Halloween and Food Allergies

*The answers to these questions and the information available is constantly changing. We will make updates accordingly as soon as possible. We appreciate your understanding and patience in this fluid situation.*

Who is eligible for the vaccine(s)?

• The Pfizer vaccine has been approved for ages 16 and up. The Moderna vaccine has been approved for ages 18 and up.

How do the vaccines differ?

• Pfizer: 2 injections 21 days apart. 95% efficacy measured starting from 7 days after the second dose was administered.
• Moderna: 2 injections 28 days apart. 94.1% efficacy measured starting from 14 days after the second dose.

What are the most common side effects?

• Pain at the injection site, fatigue, headache, muscle ache, joint aches. Less commonly fever. These are signs of the immune system being activated. They are not a sign that the vaccine is unsafe.

What about those people who had severe allergic reactions to the Pfizer vaccine?

• There have been a handful of reports of severe allergic reaction after receiving the Pfizer vaccine. This was not seen in the clinical trial, and not all the details are known at this time. Locations administering the vaccine must have appropriate medical treatment to treat immediate allergic reactions. No such reports have been made with the Moderna vaccine.

Can I get sick from the vaccine(s)?

• There is no active virus in the vaccine that could make somebody sick. The vaccine uses mRNA to teach our immune systems to recognize and protect against COVID-19. To learn more about mRNA vaccines please see the CDC website.

Who should not get the vaccine(s)?

• Those who have a known history of severe allergic reaction to any component of the vaccine, or a history of severe reaction to the first dose of the vaccine.

Will I have a choice between the vaccine I get? If so which one should I choose?

• At this point, we expect that most people will not have a choice between which vaccine they receive. We recommend people accept whatever vaccine is available to them.

Will AACPC have the vaccine(s)?

• No, AACPC does not expect to receive any vaccine to administer. There are several sites in Colorado that have ultra-low temperature freezers required for Pfizer’s vaccine who will help administer and distribute the vaccine. We are unsure of how vaccines will be administered to the general public, but expect this information to be available in the next few weeks.  We will be updating this post as we learn more.

Who will be vaccinated first?

• Frontline health care workers who have direct contact with COVID-19 patients as well as long-term care facility staff and residents will receive the vaccine first. Next moderate-risk health care workers and responders will receive the vaccine, followed by higher-risk individuals and essential workers, and finally the general public.

How long does protection last?

• It will take time to answer this question. It is not currently known how long immunity will last.

Once I have been vaccinated, can I go back to “normal”?

• It is unknown if either vaccine prevents asymptomatic infection. It is not known if vaccinated people can transmit the virus if they become infected but don’t themselves develop symptoms. Therefore, we recommend continuing to wear a mask and practice social distancing until more is known.

I have already had COVID-19 infection, should I still get the vaccine?

• Because there is evidence that immunity may not be long-lasting, the current recommendation is that all persons, once eligible, receive the vaccine.  We do recommend that if you have current or active COVID-19 infection, that you wait until after the recommended isolation period to receive the vaccine.

Resources:

https://www.cdc.gov/vaccines/covid-19/index.html

https://covid19.colorado.gov/vaccine

What is an E-cigarette

Electronic cigarettes (e-cigarettes) first entered the United States market in 2006 and were originally marketed as a tool for traditional cigarette users to use as a harm-reduction product and aid in smoking cessation.  Since that time, they have gained popularity in a wide variety of users, including adolescents and individuals who had never smoked cigarettes.  E-cigarettes are electronic devices that consist of a power source, heating element and reservoir for the e-liquid.  The e-liquid in typically made of 3 components which include a solvent in the form of glycerin or propylene glycol, flavoring and nicotine. In an e-cigarette, this liquid is heated and an aerosol is produced which is inhaled and exhaled or “vaped”. E-cigarettes come in a variety of shapes and sizes and range from looking like regular cigarettes, pipes to USB flash drives and pens.

E-cigarette safety

Unfortunately the safety of e-cigarettes when it comes to long-term health effects is largely unknown.  While the solvents and flavors used in e-cigarettes are generally safe for oral consumption, the safety of these once aerosolized in unknown. Chemicals found in aerosols of e-cigarettes are known toxins or carcinogens and include formaldehyde, acetaldehyde, acetone, acrolein, benzene, toluene, and metals including nickel, copper, zinc, tin, lead, chromium, manganese, arsenic. In vitro and animal studies have found evidence of cell damage, cell death, inflammation and impaired ability to fight bacterial and viral infections. It is known that nicotine is a toxic substance which raises blood pressure, increases heart rate and risk for cardiovascular disease.

E-cigarette use and adolescents

There has been a steady increase in e-cigarette use in middle and high school adolescents over the past decade.  Based on the 2020 National Youth Tobacco Survey, 19.6% of high school students and 4.7% of middle school students reported current use of e-cigarettes.  Nicotine does have effects on the adolescent brain and can alter attention, learning, mood, impulse control and future addiction tendencies.  JUUL is a popular brand of e-cigarette in this age group and contains a high level of nicotine.  A single JUUL pod contains as much nicotine as 20 cigarettes as it uses nicotine salts which allows high levels of nicotine to be inhaled with less irritation. Many adolescents who use e-cigarettes report respiratory symptoms including cough and phlegm production and have an increased prevalence of asthma and chronic bronchitis. It is unknown whether this is due to chronic airway inflammation or increased susceptibility to infection. Some to the chemicals and flavors in e-cigarettes are known to be associated with respiratory disease and irritation.

Asthma and e-cigarettes

The safety of use of e-cigarettes is asthma patient’s remains unclear.  There is some data from a large federal government telephone survey of adults.  This data was analyzed and results were published in the BMC Pulmonary Medicine.  It was found that approximately 11% of e-cigarette uses reported having asthma as compared with 8% in those who had never used.  People who were current e-cigarette users were 39% more likely to self-report having asthma when compared to non-users.  Individuals who used e-cigarettes some days were 31% more likely and daily users 73% more likely to report asthma when compared to non-users.  The same data was analyzed and published in the American Journal of Preventative Medicine and similar numbers were found for chronic bronchitis, emphysema and COPD. The data appears to be even worse for individual who smoke traditional cigarettes and use e-cigarettes in combination.

EVALI (e-cigarette or vaping product use associated lung injury)

A serious complication of e-cigarette use is EVALI (e-cigarette or vaping product use associated lung injury).  There were over 2,000 suspected cases of this severe lung disease reported by the CDC in 2019.  The majority of patients had respiratory, gastrointestinal and constitutional symptoms which quickly progressed to severe acute lung injury. Asthma was reported as an underlying condition in 30% of these patients.  In the majority of cases, modifications had been made to the e-liquid by the user or manufacture or both.  Cannabidol, tetrahydrocannabinol (THC), medium-chain triglycerides and vitamin E acetate were often found in these cases.

Resources

J Allergy Clin Immunol. 2020 January:145(1): 97-99. Doi:1016/j.jaci.2019.11.001

www.aaaai.org/contitions-and-treatments/library/allergy-library/electronic-cigarettes-allergy-asthma

www.hopkinsmedicine.org/news/newsroom/news-releases/vaping-increased-offs-of-asthma-and-copd

www.uptodate/contents/vaping-and-e-cigarettes

www.lung.org/quit/quit-dmoking/e-cigarettes-vaping/impact-of-e-cigarettes-on-lungs

Centers for Disease Control and Prevention Office on Smoking and Health