Ask An Expert: Vaccine FAQs

How does the vaccine work? How'd it get finished so fast? Also a round bird

Today, I’m very excited to introduce you to Alicia Kalsi, an awardsforgoodboys community member extraordinaire who, very importantly for our purposes, is a health behavior specialist who graciously helped answer some of my vaccine questions. For fellow disabled friends, keep in mind some of this might not apply / apply directly to you, so be sure to check in with your doctor / consult other people with your diagnosis. I’ve included further resources just for you (chic!) at the end of the newsletter. 

Here’s a little more about Alicia before we dive into all the questions you are maybe embarrassed to ask. Don’t worry, I have no shame, I will ask for you. (Also feel free to email me things of this nature, happy to help!). 

I'm Alicia Kalsi, MPH (she/her). I graduated from the University of Michigan School of Public Health in 2020 with a Master of Public Health degree, specializing in Health Behavior and Health Education. I currently work as a coordinator for the University of Michigan COVID-19 Community Sampling and Tracking Program, overseeing campus-wide testing for students, staff, and faculty. I want everyone who reads this to give their pets a treat and tell them it was from me.

Thanks Alicia, Clem is getting a treat on your behalf right now. 

Q; First things we get it? 

A: PLEASE get the vaccine if you are able to. Each person that gets fully vaccinated brings us one step closer to normalcy. Protecting yourself and others is sexy and cool and fun and fresh. 

ID: a smiling good boy with a text bubble says “I’m getting vaccinated!” and below a smiling face says “king shit” around other supportive text bubbles.

Q: WTF re: how it got rolled out so fast? Should I be scared of that? 

A: This has been the fastest vaccine rollout in history, so I understand why there is skepticism; a fast-tracked vaccine like this isn't something we're used to seeing, and we get scared of the unfamiliar. But the real question that we should be asking here isn't why this vaccine came out so fast, but rather why other vaccines are so slow.

The short answer: Money.

The long answer: I think this article from the Henry Ford Health System (what can I say, I love to keep it local) does a pretty good job explaining the biggest hurdles to getting vaccines out quicker: recruiting researchers and participants, funding, time lapses between clinical trials, and FDA approval. For COVID-19, we had many willing participants and researchers, seemingly infinite funding, and no lapses in trials from being unable to secure grant funding, participants, or renewing approvals. As for the FDA approval, since we are in a state of emergency and the vaccines had already demonstrated pretty decent safety and efficacy in their initial trials, they were granted Emergency Use Authorization (EUA), essentially fast-tracking them for production. 

While I'm not expecting all future vaccines to be rolled out this fast, I'm hoping this gives people an idea of just how much we can achieve when we provide adequate resources for public health initiatives and research. 

Q: What does herd immunity actually mean? 

A:  Herd immunity, or community immunity, is when a significant portion of a population (or herd) is immune to an infectious disease.  As the number of immune folks in a population increases, the number of opportunities for non-immune people to get infected with the disease decreases. When enough of us are immune, there aren't enough opportunities for the disease to spread. These simulations from NPR do a great job at illustrating how herd immunity works in different scenarios.

The amount of immunity needed to achieve herd immunity depends on the infectious disease. We're not at herd immunity for COVID-19 just yet, and we don't have an exact threshold of people that would make us all say "COVID is over!" if it was reached. Dr. Fauci said back in December that he's thinking around 80% of the population being vaccinated would be enough. More recently, he and other experts are estimating that somewhere between 70% and 85% might be enough, but we're learning new things all the time. Check the CDC website or your local health department for the most up-to-date info!

Q: How do the vaccines even work? 

A: We currently have two different types of vaccines available: the mRNA vaccines, and the adenovirus/vector vaccines. You know how in those computer generated illustrations of COVID-19, it's depicted as a spike-covered sphere (it kinda resembles a crown, hence coronavirus)? Those are called S proteins (I will refer to them as spiky boiz because I think that name is funnier and less intimidating), and they are essentially harmless. Both of the vaccines focus on getting your body to recognize the spiky boiz, and produce antibodies that will fight the spiky boiz if they show up again in the future (like if you come into contact with COVID-19). 

The mRNA vaccines (the ones from Pfizer and Moderna) are a newer, innovative approach, and I think they're super cool. They introduce your body to an mRNA code that gives your cells instructions on how to make the spiky boi protein. The cells then display this protein on their surfaces, and destroy the instructions. Your body recognizes the spiky boiz as a Weird Foreign Thing, and will trigger an immune response, producing those aforementioned antibodies. Think of it as a really funny joke that a friend sends you through one of those voice messages that disappears after two minutes; the message itself eventually disappears, but you'll be remembering and laughing at the joke long afterwards.

