I really don’t want to put a dampener on all this excitement, but I feel that we need to remind our patients that even though they may have had their first COVID-19 vaccine dose, they are not immune.
There is currently no conclusive evidence that one or two doses can stop a vaccinated patient from passing on the virus. Give your vaccinated patients a simple explanation of how the immune system works and ask them to just pretend they haven’t had the jab.
Patients have been hibernating for almost a year and now they feel invincible, which is not surprising at all. Since they first heard about the approval of the first COVID-19 vaccine in December 2020, they have been waiting eagerly to be invited for their jab appointment.
When the day finally arrived, they prepared with anticipation to attend. They had some exciting news for family and friends: “I’m getting my jab today,” which may have been the first update they’ve been able to share for months.
They had their vaccine, and everything probably went smoothly. They may have anticipated some moderate side effects, but only felt a heavy arm – which may have been a psychological reaction as they wanted an excuse not to do the dishes that evening!
It takes up to four weeks after vaccination for their body to build protection against the virus, so they waited but started planning. Meanwhile, they saw others starting to meet up again. They had been longing to go out and see loved ones. They have had the vaccine now, so they must be safe from the virus? No.
As a pharmacist, you are in a position to reach out to patients and remind them that, although we need to celebrate the fact that these incredibly effective vaccines have been developed, there are rare cases of people becoming infected COVID-19 after being fully vaccinated.
This is how I explain the immune system to my patients in simple terms: When you have your first vaccine dose you start producing troops of B cells, which make antibodies. These cells are short-lived.
Next, your immune system will activate an army of T cells, these are soldiers who are trained to identify a particular pathogen and kill it. Some of these are called “memory cells”, which can survive for a longer period. We do not yet know the lifespan of memory T cells produced in response to the COVID-19 vaccine.
When patients receive their second vaccine dose, the booster, there are already enough short-lived B cells, so your body can concentrate on the mass production of T cells. After your booster dose, you end up with a larger and stronger army of T cells, and memory T cells, and to some extent a larger troop of memory B cells.
But even with two doses of the COVID-19 vaccine, there remains a risk of transmitting the virus to others. So, please tell your patients to get their jab, then go home and stay safe, saying: “Don’t fool yourselves, just pretend you never had the vaccine.”
Shilpa Patel is a GP pharmacist and partner at Brighton Health and Wellbeing Centre, where she leads their COVID-19 vaccine programme