Before Your Appointment: Recommendations from our Vaccine Nurses

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You finally got your vaccine appointment—awesome! So, now what?

As COVID-19 vaccine supply increases in Washington State, you will begin to see a lot more opportunities for people to schedule an appointment. However, with increased supply also comes more advice about how best to prepare your body before your vaccine appointment.

While some advice may be helpful, you may also begin to find suggestions circulating online, including some with little or no research backing them up. So, what’s credible and what’s not? Below is a helpful list of tips and reminders for the days leading up to your vaccination appointment—all of which come straight from the CDC and our vaccine clinic nurses.

Talk to your doctor about the vaccine

Before you make a vaccine appointment, be sure to talk to your doctor if you have concerns. Also, those with a history of severe allergic reactions (anaphylaxis) to vaccine or injectable (intramuscular or intravenous) medication should consult with their health provider to assess risk prior to receiving the COVID-19 vaccine.

Don’t get a COVID-19 vaccine at the same time as other vaccines

Wait at least 14 days before getting any other vaccine, including a flu or shingles vaccine, after you get your COVID-19 vaccine. If you get any other vaccine first, wait at least 14 days before getting your COVID-19 vaccine. This is because there is currently limited information on the safety and effectiveness of getting other vaccines at the same time as a COVID-19 vaccine.

As more information becomes available, this recommendation may change. Your healthcare provider can help you decide the best vaccination schedule for you and your family.

Consult your doctor if taking medication for underlying medical conditions

For most people, it is not recommended to avoid, discontinue, or delay medications for underlying medical conditions around the time of COVID-19 vaccination. However, your healthcare provider should talk to you about what is currently known and not known about the effectiveness of getting a COVID-19 vaccine when taking medications that suppress the immune system.

If you have questions about medications that you are taking, talk to your doctor or your vaccination provider.

Don’t take a pain killer beforehand to prevent vaccine-related side effects

It is not recommended you take over-the-counter medicine, such as ibuprofen, aspirin, or acetaminophen, before vaccination for the purpose of trying to prevent vaccine-related side effects. It is not known how these medications may affect how well the vaccine works.

However, if you take these medications regularly for other reasons, you should keep taking them before you get vaccinated. It is also not recommended to take antihistamines before getting a COVID-19 vaccine to try to prevent allergic reactions.

If you currently have COVID-19 or if you’ve been exposed recently—WAIT!

If you have tested positive for COVID-19 or been exposed to someone who has the illness, you should not go to the vaccination site to get your shot until your symptoms and isolation period have passed.

However, if you have had COVID-19 in the past and have since recovered, it is recommended that you get the vaccine. If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine. Talk to your doctor if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.

Talk to your doctor if you have severe reactions after your first dose

If you receive an mRNA COVID-19 vaccine (Pfizer-BioNTech COVID-19 Vaccine or Moderna COVID-19 Vaccine), you will need two shots to get the most protection. If you receive the viral vector COVID-19 vaccine, Johnson & Johnson’s Janssen (J&J/Janssen) COVID-19 vaccine, you will only need one shot.

You should get your second shot even if you have minor side effects after the first shot unless a vaccination provider or your doctor tells you not to get it. If you experience severe reactions to your first dose (such as anaphylaxis), your doctor may advise you against receiving your second dose.

Give your body what it needs!

And lastly—take care of yourself before the big day! Before your appointment, make sure to stay hydrated and eat some nutritious foods. Try to limit alcohol intake prior to your vaccination and get some good sleep the night before. You’ll want to continue practicing these habits for a day or two after your appointment, as well.


Updated Quarantine Requirements for Vaccinated Persons

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On February 10th, the Centers for Disease Control (CDC) announced some recent changes to quarantine requirements for those who are fully vaccinated. This update comes at a perfect time as more people are getting vaccinated and as many are beginning to wonder what life will look like post-vaccine.

If you have been following the news, or if you have been recently vaccinated, you have most likely heard the recommendations: Vaccinated persons should continue to follow current guidance to protect themselves and others, including wearing a mask, staying at least 6 feet away from others, and avoiding crowds.

But why must those who have received both doses of vaccine continue to practice these safety precautions? Shouldn’t we be able to go back to normal once vaccines are more readily available?

Well…the science just isn’t there quite yet to tell us otherwise!

What we know—and don’t know just yet

We know that the currently approved COVID-19 vaccines are highly effective at preventing symptomatic COVID-19, meaning that those who have received a full vaccine series have protection against developing symptoms and are especially protected against severe illness related to COVID-19. The evidence also shows that symptomatic and pre-symptomatic transmission has a greater role in transmission that purely asymptomatic transmission.

