COVID-19 Post-Vaccination Symptom Protocols

• In today’s Recommendations for Industry, we discuss what to do if a person exhibits symptoms after receiving the COVID-19 vaccine. Read More
• The Super Bowl is this Sunday. Please do not “go crazy”; to prevent a superspreading event and continue our decreasing trends of COVID-19, remind your workforce of the importance of practicing social distancing and wearing masks.
• The FDA is scheduled “to discuss the request for EUA for a COVID-19 vaccine from Janssen Biotech” – the Johnson & Johnson vaccine.
• The United Kingdom has put $9.6M into a study that will look into the effects of mixing vaccine types for those vaccines that require two doses with hopes that it may create a more flexible immunization program. Despite this, in the U.S., TAG and the CDC do not recommend this until further studies are conducted.
• A second study (in pre-print) from the UK finds that the B117 variant may be “35% more deadly than the standard virus” which echoes the UK government’s Jan. 22 report that found “the variant may be 30% more deadly.” However, as we discussed before, these findings are based on limited studies and the UK government warns that more data is needed.
• A recent study from Ontario, Canada, finds that dialysis patients are five times more likely to be infected by COVID-19 and almost four times more likely to die from COVID-19.
• The CDC is tracking the number of identified variant cases throughout the U.S. However, these numbers may be underestimated.
• A recent Science study, that analyzed over 10 million cell phone’s mobility data in the U.S., has found that “as of October 2020, individuals aged 20-49 are the only age groups sustaining resurgent SARS-CoV-2 transmission with reproduction numbers well above one, and that at least 65 of 100 (65%) COVID-19 infections originate from individuals aged 20-49 in the US.”
• A recent preprint finds that the AstraZeneca-Oxford University COVID-19 vaccines provides strong protection after the first of two doses. This may allow the spacing out of the second dose in a more manageable way.
• In order to travel to/from many locations, a negative COVID-19 test result is needed. There has been an increase in fake COVID-19 documentations; both for tests and also “fake vaccination documents.” Ultimately, this may create a very real problem for travel.

COVID-19 Post-Vaccination Symptom Protocols

Q. With some people having viral symptoms following a COVID-19 vaccination, how do we know if the person has the virus or is reacting to the vaccine? And when should they return to work?

A. Because we cannot differentiate between a vaccine reaction and the actual disease, TAG recommends that businesses take a cautious approach, assuming the symptoms are COVID based, for the protection of other employees and the business as a whole. That is:

• Any employee who has symptoms associated with COVID-19 should stay home for 10 days following system onset even if the employee was recently vaccinated and suspects that the symptoms are due to the vaccine.
• If symptoms following a vaccination resolve sooner without the aid of medication, the employee can return to work sooner if a COVID-19 PCR test is taken and returns negative.
• Other employees who experience COVID-19 symptoms but were not recently vaccinated may return to work when symptoms have resolved for 24 hours if it is at least 10 days post symptom onset or they have a negative test/medical assessment.

Additionally, because there may be some operational impact if a high percentage of your employees would have post-vaccination symptoms, TAG recommends that employee vaccinations be staggered as much as possible. 

The country overall is doing very well in reducing cases, but we are not out of woods when it comes to the variants – and, given that community case rates are still relatively high in many parts of the US,  bringing back symptomatic people who may, indeed, have the virus can increase the risk of workplace transmission. As vaccination rates continue to increase, we expect to see a slow and steady reduction in the national case rate.  Right now, we are in a period of this pandemic where more infectious variants are becoming the predominant strains while vaccination rates (and some natural immunity from previous infections) are increasing.  We are closely watching for rapid surges in cases over the next month that could signal the impact of these new (B.1.17, B.1.153, P.1, and others) emerging variants.

• In Wednesday’s Recommendations for Industry, we discussed TAG’s COVID Risk Matrix and some encouraging trends. Read more here.
• OSHA’s new COVID-19 protection guidance document – and what it means to your business. [Read more]. 
• Some people may still test positive after getting a COVID-19 vaccine. Why is that? This can be due to a few different reasons including:
  • There is a lag between vaccination and protection.
  • Vaccination prevents most, but not all disease.
  • Vaccination prevents disease, but infection, it's unclear.
  • Vaccines do not work retroactively – if you have been ill before and didn’t know it, you may still test positive!
  • The variant question
• Recent studies, reported by CIDRAP, are finding that the new COVID variants may create worry about vaccine resistance. “Overall, the [Pfizer] vaccine is likely to be effective against B117, though its efficacy is somewhat affected. Though they found wide variation among individuals, on average B117 required a twofold increase in serum antibody concentration to neutralize the virus. However, when researchers added the E484K mutation, substantially higher antibody levels—on average, a 10-fold increase—were needed for neutralization.”
• Globally, 10 more countries reported B117 (UK Variant) cases, raising the total to 80 across all six of the WHO's regions. For B1351, 10 more countries have confirmed cases, putting that total at 41 across four WHO regions. And for P1, two more countries detected cases, raising the number to 10 across four of WHO's regions.
• To address vaccine equity and distribution, the Biden administration plans to begin shipping 1 million COVID-19 vaccines weekly to pharmacies.
• In Monday’s Recommendations for Industry, we discussed OSHA’s new COVID-19 protection guidance document – and what it means to your business. [Read more]. 
• The FDA “has placed all alcohol-based hand sanitizers from Mexico on an import alert to help stop products that may be in violation from entering the U.S. until the agency is able to review the products’ safety. The agency has seen a significant number of hand sanitizer products from Mexico that were labeled to contain ethanol (also known as ethyl alcohol) but tested positive for methanol contamination or 1-propanol.” Read more here.
• Click here to access FDA’s list of unapproved hand sanitizers in addition to tips for consumers for what to look out for when purchasing hand sanitizers.
• AstraZeneca’s vaccine will move forward in the E.U. with the drug-company supplying “an additional nine million [doses] by March.”
• Last Friday, we discussed Determining Your Employee Vaccination Strategy in the Recommendations for Industry.
• Johnson and Johnson’s COVID-19 vaccine demonstrates 72% efficacy in the U.S.; however, its efficacy dropped to 57% in South Africa where the 501Y.V2 strain of COVID-19 has fueled a second COVID wave.
• In United Kingdom trials, Novavax’s vaccine shows 89% efficacy. A small study in South Africa indicates this vaccine may be less effective against the South African variant