The COVID-19 Vaccination Process

We’ve all be wondering: when will this pandemic be over? What will break the thrall of this virus? To some degree, it is time.

To another degree, it is the wonderful and fast development (through smart science and hard work) of vaccines that will prevent severe illness and stop the spread of the deadly COVID-19 virus.

Waiting for my vaccination turn

As soon as vaccines started getting approval in the United States, I eagerly anticipated the shot. However, I understood that prioritizing older adults (especially 65 and older) was important due to the heavy toll of the virus, and was happy to wait my turn.

While I waited for prioritization to reach people with chronic conditions (like autoimmune and immune-compromised), I also tuned into any guidance from the rheumatology community and my doctor specifically. For the last year, I have stayed in touch with my rheumatologist via regular telehealth appointments.

Recovering from COVID-19

Thankfully, my condition stayed relatively stable during the pandemic with no major crises except for (having COVID last spring, which turned out okay because I had a mild case). But, I wanted to stay in touch with my doctor to hear any news or developments on the vaccine or guidance for autoimmune patients.

Helpful guidance by the ACR

It took time for a thoughtful review of the known science, but the American College of Rheumatology (ACR) released their guidance on vaccinations for rheumatology patients.

Many unanswered questions

I read it carefully and appreciated that they were thorough, while also acknowledging that there are still a lot of unknowns. For instance, will the vaccine work as well on people who are immunocompromised? Will the vaccine be impacted by immunosuppressive medications? Will booster shots be needed? More research and time are needed to track patients and study the vaccine on autoimmune and immunocompromised people as, unfortunately, the original trials need not track these patients.

However, the major takeaway was the recommendation that autoimmune patients be vaccinated as soon as possible because some protection from the dangerous virus is better than zero. And also, any flares that may spike with the vaccine should be temporary. Bottom line: the risk from the vaccine is less than going without it and potentially suffering serious health damage (or death) from the virus.

Checking in with my rheumatologist first

Even so, I didn’t sign up for the vaccine before checking with my rheumatologist as he knows my personal health history and issues very well. He had no reservations about me getting vaccinated and just asked that I keep him posted on how I was doing. For me, the reward of increased safety from the virus (even if the vaccine is less effective on immunocompromised people) was worth the risk of a temporary reaction or flare.

Navigating the vaccination process

I don’t want to get into the details of my complaints with the vaccination rollout. But generally, it has been more chaotic and challenging than I would have liked. Some states prioritized people with at-risk conditions quickly, some later (like my locality), and some not at all.

Another challenge has been getting my primary caregiver (my husband, Richard) a vaccine, as we had yet not had any luck. It’s important for him to get vaccinated not just for his safety, but for mine because I am immunocompromised and we don’t know that the vaccine will have maximum effect for me.

Scheduling the first vaccine appointment

Getting my first vaccine appointment was extremely difficult. The technology did not work well. In fact, we thought we had failed and were surprised when I received an appointment confirmation email several hours later. I scared the wits out of Richard when I saw the email in my spam box and started shouting! Hopefully, the technology is improving and locations for shots are increasing in such a way that it will get easier.

The other challenge was that we had to pick a location a half hour away, which meant Richard taking me in my manual wheelchair in a taxicab to ensure we could get to the appointment. The process was not easy and only available to us because we had the time (sick leave) and money to make the trip.

Scheduling around my biologic injection

Once we reached the site, getting the actual vaccine was easy. I had to show my ID, insurance card (there is no charge for the vaccine, but insurance pays for performing the injection), and the confirmation email that included a code. Then into a quickly moving line.

I didn’t have to provide documentation of why I was prioritized. I also didn’t have a choice about which vaccine, but was fine to receive the Pfizer. (This may be changing shortly as I am seeing some places offering choices now that three vaccines are approved.) The nurse asked about allergies and then did a quick jab. There was a 15-minute wait to ensure no bad reaction and I booked the second appointment before heading back home.

Postponing the biologic turned out okay for me

For my second shot, I checked back in with my doctor because it happened to be scheduled on the same day as my bi-weekly biologic injection. He instructed me to delay my biologic 2-3 days in the hopes that the medication would not suppress the vaccine.

We returned to the same site for the second jab and all went smoothly. On the day of the first vaccination, I was having a bad day and didn’t feel well (fatigue and headache); on the second shot, I was fine. (I chalk it up to having a bad health day on the first shot, just an unlucky coincidence.)

Luckily, my rheumatoid arthritis has been feeling relatively okay so postponing my biologic turned out fine. I did take 2 extra milligrams of prednisone for a couple of days, but that wasn’t much for me.

I feel a bit of relief

I’m feeling relieved to be vaccinated, but don’t expect any big changes in my life yet. I will continue to mask, socially-distance, and practice the measures to keep myself and others safe. Gradually as more vaccinations happen, I’ll be able to see more people safely again in person.