While mRNA COVID-19 vaccines (like Pfizer and Moderna) have demonstrated high efficacy at preventing severe and symptomatic COVID-19, there is limited information on how effective the vaccines are at reducing transmission and how long protection lasts. The efficacy of the vaccines against emerging SARS-CoV-2 variants is also not yet known.

As we wait to learn more about how much vaccines are able to reduce transition, it is best to be cautious. Counties across Washington State have shown reductions in COVID-19 cases in the past several weeks, and it is best to keep doing what we know works best against the virus.

If you are like me though, you may be looking for a glimmer of hope for the coming months. The updated CDC quarantine guidelines is a promising example of the benefits that vaccinated individuals will begin to see.

Updated Guidance for Vaccinated Persons

The CDC states that vaccinated persons with an exposure to someone with suspected or confirmed COVID-19 are not required to quarantine if they meet all of the following criteria. Persons who do not meet all three of the below criteria should continue to follow current quarantine guidance after exposure to someone with suspected or confirmed COVID-19:

1. Are fully vaccinated (i.e. it has been longer than two weeks following receipt of the second dose in a two-dose series, or it has been longer than two weeks following receipt of one dose of a single-dose vaccine).

2. Have remained asymptomatic since the current COVID-19 exposure.

3. Are within three months following receipt of the last dose in the series (meaning that an individual is no more than three months out from their last vaccine dose).

Experts are currently gathering data about the duration of immunity to COVID-19 post-vaccination. At present, we have good data confidence to say that immunity lasts for 90 days (or three months). This may change as more data is gathered and analyzed.

Vaccinated healthcare personnel, patients, and residents in healthcare settings

If you are a healthcare worker, patient, or resident of a healthcare setting, these new updates will not apply to you. This exception is due to the unknown vaccine effectiveness in this population, the higher risk of severe disease and death, and challenges with social distancing in healthcare settings. These individuals must continue to follow current quarantine guidance.

Exposed and feeling sick. Now what?

Fully vaccinated persons who do not quarantine should still watch for symptoms of COVID-19 for 14 days following an exposure. If they experience symptoms, they should be clinically evaluated for COVID-19. In addition, vaccinated persons should continue to follow current guidance to protect themselves and others, including all other SARS-CoV-2 testing recommendations and requirements, and state, territorial, tribal, and local travel recommendations or requirements. For local information, visit: https://www.skagitcounty.net/Departments/HealthDiseases/coronavirus.htm.

More to come

The CDC quarantine recommendations for vaccinated persons, including the criteria above, will be updated when more data becomes available and additional COVID-19 vaccines are authorized.

To find out if you are currently eligible for vaccine in Washington State, visit www.findyourphasewa.org. If eligible, people can register for an appointment at one of the many vaccine provider locations: https://www.doh.wa.gov/YouandYourFamily/Immunization/VaccineLocations. Please know that vaccine supply is still quite limited at this time, and it will take several months for all currently eligible individuals to receive vaccine.

For information about Skagit County Public Health’s vaccination clinic at the Skagit County Fairgrounds, visit www.skagitcounty.net/COVIDvaccine or call the Vaccine Hotline at (360) 416-1500.


New Mask Guidance from the CDC

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The Centers for Disease Control and Prevention (CDC) recently released new research that found wearing a cloth mask over a surgical mask offers more protection against COVID-19. Findings also showed that tying knots on the ear loops of surgical masks can improve fit and create better protection. This information has prompted new mask guidance at a time when many are experiencing heightened concern over fast-spreading variants of the virus.

Wearing a mask correctly—and consistently—is one of the most effective tools we have against preventing the spread of COVID-19. It is important to choose a mask that fits well and also provides the necessary protection against viruses and aerosols.  

According to the CDC, these are the two most important things to consider when it comes to masks:

1) Make sure your mask fits snugly against your face. Gaps can let air with respiratory droplets leak in and out around the edges of the mask; and

2) Pick a mask with layers to keep your respiratory droplets in and others’ out. A mask with layers will stop more respiratory droplets getting inside your mask or escaping from your mask if you are sick.

Here is a list of “Do’s” and “Don’ts”:

DO

Choose a mask with a Nose Wire:

  • A nose wire is a metal strip along the top of the mask. Nose wires prevent air from leaking out of the top of the mask.

Use a Mask Fitter or Brace:

  • Use a mask fitter or brace over a disposable mask or a cloth mask to prevent air from leaking around the edges of the mask.

Check that it Fits Snugly over your nose, mouth, and chin:

  • Check for gaps by cupping your hands around the outside edges of the mask.
  • Make sure no air is flowing from the area near your eyes or from the sides of the mask.
  • If the mask has a good fit, you will feel warm air come through the front of the mask and may be able to see the mask material move in and out with each breath.

