetes, and when they did, they usually weren’t separated out between Type 2 (controlled with lifestyle or medication) or Type 1 (requiring insulin shots). I would be near to the Type 2 category.
For the results they DO have, the numbers drop for efficacy — anywhere from 15-25% lower than that of the general population. Again, though, that’s the efficacy rate against contraction. Very few of the studies reported had reliable reporting on the secondary efficacy, but it LOOKED like 100%.
Yet you can only get one vaccine type, and I was reasonably sure I was good to go with the AZ one, but as I said, I wanted to be sure. I booked my appointment and then reached out to the GP for a quick consult before getting it.
My questions broke down into three steps:
a. As a near type 2 patient, was there anything that suggested I should wait for Pfizer over AZ? Was there anything with my health that said “wait”? As expected, and as hoped, she confirmed that the second efficacy number is close to 100% still for AZ for diabetics, and thus, yes, availability is more important than initial efficacy.
b. My household has an atypical profile with all three of us in the house having higher-risk profiles individually. Did that change anything in the calculation? I was mostly worried that I could still contract it with the lower rate and transmit it to them. But “some” immunity faster is still better than efficacy rates, as expected and hoped. It might even strengthen the rationale, although it is a double-edged sword, of course.
c. The last question was one I found no information about anywhere…some disease profiles suggest that the person should NOT wait 4m for the second dose but should get it sooner rather than later. Certain auto-immune diseases for example are being recommended to get Dose #2 as soon as possible. While AZ is being rolled out for dose #1 now, and the second in 4m, I wanted to know if anything in my personal or household profile changed that calculation. Put bluntly, if I could get Dose #1 of AZ now but Dose #2 wasn’t available for 4m, but I could wait a month for Pfizer but get 2 doses a couple of weeks apart, then waiting might get me “completed” for dose #2 faster. Diabetes didn’t seem an obvious candidate to avoid the waiting period, but as I said, you can only get one dose. I didn’t want to find out after the fact that I should have gone another route.
In the end, I was all clear. I was expecting to be, sure, but I did want to be sure. It’s too important to rely on Dr. Google for this one.
I confess, I don’t often think of it as a shot. Sure, I say “flu shot” like everyone else, and my “COVID shot”, but I would never use it as a verb. A couple of friends posted about being shot and I was like, “Huh?”. Because for me, it is very clearly a stabbing. 🙂
I booked the appointment through my GP’s online site and was relatively shocked to see that they had Sunday appointments available. I didn’t click as soon as I got the first notice, I wanted to check a few things, but I was able to book on Thursday for Sunday’s schedule. Pretty quick overall.
I arrived, parked in the lot next door (free on weekends!), and entered the hospital (the clinic is in the first floor of a LT care facility). A security person directed me to a COVID screening form, a receptionist checked me in and gave me a new mask, a nice escort took me to an available nurse in one of the examining rooms, and it was on like Donkey Kong.
Cathy, the nurse, did a simple run-through of who I was, checked my contact info so I could get receipts and follow-up notifications, screened me for a bunch of Qs again about reactions or likely reactions to a vaccine, confirmed a few details about the vaccine itself (where I was like, huh? Oh right, yes, she should tell me what she’s injecting, I suppose). Small needle, go to the waiting room for 15 minutes.
While I was in the waiting room, I got the notification from the scheduling portal for my second dose. They also told me orally that it was assuming they got the vaccine then, and nothing changes to either move it up or back. It’s an administrative booking, basically, more of a reservation than any guarantee that they’ll have a dose available then or that it will take that long.
I killed my 15m and left. About 30m after I got my shot, the Ministry of Health sent me a confirmation email as my immunization record.
My mental / emotional reaction
I said to Andrea and Jacob that I might cry when I got it. So much stress, and here’s a small light at the end of the tunnel. And as I walked towards the hospital, I did feel quite emotional. All the way through it? Nada. Just process.
When I left the building, I let the experience flow into me, and while I felt like I *could* react more for a release, I wasn’t feeling like I needed it. I was fine. Ho hum even.
I found it a bit odd, actually. I wanted to ring a bell, smash a pinata, get doused in confetti, have someone solemnly say, “I now pronounce you vaccinated”.
But ten minutes after I left, I was back in my ongoing mindset. The NY Times had a great article this past week about the new term for those who are stuck between normalcy and not-quite-depression — it’s called languishing. And it almost precisely captures what I have been feeling for the last two months as I recovered from my leg wound and rebuilding my website.
Now that I’m done the rebuild, I feel almost out of sorts. There’s no fanfare for finishing THAT either. I feel like there should be a reward for myself, some milestone to celebrate somehow, and yet here is perhaps one of the biggest milestones of the last 14m, and I was already past it and thinking, “Hmm, what’s for dinner?”.
Right up until Andrea hugged me at home. Then I lost it. I could probably lose it again right now, while I am writing this, if I let myself. The built-up energy, the tension in my heart and mind. Yet it isn’t honestly about me, not really. Sure, I’m scared like everyone else, and with my health, there’s a good chance that long-term ventilator use would not end well if I was hospitalized.
But my biggest worry is about Jacob and Andrea. I am their biggest vector. Jacob has almost no other vectors BESIDES me, actually. And the thought of my getting sick and exposing them, or leaving them without my support, is scary AF.
The journey isn’t over
Earlier today, I received my feed from GoComics.com and I loved the post by Tim Campbell (here). In the comic, it shows a person running a race and crossing under a banner held up by two vaccine needles. The caption reads, “Keep Going. This is not a finish line.”.
And it’s not, in oh so many ways. But let’s cut it to two.
First, the obvious one, just because I have a single dose, or even if I had a double dose, I still have to keep social distancing and wearing a mask. It doesn’t change my life until we get closer to herd immunity.
Second, the bigger issue? It’s one dose of six that my household needs. I need another dose of course. Plus Andrea is consulting with one of her doctors on her best way forward, similar to my discussion above. In the meantime, she’ll take whoever offers her an appointment first, and she’s registered multiple places. With 2 doses needed for her.
But Jacob is turning 12 in May, and probably by the fall / early winter, there will be options for people down to the age of 12. I chatted with him recently about how he feels about it, and while he has no strong views about the vaccine or not, the abstract doesn’t really resonate with him vs. the practical issues of going to school or being virtual. The bigger issue for him is that he doesn’t like needles. I told him he needs to get comfortable with the idea because I don’t know of too many reasons we wouldn’t do the vaccine for him if it’s generally available. 🙂 Maybe he can race his cousins although a couple of them might have a leg up, having a doc for a mom. 🙂
So where does that leave me? A tad bit more hopeful than I was this morning. I’m still languishing.
But I’m at least languishing with a small hole in my left arm. I’ve taken my step towards joining the herd.