The Impact of the COVID-19 Vaccine

Impact of the J&J vaccination at Netcare

During March and April 2020, 33 180 Netcare healthcare workers (HCWs) were vaccinated with the J&J vaccine. When the third wave caused by the Delta variant hit SA in June 2021, we saw a significant reduction in HCWs diagnosed with COVID-19 when compared with the first and second waves, and despite having a 50% more contagious variant. Furthermore, while about 10% of healthcare workers diagnosed with COVID-19 had to be hospitalised during the first two waves, less than 3% were hospitalised for severe COVID-19 during the third wave, thanks to vaccination. Worldwide, similar results as that of Netcare were confirmed.

VACCINE = 79% reduction in infections and 75% in hospitalisation for severe cases

Breakthrough infections and transmission

(A breakthrough infection (BTI) is when an infection occurs despite someone being fully vaccinated.)

Vaccination does not prevent all infections and does not prevent all transmissions. However, persons with breakthrough infections are contagious for a much shorter time than those who have not been vaccinated and the overall risk of transmitting the virus is reduced by almost to 75%. It has also been shown that healthcare workers that have a BTI are 30% less likely to infect their household.

COVI-19 infection is rare in vaccinated people (1 to 3%), less severe in 75% of cases and with 50% less long COVID-19 complications.
Vaccinated patients are 75% less likely to infect others.
Vaccination alone will not stop the pandemic but can slow it down in addition to other precautions such as wearing masks and maintaining social distancing.

Pregnant women and vaccination

Pregnant women were initially excluded from the vaccination campaign as there was not enough safety data available and little was known of the impact of COVID-19 on pregnancy. Since then, we have learned that COVID-19 is dangerous for pregnant women with a 20-fold increased risk of being hospitalised. The risk of pre-term and still birth is also increased.

The vaccine is safe during pregnancy and does NOT increase the risk of miscarriage in early pregnancy. Another positive point is that the vaccine provides protection to the newborn infant from infections that could occur in the first months.

Pregnant women and women contemplating pregnancy should get vaccinated

Vaccination for young adults, adolescents and children > 12 years old

While it is true that these categories of individuals have less severe COVID-19 than older people, the risk of severe COVID-19 is real if they have any comorbidity such as obesity, diabetes, high blood pressure or immunosuppression. Children can develop clinical complications called multisystem inflammatory syndrome which are potentially dangerous.

As usual, the vaccine is more effective in children than in adults. It is also very safe in children. Children and adolescents aged 12 to 18 only get one injection to prevent extremely rare cases of myocarditis (3 to 15 cases per million of first doses).

Myocarditis is a heart inflammation that occurs mostly in young boys and male adults vaccinated with an mRNA vaccine within several days after the second injection. Cases are usually mild and recover quickly after treatment.

Long COVID-19

Most people who survive COVID-19 recover completely within a few weeks. Some people, even if they had mild or non-symptomatic disease, will continue to experience symptoms for weeks and even months. This is called long COVID-19. All age categories can have long COVID-19.

Symptoms can include chronic fatigue, headache, palpitations, chest pain, shortness of breath, muscles or joint pain, and loss of smell or taste. neurocognitive symptoms include memory, concentration or sleep problems. depression, mood disorders and anxiety are frequent.

Globally, symptoms of long covid-19 affect a third of patients, for three to six months after a diagnosis of covid-19. the risk is lower in children, but research suggest that 2% to 14% still have covid-19 symptoms three months after the covid-19 episode. the cause and the duration of long covid-19 is still unknown and research is ongoing. fortunately, recent studies have shown that vaccination reduces the risk of long covid-19 by 50% in bti.

What about booster vaccines?

Boosters are recommended for the Johnson & Johnson and Moderna vaccines. A booster given six months after the single shot increases the antibody levels irrespective of the person’s age.

Everyone can get a booster but individuals over 65 years and or with comorbidities should definitely have a booster.

In countries with high proportions of vaccinated people, breakthrough infections occurred mostly in the elderly and immunocompromised people. Boosters are recommended for any individual over 65 years or with comorbidities.

Vaccine side effects

More than 6.89 billion doses have been administered worldwide across 184 countries. In South Africa, 21.3 million doses of the vaccine have been administered. Side effects of the vaccines are very well documented. Common side effects are usually mild and short-lasting: pain around the injection site, fever and chills, headache and muscles aches, and usually occur after the second injection.

48.7% of the world population have been vaccinated

Severe side effects such as clotting and severe allergic reactions are exceedingly rare events and may affect few people in a million.