Add Layers of material. Here are three different ways to achieve this:

  • Use a cloth mask that has multiple layers of fabric.
  • Wear one disposable mask underneath a cloth mask.
  • Use a two-layer mask that has a pocket for a filter.

Knot and Tuck ear loops of a 3-ply mask:

  • Knot the ear loops of a 3-ply face mask where they join the edge of the mask
  • Fold and tuck the unneeded material under the edges
  • For video instructions, see: https://youtu.be/UANi8Cc71A0external icon.
  • Don’t like this style? You can also try using a mask extender or hair clip to hold the ear loops tightly at the back of your head.

DON’T

Combine two disposable masks: Disposable masks are not designed to fit tightly and wearing more than one will not improve fit.

Combine a KN95 mask with any other mask: Only use one KN95 mask at a time.

For more ways to improve the fit and filtration of your mask, visit: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/mask-fit-and-filtration.html.


New CDC Guidance for Quarantine Guidelines

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December 4, 2020

Skagit Public Health adopts guidance to align with CDC’s new quarantine guidelines.

Today, Skagit Public Health announced that they will adopt the Centers for Disease Control’s (CDC) and the Washington State Department of Health’s new guidance on quarantine timeframes. You can see the CDC’s full guidance here, and the Washington State Department of Health’s press release here.

The CDC, Washington State Department of Health and Skagit Public Health continue to encourage those who have been known close contacts of COVID-19 cases to quarantine for 14 days. However, there are certain circumstances that could allow for a shortened quarantine. These include:

  • If a person who is in quarantine has no symptoms, quarantine can end after Day 10. The person still needs to monitor for symptoms through day 14. If they develop symptoms, they need to isolate immediately.
  • If a person who is in quarantine receives a negative COVID-19 test and has no symptoms, quarantine can end after Day 7 if they are able to get tested within 48 hours before ending quarantine. The person still needs to monitor for symptoms through day 14. If they later develop symptoms, they need to isolate.
  • Ideally, an individual still quarantines for 14 days from the last day they were exposed. If they live with or care for someone who has COVID, that person has to finish their isolation before calculating quarantine end dates. 

“I want to be clear- there is still risk associated with ending quarantine earlier than 14 days. But, research has shown that it is a very small portion of the population that becomes contagious between 10-14 days after exposure, and we know that 14 days is an incredibly burdensome amount of time for people to properly quarantine. We want to lessen the burden of the pandemic wherever possible.”

Skagit Health Officer Howard Leibrand

More information on Skagit County’s COVID-19 response is available at www.skagitcounty.net/coronavirus. If you have questions or need additional information, call Public Health at 360-416-1500.


Children and COVID-19: What do we know?

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COVID-19 is called a “novel” coronavirus because it is a new viral strain that has not previously been seen in humans. Because it is new, scientists continue to learn about the disease and how it impacts us. One topic we are gaining a growing understanding about is how COVID-19 affects children. The Centers for Disease Control (CDC) released updated guidance last week to reflect new information about COVID-19 and children.

Do children get COVID-19?

Yes. The fact that children can catch COVID-19 is not new, but it has not been clear how susceptible children are for infection. We know that children have made up a smaller percentage of COVID-19 cases. The CDC’s latest guidance notes that while children make up 22% of the population, only 7% of all diagnosed cases of COVID-19 in the United States were for children (as of 8/3/20). In Skagit County, the percentage of cases in children is somewhat higher at 14%, but children still make up a lower proportion of cases than in the adult population.

One explanation for the lower COVID-19 rate among children is that because kids frequently get colds, which are often caused by other coronaviruses, their antibodies provide some protection from COVID-19. Another theory is that community measures like school closures were effective in keeping children safe. As communities have opened up, cases in children have increased. Nationwide, there was a 90% increase in child cases over the four weeks from 7/9/20 to 8/6/20.  

During these times, it can be expected that our children are experiencing heightened anxiety. The CDC has some wonderful recommendations to help adults have conversations with children about COVID-19 and how to cope with stress.

What are COVID-19 symptoms for children?

Generally, COVID-19 symptoms in children are similar to but milder than in adults. The most common symptoms in children are cough and/or fever, but children may also show no symptoms at all.

According to a recent American Academy of Pediatrics report, severe illness due to COVID-19 is rare among children. Although infrequent, children younger than age 2 appear to be at higher risk of severe illness with COVID-19 than older children. This is likely due to their immature immune systems and smaller airways, which make them more susceptible to developing breathing issues.

