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Illustration for article titled Here Are the Side Effects to Expect from Your COVID Vaccine (and How to Deal With Them)

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You’ve probably heard about the COVID vaccines’ side effects, and by now are well aware that there is no “standard” reaction to the shots—everyone handles them differently. Still, it’s better to go into your appointment(s) armed with as much knowledge as possible—especially if it means preventing or reducing unpleasant side effects. Here’s what to know about dealing with the COVID-19 vaccines’ side effects both before and after your shot.

How common are COVID-19 vaccine side effects?

Before we go any further, we should note that experiencing side effects isn’t specific to the COVID vaccine: They can occur after a flu shot or other vaccination, and are a sign that your body is responding to the vaccine. Specifically, in the case of the COVID vaccine, that “your immune system is instructing your body to react in certain ways: it increases blood flow so more immune cells can circulate, and it raises your body temperature in order to kill the virus,” the World Health Organization (WHO) explains.

So, when someone experiences mild-to-moderate side effects following the COVID vaccine, it’s not uncommon for their doctors or family members to reassure them that not only is this normal, it’s also a good thing. It doesn’t mean that the vaccine is dangerous—it means that it’s doing its job.

But does that mean people who don’t experience side effects should be worried that their shot didn’t take? Well, no. “Experiencing no side effects doesn’t mean the vaccine is ineffective,” the WHO explains. “It means everybody responds differently.” It also means that as great as it would be to be able to prevent or control our COVID vaccine side effects, our body’s going to do its thing.

There are, however, ways to reduce the discomfort of the side effects (which we’ll get to in a minute), but Dr. Joel Kammeyer, an infectious disease specialist and assistant professor at The University of Toledo College of Medicine and Life Sciences, wants us to put things in perspective when we think about our chances of experiencing some type of post-vaccination pain or discomfort.

“We should recognize that more than 80% of study participants experienced side effects in the vaccine trials, most of which were fatigue and injection site reactions,” he tells Lifehacker. “Side effects are the norm—not the exception.”

What are the potential side effects of the COVID-19 vaccine?

According to the CDC, the most commonly reported side effects from the COVID-19 vaccines resolve after a few days, and include:

  • Swelling, redness and pain at injection site
  • Fever
  • Headache
  • Tiredness
  • Muscle pain
  • Chills
  • Nausea

Though extremely rare, some people do have a severe allergic reaction—also known as anaphylaxis—to the COVID vaccine. If this appears to be the case, call 911 and seek immediate medical attention.

Preparing for the vaccine

The only thing vaccinated people enjoy more than recounting their inoculation experience—including any side effects—is giving yet-to-be vaccinated folks advice on preventing or dealing with side effects. But with so many pointers floating around, how do you know which to listen to and which to ignore?

Yes, the Centers for Disease Control and Prevention (CDC) does have some guidance on this—some being the operative word—leaving lingering questions what we actually can control in terms of COVID vaccine side effects. Here’s what we know so far, courtesy of the CDC and two infectious disease specialists.

Is it OK to take pain relievers before your appointment?

One thing the CDC is clear about is that we should avoid over-the-counter medicines—like ibuprofen, aspirin, acetaminophen, and antihistamines—before getting vaccinated for the purpose of trying to prevent vaccine-related side effects, including allergic reactions. The reasoning is that at this point, we’re still not sure how these medications might affect the vaccine’s effectiveness. Check with your doctor if you take any of these medicines as part of a regimen.

Does being super-hydrated prevent side effects?

As humans, we can feel helpless pretty easily—especially in health-related situations. So when in doubt, we start doling out advice to ourselves or others, which typically includes a recommendation to stay hydrated. Our quest for ways to prevent side effects from the COVID-19 vaccine is no exception.

In fact, the EMT who gave me my second dose of the vaccine instructed me to drink as much water as I possibly can “without being uncomfortable” to reduce the severity of any side effects. While it makes sense being dehydrated while experiencing side effects might make someone feel worse, is pumping ourselves with water before and after our vaccine going to provide us with some type of liquid protection shield? Kammeyer is not convinced.

“Staying well-hydrated is a good idea in general, but this is unlikely to prevent side effects,” he says. “Maintaining hydration certainly doesn’t hurt anything, but I would have no expectation that side effects could be prevented or limited by staying hydrated.”

The CDC does mention that having a beverage or snack may help prevent fainting after receiving a vaccine, but again we’re talking about a normal level of hydration (so no need to go overboard).

Is there an ideal time to schedule your appointment?

Most of the country isn’t yet in a place where we can schedule COVID vaccines like any other medical appointment, choosing a time and day that works best for us. Anyone who has ever gone through the online booking process knows how quickly those appointments go, and how little choice you usually have in their timing.

But let’s say you did have the option. Is there a certain time of day when people experience fewer side effects from the vaccine? Dr. Keith Armitage, an infectious disease specialist at University Hospitals in Cleveland, where he is also the medical director of the Roe Green Center for Travel Medicine & Global Health, says that he’s “not aware of any time of day that would be advantageous.”

Similarly, Kammeyer says that “nothing would be gained” by scheduling your vaccine appointment at a certain time of day in an attempt to prepare for or lessen the side effects. “We know from the original clinical trials for the vaccines that many side effects occur within 24 hours, but others may not occur for as long as a week,” he explains.

Having said that, if you’re concerned that you’ll feel fatigued after the dose, you could always schedule the shot for the end of the day, so you won’t have to worry about having to go back to work. And speaking of which…

Should you arrange to take a sick day the day after your appointment(s)?