The adenovirus/vector vaccines (the ones from Janssen/J&J and Oxford/AstraZeneca) use an approach that has been around a bit longer. They have the same end result as the mRNA vaccines, but get there in a different way. These vaccines use an inactivated form of adenovirus, also referred to as a viral vector. Instead of entering your cells and reproducing like a normal adenovirus would, they introduce the mRNA instructions to create the spiky boi protein. From there, the process is very similar to the mRNA vaccines: the body will put the protein on cell surfaces and destroy the instructions, recognize the spiky boiz as foreign, trigger the immune response, and produce antibodies. Think of it as a Kinder Surprise egg where the outside is an inactivated virus, and when you crack open its shell, the little toy inside is a spiky boi protein. Yummy! I think this guy's series of TikToks on how both of the vaccines work are fun and easy to understand, especially if you're more of a visual learner. I'm kinda mad that I didn't think of doing something like this first because they're so good.

ID: A drawing of a needle with the vaccine and satirical text that reads “scientifically proven that men who get vaxxed have the best, biggest, and brightest cocks.”

Q: Okay, I’m gonna get the shot. Now what?

A:  After being fully vaccinated, meaning two weeks after your final dose, what you can do depends on what you want to do and who you are doing it with. You can visit other vaccinated folks, being maskless and less than six feet apart. You can visit one household of unvaccinated folks who are not high-risk, also being maskless and less than six feet apart. We still recommend social distancing and mask wearing when in public, and ask that you still avoid medium-to-large gatherings, regardless of who's there. 

As much as I want to go and kiss the foreheads of all of my friends, we've still got a bit of waiting to do. While we have evidence to show that the vaccines are effective against the initial strain, we still don't have enough evidence to know they'll be *just* as effective against variants. Additionally, the vaccines don't have 100% efficacy. While it's not likely, it's still possible to get COVID-19 after being vaccinated. Even if you're vaccinated, PLEASE continue to stay home if you can, wash your hands, wear your masks, and get tested. The end is in sight, but only if we keep doing what we're doing. Stay tuned and stay optimistic!

Vaccine advice from your local disabled pals—compiled by my friend also named Shelby from All Kinds with help from Alyssa. They rule!

Generally great resources:

Other important information:

  • While public health experts agree that the best vaccine is the one available to you, as a chronically ill and/or disabled person, it is well within your rights to research vaccine types and schedule according to the one you and/or your medical team believes will be the best fit for you. 

  • If you are unable to visit a vaccination site and are having a hard time finding an at-home provider (ie you are “homebound” to use an imperfect descriptor), try calling your city’s vaccine hotline, your local health department, or try getting in touch with your state’s disability rights group, as they tend to be connected to the government in ways that disability justice and mutual aid organizations are often not. Unfortunately, most of these “homebound” services are hinging upon what will come of the J&J pause. 

  • If hygiene is important to you and feasible, consider showering or doing other hygiene-related tasks prior to vaccination, as side effects may prevent you from doing these tasks easily. 

  • Consider putting on fresh bedsheets, tidying up your bedside table, or anything else that may make your space more welcoming for a post-vaccine extended bed hangout. 

  • If at all possible, consider scheduling your doses on days off work, as it may make accommodating potential symptoms easier. 

  • Many people report arm pain and an inability to lift their arm. If you are a manual wheelchair or other mobility aid user, plan accordingly if at all possible. Consider getting the shot in your non-dominant arm if that’s an option for you. Consider taking off bras, binders, corsets, adaptive gear, or anything else that may be difficult to get off with reduced arm capacity once you get home from your vaccine. Consider changing into a button-up shirt at that time as well because it may be easier to get on and off if your arm goes out. 

  • Gather supplies like ice packs (for headaches or other aches), heating pads, humidifiers (some people report sinus dryness post-vaccine) Tylenol (NAISDS sometimes dampen immune responses), electrolytes, water bottles, protein bars, microwaveable meals, precut veggies and fruit, plastic straws, and snacks prior to your appointments. It’s likely that you’ll have a hard time doing self-care and the aforementioned items make it easier! Thank disabled people for that! 

  • Consider not starting new medication prior to your appointments, as it may be really hard to distinguish what is causing a reaction. If you’re starting any kind of medication, you’ll want to know if you have side effects, so try to space it out if possible. 

  • For many people, the vaccine appointment may be the first time they’ve been in such a populated place in a long time! Consider that you may have new sensory needs. Wear noise canceling headphones, suck on a lozenge to calm your vagus nerve (as long as you can pop it in safely without exposure), bring headphones to play music, bring stim toys, and plan something to look forward to after, like watching a new episode of Summer House on Bravo, for example. 

