MCESDA Disaster Digest
3rd Dose Vaccines for the Immunecompromised
Information originally published by the CDC and can be found here
Who should receive a 3rd dose?
As of August 13th, the CDC is recommending that some groups of immunocompromised people to receive a third dose of the COVID-19 vaccine. This includes people who have:
- Been receiving active cancer treatment for tumors or cancers of the blood
- Received an organ transplant and are taking medicine to suppress the immune system
- Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
- Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
- Advanced or untreated HIV infection
- Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response
Those with weakened immunity are not only less likely to be fully protected by two doses, but also more likely to develop serious complications if ill with COVID-19. Anyone questioning whether they fall into these categories or if another illness may put them more at risk should talk to their primary care provider for more information.
Frequently Asked Questions
How long after getting my initial COVID-19 vaccines can I get an additional dose?
CDC recommends the additional dose of an mRNA COVID-19 vaccine be administered at least four weeks after a second dose of Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine.
Can you mix and match the vaccines?
For people who received either Pfizer-BioNTech or Moderna’s COVID-19 vaccine series, a third dose of the same mRNA vaccine should be used. A person should not receive more than three mRNA vaccine doses. If the mRNA vaccine product given for the first two doses is not available or is unknown, either mRNA COVID-19 vaccine product may be administered.
What should immunocompromised people who received the J&J/Janssen vaccine do?
The FDA’s recent EUA amendment only applies to mRNA COVID-19 vaccines, as does CDC’s recommendation.
Emerging data have demonstrated that immunocompromised people who have low or no protection following two doses of mRNA COVID-19 vaccines may have an improved response after an additional dose of the same vaccine. There is not enough data at this time to determine whether immunocompromised people who received the Johnson & Johnson’s Janssen COVID-19 vaccine also have an improved antibody response following an additional dose of the same vaccine.
What are the benefits of people receiving an additional vaccine dose?
CDC recommends the additional dose of an mRNA COVID-19 vaccine be administered at least four weeks (28 days) after a second dose of Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine.
What are the risks of vaccinating individuals with an additional dose?
There is limited information about the risks of receiving an additional dose of vaccine, and the safety, efficacy, and benefit of additional doses of COVID-19 vaccine in immunocompromised people continues to be evaluated. So far, reactions reported after the third mRNA dose were similar to that of the two-dose series: fatigue and pain at injection site were the most commonly reported side effects, and overall, most symptoms were mild to moderate.
However, as with the two-dose series, serious side effects are rare, but may occur.
Edit: Shortly after this piece was published, it was announced that it may be recommended that everyone gets a 3rd Booster shot. Official guidance has not been released yet, but we will have a post covering that information as soon as its available.
What to Do about Delta
It has been about 20 months into the COVID-19 pandemic and 16 months since McDonough County’s first cases. Throughout this time we have seen some fantastic gains in terms of hosting mass vaccination clinics and about 50% of our residents have at least one dose of vaccine, which is exciting news! Despite these victories, we still see an increase in COVID-19 cases both nationally and at our local county level. Now, with the new Delta variant, it is important to remember that the pandemic is not over, but evolving into new uncharted territories.
So how is Delta Different?
The Delta variant is a spike-protein mutation of the original SARS-CoV-2 virus that causes COVID-19. As you may remember from previous posts, spike-proteins are the spikes found on the surface of the virus, and in most pictures you have seen lately are depicted as red. Our immune system uses these proteins to identify which virus is attacking the body, and scientists have used this to help create our current vaccines. It’s not the first mutation, and Alpha, Beta, and Gamma variants have also been found throughout the United States.
In most ways, they are exactly alike, with similar symptoms of persistent cough, fever, loss of taste and smell, and other respiratory symptoms (Bernal et al., 2021). The main way they differ in transmissibility. The Delta variant has been proven to be more contagious, which will ultimately lead to more cases and more deaths. And as you would expect with a change in the spike-protein, there is some evidence that vaccines are less effective at preventing the spread of this new variant, though still effective at preventing serious illness and hospitalization.
Are the Vaccinated Vulnerable?
The rise of the Delta virus means that we may want to reconsider our safety measures. For the unvaccinated, the risk for catching and transmitting the disease has been high the whole pandemic, and CDC guidance strongly recommends safety measures of staying at home and wearing masks indoors for this group. Vaccinated people are still significantly less at risk for contracting COVID-19, and more importantly, the vaccine drastically reduces negative outcomes when a breakthrough case occurs. The best prevention method for against COVID-19, even the Delta variant, is to get vaccinated!
For the vaccinated, the CDC has been monitoring the situation closely, frequently updating their guidelines to ensure that lessening restrictions is not at the expense of safety. The CDC guidance for fully vaccinated individuals is less restrictive than for those who are unvaccinated.