Recognizing that not everyone has the privilege of being able to take a paid sick day to deal with potential side effects from a vaccine (or, ever), is doing so a good idea for those with that option?

According to Armitage, a significant number of people don’t feel like working after their second dose of either the Pfizer or Moderna vaccine. In fact, he says that it’s common for those in the medical profession to schedule their vaccine before a day off. “About one-third of people get a fever, and maybe half of those do not feel like working, so it is reasonable to plan [to take a sick day],” Armitage explains.

Dealing with side effects after getting vaccinated

So that’s what we can (and can’t) do to prevent side effects from the COVID-19 vaccine. But what about if you’re part of the 80% of people who are experiencing some type of pain or discomfort? Here’s how to handle some of the most frequently reported.

Arm pain and soreness

As one of the most common side effects of the COVID-19 vaccine, you may be wondering what you can do to help reduce pain or soreness in the arm that received the shot. The CDC recommends two things:

  1. Applying a clean, cool, wet washcloth over the area
  2. Using or exercising your arm

But what about massaging your arm at the injection site? This has been suggested as a way to deal with pain from other types of vaccines, but could it help with this one? Here’s Kammeyer’s take:

There are no official recommendations regarding massaging the injection site to reduce arm pain. This was not studied in the vaccine trials, but it is very unlikely that massaging the injection site would make a difference to the efficacy of the vaccine. Moving the arm frequently after receiving the injection may be more helpful than massage, but massage is unlikely to cause harm. If it helps, I would not object.

Fever

If you end up with a fever after your COVID vaccine, the CDC recommends drinking plenty of fluids, and “dress[ing] lightly.” So does that mean being exceptionally hydrated before your vaccine could have prevented this side effect?

Armitage doesn’t think so, noting that it’s just standard when treating fever. “Anytime you have an illness with any kind of fever, it is good to stay hydrated, because fever can increase your loss of fluids,” he explains. “I cannot think of any other reason why fluids would help [as a way to prevent vaccine side effects.]”

Fatigue

There’s a lot going on in your body post-vaccination, so it’s not surprising that fatigue is another common side effect. But is it better to listen to your body and sleep when you want to, or get through the rest of the day and stick to your usual sleep schedule? That’s up to you.

“The fatigue will come and go regardless,” Kammeyer explains. “The proper recommendation here would be individual-dependent. Naps are certainly fine, and pushing through and maintaining a typical sleep routine is also fine—whatever works for the individual. In a few days, the fatigue will be gone regardless of what you do.”

But what about the conventional wisdom that resting when we’re not feeling well is necessary in order to give your body the chance to heal? Does that mean that if someone is feeling fatigued after their vaccine and they don’t rest when they’re tired, it could make the vaccine less effective?

Nope. According to Armitage, continuing about your day without a nap will not decrease vaccine responsiveness, or pose a threat to a person’s overall health. “There is no harm in pushing through, if that is what people want to do,” he explains. “There is no long-term downside—although people may feel more tired in the short-term.”

Lumps

While we’re on the subject of side effects, this seems like a good time to mention that if you develop a new lump or tenderness under your arm, near your armpit, or on your neck after receiving the COVID vaccine, there’s no need to panic. It’s probably a swollen lymph node, and another way for our bodies to let us know that it’s getting ready to fight off what it perceives as SARS-CoV-2.

The CDC reports that 11.6% of vaccine recipients experienced swollen lymph nodes after their first COVID vaccine dose, and 16% after their second, noting that in most cases, swelling appeared between two and four days after vaccination. Physicians have observed that the lumps form on the same side of the body where a person received their shot.

“It’s a normal occurrence while your body is building an immune response to fight the virus,” Dr. Holly Marshall, division chief of Breast Imaging at University Hospital Cleveland Medical Center explains in a statement. “The swelling may be a sign that the body is making antibodies in response to the vaccine as intended.”

Is it safe to take pain relievers, and if so, what kind?

Yes, it’s safe to take pain relievers to deal with arm pain, fever, muscle aches and other side effects—but there’s some nuance. According to the CDC, it’s fine to take over-the-counter medicines—like ibuprofen, acetaminophen, aspirin, or antihistamines—to help manage side effects, provided “you have no other medical reasons that prevent you from taking these medications normally.” That same paragraph also includes the usual “talk to your doctor” language regarding taking any of the OTC medicines for vaccine side effects, which is a good idea if you have any questions.

While the CDC gives the green light to take ibuprofen (e.g. Advil or Motrin), acetaminophen (e.g. Tylenol), or aspirin (e.g. Bayer) for vaccine side effects, many people have been instructed by their doctors—or the person administering their vaccine—to stick with Tylenol.

You may have also seen headlines over the past few months indicating that taking non-steroidal anti-inflammatory drugs (NSAIDs) after receiving the vaccine could dampen the response of a person’s immune system. (Both ibuprofen and aspirin are NSAIDs.) So does that mean no Advil, after all?

Most of those news stories were reporting on a recent study published in the Journal of Virology that found that using NSAIDs to treat COVID-19 may dampen the inflammatory response and production of protective antibodies in mice. Though the authors note that more research needs to be done in order to determine whether the same response could occur in humans, their findings “raise the possibility that NSAIDs may alter the immune response to SARS-CoV-2 vaccination.” But again: this is early research just done in mice so far.

According to Armitage, people who experience side effects following their second dose of one of the mRNA vaccines (i.e. Pfizer or Moderna) can safely take NSAIDs or acetaminophen.



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