  • Prepare for the vaccination site to be very efficient, IE fast. While most vaccination locations sadly don’t provide access information, you can likely expect someone to check you in and take your temp/ask about possible COVID exposure, someone to ask for your name and potentially collect an ID (you do not need to have an ID to get a vaccine!), fill out paperwork, wait for your name to be called, and then be taken to a chair to get your shot. Then you’ll likely be brought to another chair to wait for 15 minutes. If you are filling out paperwork and have hesitancy or realize that you need to ask more questions, inquire as much as possible and even consider rescheduling. You know your body best and the Medical Industrial Complex demands that we be our own best advocate if at all possible, which is a very sad reality. 

  • Right before the jab, drop your jaw as much as possible and say “aaaaaah” or “rrrrrrr.” This will relax your muscles and hopefully make your arm muscle less sore. Also try to move your injection arm if you can as to reduce soreness in the hours following your vaccine. 

  • If you’re a sensitive or reactive person, feel free to stay longer than 15 minutes! The vaccination staff will likely understand and respect your choice to do so. 

  • Your vaccine side effects may last a lot longer than your nondisabled counterparts, which really stinks! Allow yourself to feel bummed out about it. 

Random vaccine tidbits:

  • The vaccine may make your tattoos itchy. Apparently it’s normal and should dissipate! 

  • While we can’t give medical advice because we aren’t doctors, track any and all rashes that may appear by taking photos in good lighting and even tracing the outline of the rash with a ballpoint pen.  Similarly, track any symptoms on a piece of paper or in a phone note. It can be hard to remember what happened in a pain or sickness fog and this info may be helpful for your medical history in the future. 

  • Again, we can’t give medical advice,  but of course, if you have trouble breathing post-vaccine, it’s time to go to the ER.

  • The vaccine may change your menstrual cycle. If this happens to you, consider putting your info into this survey:

Twitter avatar for @KateClancyDr. Kate Clancy 🏳️‍🌈 @KateClancy
Our survey was approved and made it through production! VACCINATED MENSTRUATORS ASSEMBLE: (This is a project to explore whether the covid vaxes affect the periods - if you have menstruated before and got the vax, take 15 min to tell us your experiences!)Research Consent
  • You can’t be denied a vaccine for not having a SSN or insurance. Your immigration status should not impact eligibility. The vaccine should not cost any money. If you’re at a place that charges or demands any of the aforementioned, get outta there! 

  • Take a photo of your vaccine card or scan it and save it to a place you’ll remember. Keep the card somewhere safe and don’t laminate it in case we need booster shots in the future. 

  • While it is rare, people are still catching COVID after getting vaccinated. Continue distancing, wearing masks, and focusing on good ventilation. And help your neighbors and pals find vaccine appointments if you have capacity to do so!

If you found this helpful, please consider donating to the Disabled Elders Fund.

Here are other things I’m thinking about re: vaccination. There’s a lot, and all of this sort of just scratches the surface! But alas, my newsletter is not an encyclopedia nor medical journal although, if the birdfluencing doesn’t work out for me you know where I’ll pivot to next.

  • If you can get involved in helping get the basic info out about the vaccine, like the fact that it’s available to everyone and free of cost, great!

  • Some other things I’ve noticed: the vaccine websites are glitchy! Maybe this is true where you live too. I had to refresh often / keep checking back for appointments. Of course computer access and use are certainly not the only access barriers—that linked article notes some other important access aids could include “offering to schedule and pay for ride-sharing options or public transportation. Many volunteers also help make phone calls to pharmacists or other health professionals on behalf of people who need communication help.” 

And then, there’s the reality that while many vaccines are being developed around the world, it is imperative countries with the resources to share vaccines to do so. It’s not simply a moral obligation, but in the best interest of public health everywhere: “If the rich world continues to hoard vaccines, the pandemic will drag on for perhaps as long as seven more years,” writes Dr. Gavin Yamey, a professor of the practice of global health and director of the Center for Policy Impact in Global Health at Duke.

What vaccine info did I miss? What are you thinking about? Obviously lots of this is changing all the time, so will edit as needed. Let me know. Clem is unavailable for a photo at this time because she cannot stop pooping. In lieu of my dog, here is a bird I like, the bearded reedling.

ID: a photo of an extremely round bird called the bearded reedling. the round bird is grayish in the middle with orange / brown highlights on the tail and sides. They are also doing the splits.

With love,
Shelby (and Clem)