Vaccinated people can enjoy the following:
- Activities with friends and family that are also vaccinated
- Domestic and International travel
- Unmasked outdoor activities
- Unmasked indoor activities in locations with low transmission, of which a map can be found here. Because of the Delta variant, the CDC recommends wearing a mask indoors in parts of the country with substantial or high transmission. Unfortunately, this does include McDonough County right now, so consider wearing a mask to indoor locations even if you are vaccinated until rates reduce.
The Delta variant has changed the landscape of the pandemic in certain ways, but fortunately many of the safety measures are the same: stay at home if you are ill, wear a mask as a courtesy to others, and most importantly get your vaccination. Hopefully with enough participation in these activities we can see a reduction in transmission and prevent more cases and deaths within our county.
Heat Advisory in Effect
A Heat Advisory is in effect until Thursday at 8pm. Heat index values of 100 to 105 expected this afternoon and evening, and again Thursday afternoon and evening.
Summer Bummers III: Fire Safety
Today’s summer preparedness topic is burns. No, not sunburns, though plenty of those happen as well. Summer has the highest frequency of severe burns, mostly due to outdoor activities. The US Fire Administration has put together some important safety tips on how to celebrate the summer holidays without a trip to the ER.
Grilling and Firepits
- Always grill outside to prevent both fires and smoke inhalation.
- Let the Grillmaster cook in peace! Keep a 3ft distance between the grill and any other objects or guests, especially kids and pets.
- Stay within line of sight of your grill or firepit, or really any open flame
- Make sure to light your grill after opening the lid.
- Clean your grill or firepit regularly, and empty out charcoal into a metal can (once cooled).
First, it is important to note that even legal fireworks can be very dangerous. Even a simple “sparkler” can become as hot as 1200°F. The safest way to enjoy fireworks is to watch them performed by trained professionals, such as the ones that will be hosted in Macomb for the 4th of July (information here). It is also important to note that there are fireworks that may be legal in other states, but illegal in Illinois, including bottle rockets and roman candles. For more statistics regarding fireworks hazards, see this interesting report from the Consumer Product Safety Commission: Fireworks Report 2018
Prevention is obviously preferred, but sometimes accidents happen anyway. For initial first aid of a burn, run the wound under cool water for 3-5 minutes. Then, wrap it up with a clean, dry cloth or sterile bandage. See a doctor if the burn is larger than your palm or with any sign of infection (pus, oozing, not fading after 2 weeks). Any burn that covers a critical part of the body, such as face, hands, feet or groin may need medical attention. Most importantly, signs of charring or black skin is a sign of 3rd degree burn, which will definitely need emergency care.
Summer Bummers Part II: Hydrate or Die-drate
Information adapted from the CDC
In the first part of our “Summer Bummers” series we discussed the hazards associated with exposure to heat. One heat-related illness, dehydration, was a big enough topic that we felt it deserved it’s own post. Dehydration can range from feeling slightly off and ill to a full-blown medical emergency, so it is crucial to know the signs before you venture out in the summer sun.
Why we need water
Water is crucial for body composition and performance of essential functions. Fun fact: the average human body is comprised of 60% water! This percent varies among body types, as children have a higher concentration of water than adults, and men have a higher concentration than women. Water can be found all throughout the body, even in less squishy parts like bones.
A more scientific answer for why we need water, it’s important for cellular function. Cells use water for transporting both nutrients and waste in a process called osmosis. Excess minerals, like sodium, potassium, and calcium will be removed from the body through water, either through sweat or urine. One of the wastes that cells can eliminate through water is excess heat, which is why we sweat during the summer or from vigorous exercise. Sweating too much, or merely not replacing the liquid we regularly lose due to urination and respiration, can cause dehydration.
Chronic dehydration can cause a slew of problems, including unclear thinking, mood change, constipation, and kidney stones. Dehydration also increases the likelihood of heat-related illness, as described in our last post. Fortunately, the signs of acute dehydration are rather easy to spot once you know them. The biggest sign that you are beginning to feel dehydrated is feeling thirsty. If your body is wanting water, drink it! Other, perhaps less obvious signs are:
- dark yellow and strong-smelling pee (see chart below)
- feeling dizzy or lightheaded
- feeling tired
- a dry mouth, lips and eyes
- peeing little, and fewer than 4 times a day
If you are feeling any of these symptoms, it’s a good opportunity to drink more water before it becomes more serious. Contrary to what you may have been taught, there is no set number for how many cups of water you should have per day to prevent dehydration. 6-8 cups per day may be a good estimate, but it is important to adjust this amount based on size, level of activity, external temperature and personal health variables (ex. diabetes, diarrhea, fevers, and other conditions require more water). Again: drink water if you are thirsty!
