Side effects are normal and people should take PCM if the pain is severe  

Younten Tshedup  

After more people, who have received Moderna vaccine as their second dose, shared about side effects publicly, local health experts said they are normal and not life-threatening.

The side effects include ‘severe’ pain at the place of injection, joint pain, chills, and fever.

Many recipients of the heterologous regime (Moderna after AstraZeneca) of the vaccine are experiencing the symptoms a day after the vaccination.

Some of the people Kuensel spoke to said that the pain and discomfort could be because the Moderna vaccine was more efficacious. “Lyonchhen said that if you get sick after vaccination, it shows the vaccine is working,” said a Thimphu resident who received her second dose of the vaccine on Tuesday.

She said that she began to feel ‘feverish’ towards the evening of the vaccination day. “I couldn’t sleep throughout the night as the pain on my arm grew stronger and the fever rose. I took a PCM and I was absolutely fine the other day.”

However, a few others said that the pain at the injection site and entire body ache has not receded even on the third day of receiving the vaccine. “Maybe mixing vaccines wasn’t a good idea after all. I had no side effects during my first dose,” said a corporate employee.

Kuensel learnt that some of the recipients were bed-ridden on the night of receiving the vaccine. There were a few who received the AstraZeneca vaccine as the second dose experiencing a similar form of side effects.

Should you be  concerned?

National Immunisation Technical Advisory Team (NI-TAG) member, Dr Sonam Wangchuk said, “People need not be worried.”

He said that any vaccine or medicine came with a certain level of side effect and that it was absolutely normal.

He said that the only side effect of vaccination people should be concerned with was the anaphylactic shock. This, he said, would be an immediate reaction of the body to a vaccine and that it needed medical attention. For this, the 30 minutes mandatory observation was put in place.

Dr Sonam Wangchuk said that the majority of the common side effects such as fever, headache, joint pain, and pain at the site of injection, among others, happened between 24 to 48 hours after the vaccination.

He said that as per evidence and clinical studies, the first dose of AstraZeneca vaccine produced slightly higher common side effects compared to the booster dose of the same vaccine. However, for a mRNA vaccine (Pfizer or Moderna), he said that the second dose had proportionately higher side effects than the first dose.

“Now that we are mixing the two, a few studies have shown that there will be a slightly higher side effect. However, this doesn’t mean that a heterologous regime of vaccination was associated with severe side effects,” he said.

“We are distributing paracetamol to all recipients after the vaccination. If they experience some side effects, they should take a tablet,” he said. “If the symptoms don’t subside, they should take another tablet after 12 hours because for some people the episode may last longer than 48 hours.”

However, he cautioned people not to take the paracetamol in anticipation of possible fever or headache. “You should take the medicine only if you are experiencing the pain.”

With some questioning, if the side effects were triggered by injecting a higher dose of the vaccine, Dr Sonam Wangchuk said that the Moderna vaccine was of the same quantity — 0.5ml — used during the first dose. “Even the syringes used are the same, which has a built-in auto-lock system. So, there is no chance of drawing in more content as the syringe locks itself when you reach 0.5ml.”

He added that a higher dosage of the vaccine would not trigger side effects. “People have received double doses of AstraZeneca vaccine during our first campaign. There were no associated side effects.”

According to clinical trials, Dr Sonam Wangchuk said that the people who received the Moderna vaccine experienced a slightly higher pain on the site of injection. “This is expected. However, not all would experience the same as the vaccine works differently on different people.”

Another observation was that some of the people experienced vomiting and gastrointestinal disturbance including diarrhoea after the vaccine. “However, this is all normal as these side effects were already observed during the clinical trials,” he said. “People should not be worried because we’re not seeing anything unique or extra which has not been reflected during the clinical trials of the vaccine.”

Meanwhile, 282,236 people were vaccinated at the end of the third day of the second mass vaccination campaign. Of the 1,307 adverse events following immunisation (AEFI) were reported so far, 530 were reported yesterday.

Edited by Tshering Palden