By Karen Kier
ONU HealthWise Pharmacy
As COVID-19 vaccine becomes available and more people are eligible, it might be a good idea to review the prevaccination checklist that is recommended by the Centers for Disease Control and Prevention (CDC). 

It is important to understand why these questions are relevant to the overall success of the COVID-19 vaccine. The answers allow the professionals to assess if the vaccine is appropriate for you or if they need to take extra precautions when administering the vaccine such as the potential for an allergic reaction.

The CDC provides additional guidance to healthcare professionals when evaluating the answers to the prevaccination checklist.  So it is vitally important to be honest on the screening forms for the best results. 

The first question on the form is “are you feeling sick today?”  If you answer yes to this question, it will prompt the professionals to ask more questions about how your feeling. 

Symptoms of COVID-19 may prompt additional testing or defer the vaccine for that day. If you have nonCOVID-19 symptoms that are mild, you could be eligible for the vaccine. Please let a healthcare worker determine the right timing of the vaccine if you are not feeling well. Persons who have had COVID-19 are eligible and should still get the vaccine. The screening form asks questions to further clarify timing and treatment if you had a COVID-19 infection. 

The second question is “have you received a dose of COVID-19 vaccine?”. This is important because you should have a record of vaccination. Everyone should get a card when getting a COVID-19 shot plus it is recorded in an immunization recordkeeping system. Ideally, it is best to get the same manufacturer’s vaccine both times.

This is why we ask. If someone would get two different manufacturers, then the CDC recommends not to give a third shot but considers the two shot series complete. Keep your card and take it with you for the second shot. The screening form will ask you to identify which manufacturer you received for the first dose.

The third question refers to if you have ever had an allergic reaction including a severe reaction where you became short of breath, required an epinephrine pen (Epi-Pen®) or a trip to the hospital, or had your lips, tongue, or throat swell.

The current vaccines contain PEG (polyethylene glycol) that can be found in laxatives and colonoscopy preparation products. The form asks about allergies to polysorbate as well. Polysorbate is an inactive ingredient found in many products including beauty and personal care. Polysorbate helps keep oil and water mixed together.

Some individuals who react to polysorbates may react to PEG so that is why the CDC form asks this question. Individuals with listed allergies may still get the vaccine after being evaluated by a healthcare professional.

Those with a history of allergies to PEG or polysorbates should be observed for at least 30 minutes after receiving the vaccine. On January 21, 2021, the Journal of the American Medical Association published an article detailing the cases of allergic reaction to the Pfizer vaccine.

The report indicates how rare this reaction is and how each patient was successfully treated. Some patients have a fainting episode after receiving the shot that is called a “vasovagal” reaction. This is not an allergic reaction but an episode often related to the needle or just getting a shot. Someone who has a vasovagal reaction can receive the second dose of the vaccine.  It is important that your healthcare workers know that you have this reaction prior to getting any additional vaccines. 

Another question is if you have “a bleeding disorder or take blood thinners (anticoagulants)?”  This does not have anything to do with the actual COVID-19 vaccine but rather bleeding or bruising when given the shot. This information helps the healthcare worker prepare for the shot so they can reduce bleeding after the shot. You can get the vaccine!

The screening form will ask about a “weakened immune system from either diseases or medications” such as steroids or biologics. You could still be eligible for the vaccine and most individuals would be eligible.

This information helps the healthcare professional make better decisions. If you have questions about your medications and the vaccine, contact your pharmacist for help.  The ONU HealthWise team can help identify if your medication can weaken the immune system. 

The checklist will ask you if you have received any vaccine in the last 14 days. Why is this important? As with most data on the COVID-19 vaccine, the information is based on the vaccine study information. The form asks because we currently do not know about giving the COVID-19 vaccine with other vaccines because it was not studied.

Could another vaccine change how the COVID-19 vaccine works? There is not enough information to answer that question so at this point, avoid all other vaccines if possible for at least 14 days. In most cases, it will be more important to get the COVID-19 vaccine two shot series (21 or 28 days) first then get any other vaccines as indicated by your healthcare professional.  

The CDC site updates as new information is available and is a good place to check (www.cdc.gov). Your local healthcare professionals can help with any questions and the pharmacy team at ONU HealthWise is available at 419-772-3784.