There have also been some reports of children developing a rare complication called multi-system inflammatory syndrome in children (MIS-C). MIS-C is a serious condition in which different body parts can become inflamed, which causes heart or other organ complications. The CDC is still learning about MIS-C and how it affects children, so we do not know why some children have gotten sick with MIS-C and others have not. MIS-C can be serious, even deadly, but most children who were diagnosed with this condition have gotten better with medical care.

What symptoms should I be worried about in children?

Parents or caretakers should immediately contact urgent or emergency medical care if they notice these warning signs in a child:

  • Trouble breathing
  • Pain or pressure in the chest that does not go away
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face
  • Severe abdominal pain

If you have children in your home, the CDC recommends some other general precautions for your whole household to help stay safe:

  • If others in your home have an increased risk for severe illness from COVID-19, consider extra precautions to separate your child from those people.
  • If you are unable to stay home with your child while school is out or conducted remotely, carefully consider who can best provide childcare. If someone at higher risk for COVID-19 will be providing care (e.g. a grandparent or someone with a chronic medical condition), limit your children’s contact with other people so they are less likely to come into contact with the virus and expose their caretakers.
  • Consider postponing visits or trips to see older family members and grandparents. Connect virtually or by writing letters and sending via mail.

If you do have a child that is showing mild COVID-19 symptoms or have been exposed to someone with COVID-19, the Skagit County Drive-Thru site will test anyone five years of age or older with parent or guardian approval. Families with children younger than five should reach out to their pediatric provider’s office to ask about testing.

Sources:

CDC Information for Pediatric Healthcare Providers:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html

Washington Skagit COVID dashboard:
https://coronavirus.wa.gov/what-you-need-know/covid-19-risk-assessment-dashboard

Children & COVID-19-State Level Data Report, American Academy of Pediatrics: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/


Coping with Pandemic Fatigue

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The COVID-19 pandemic has many of us stressed and worn out. We have all faced changes to our daily routines, reduced contact with friends and family, and a loss of our sense of normalcy. Many Skagitonians have been hit with financial challenges due to job loss or changes to their businesses that could not have been anticipated prior to a few months ago. Adding to the stress is that the pandemic conditions appear to be getting worse and there is not a definite end in sight.

You have probably heard of the “fight-or-flight” response. This response works well if you need to run away from a bear, but not so great for long-term stressors like the COVID pandemic.

WHO Coping with Stress during COVID19

So what can you do if you are feeling stressed and worn out?

1. Limit how often you check news or spend time on social media.

It is important to be well-informed about the pandemic. Although some people take comfort in being informed, it is easy to get worked up and anxious from watching nonstop news coverage. Have you heard of the term “doomscrolling?” It’s a newly coined word for scrolling through a never-ending doom-and-gloom on your Twitter or Facebook feed for hours and hours. Many of us do it, but we can all find better ways to spend our time.

If you want to stay informed, you should seek out COVID-19 information from local and trusted sources, like the Centers for Disease Control and Prevention, Washington State Department of Health or Skagit County Public Health. And set reasonable limits for the time you spend on social media.

2. If you feel like you are stuck in a rut, change your routine.

We are now four months into the pandemic, and most people have settled into a familiar routine. Many of us are spending more time than ever at home and are growing tired of looking at the same four walls as our days blur together. If you feel like you are stuck in the same rut day after day, you should mix up your routine.

How? If your employer allows you to work from home and is open to flexible work hours, you can try working a different schedule. Take the time to exercise before you start work, or take a longer lunch hour and go for a long walk and end your workday later.

You can also take advantage of the time cooped up in your home by focusing on a do-it-yourself project that you have been putting off. Clean your garage, touch up some peeling paint, or take on a project in your yard. In addition to keeping you busy, when you are done with the project you will get the added satisfaction from having completed a project.

3. Find healthy ways to let off some stress.

The CDC provides some great tips on coping with stress during COVID. Most are common sense tips like:

  • Take care of your body—stretch or meditate, eat healthy well-balanced meals, and exercise regularly.
  • Get plenty of sleep.
  • Avoid excessive alcohol and drug use.
  • Talk with people you trust about your concerns and how you are feeling.

4. Don’t be afraid to seek out professional help.

For some people, general stress and pandemic fatigue can become more serious. You should watch for warning signs that you’re having trouble coping, and should call your healthcare provider if stress gets in the way of your daily activities for several days in a row.

If you do not know where to turn, Skagit County is maintaining a list of behavioral health services and resources. A few key resources that are available 24 hours a day and 365 days a year are:

Don’t be afraid to reach out for help, and know that like all pandemics, this one will eventually end.