Water During an Emergency
All of this is easy enough on a normal, “blue sky” day, but what about when drinking water is scarce? Common disasters, such as floods, hurricanes or pipeline problems can limit the amount of available drinking water. The CDC recommends having at least 1 gallon of water per person in your emergency kit. If no stored bottled water is available, unscented chlorine at a concentration of 5-9% can also be used to help sanitize contaminated water. Filtering and boiling your water (instructions can be found here from the EPA) can also do in a pinch.
Remember, water is a vital nutrient you need year round, but especially during the hot months.
Hydrate, don’t die-drate, McDonough County!
Summer Bummers Part 1: Heat Hazards
Information adapted from weather.gov
Back in the winter we spoke about cold weather hazards, covering hypothermia and more. That winter weather feels so far behind us now, and with astronomical summer coming up and metrological summer well past, it’s time to talk about heat! Summer weather brings about its own host of hazards, but fortunately they are easy to prepare for. Today’s topic is specifically heat. How hot is too hot and what makes it dangerous? Let’s found out in the first part of our posts on “Summer Bummers”.
What is Excessive Heat?
We know that every summer is going to come with some uncomfortably warm weather that makes us want to turn on the air conditioning. However, from an Emergency Preparedness standpoint, only days that reach excessively high temperatures warrant an “excessive heat” advisory. An excessive heat advisory may be issued when the maximum heat index temperature is expected to be 100° or higher for at least 2 days without cooling off below 75° at night. An advisory can be escalated to a “watch” if the temperature is expected to be over 105° for two days, and a “warning” if these conditions are almost certain or are already in effect. The exact numbers can vary between locations, as some areas are more resilient to heat than others (think of Southern states, like Arizona, Nevada or Florida, compared to Alaska or Maine).
Less known than it’s opposite (hypothermia), hyperthermia is a condition where the body’s internal temperature is too high. This term applies to several different conditions that occur when the body becomes too hot: heat cramps, heat exhaustion, and heat stroke. Each of these differ in severity, symptoms, and best course of action.
- Heat Cramps
- Symptoms: Painful muscle cramps and spasms usually in legs and abdomen and Heavy sweating.
- First Aid: Apply firm pressure on cramping muscles or gently massage to relieve spasm. Give sips of water unless the person complains of nausea, then stop giving water. Seek medical attention if it persists over an hour
- Heat Exhaustion
- Symptoms: Heavy sweating, Weakness or tiredness, cool, pale, clammy skin; fast, weak pulse, muscle cramps, dizziness, nausea or vomiting, headache, fainting,
First Aid: Move person to a cooler environment, preferably a well air conditioned room. Loosen clothing. Apply cool, wet cloths or have person sit in a cool bath. Offer sips of water. If person vomits more than once, or if it persists more than an hour, seek medical attention.
- Symptoms: Heavy sweating, Weakness or tiredness, cool, pale, clammy skin; fast, weak pulse, muscle cramps, dizziness, nausea or vomiting, headache, fainting,
- Heat Stroke
- Symptoms: Throbbing headache, confusion, nausea, dizziness, body temperature above 103°F, hot, red, dry or damp skin, rapid and strong pulse, fainting, loss of consciousness.
- First Aid: Call 911 or get the victim to a hospital immediately. Heat stroke is a severe medical emergency and can be fatal! Move the victim to a cooler, preferably air-conditioned, environment. Reduce body temperature with cool cloths or bath. Use a fan if heat index temperatures are below the high 90s. A fan can make you hotter at higher temperatures. Do NOT give fluids.
Who is most vulnerable?
Anyone can be susceptible to hyperthermia and heat related complications. Long exposures, such as a full day at the pool or a sporting event will increase the odds. Strenuous activity will also increase the body’s temperature and make you more prone to hyperthermia. Some populations are more vulnerable and should take extra precautions:
- Young children- Similar to cold, their bodies are less able to adapt to heat than are adults. Hot cars are the biggest heat-related danger to children, and an average of 38 children die of hyperthermia every year from being left in cars.
- Older adults- Most heat-related fatalities are older adults, and the number of seniors dying from heat increase every year. Seniors that live alone or are otherwise socially isolated are particularly vulnerable (as evident in the 1995 Chicago Heat Wave).
- People with chronic medical conditions
- Pregnant women are also at higher risk- Extreme heat events have been associated with adverse birth outcomes such as low birth weight, preterm birth, and infant mortality, as well as congenital cataracts.
The best means of preventing heat related risks is to reduce time outdoors. Plan to stay inside on days with heat watches and warnings, and consider moving chores and activities that must be done outside to cooler parts of the day (morning and evening). If you must be outside, take occasional indoor breaks to reduce your temperature. Also, drink plenty of water, which we will cover in a future post, Summer Bummer Part II: Hydrate or Die-Drate!
Until next time, stay safe McDonough County