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Post COVID-19 Vaccine Considerations for Healthcare Personnel

Posted Dec 20, 20203 min Read

Regulatory & Clinical

Last week, the CDC issued this guidance on strategies to evaluate and managed post-vaccination signs and symptoms for health care personnel (HCP).  The guidance is aimed at (1) reducing disruptions from unnecessary exclusion of HCP from work due only to post-vaccination symptoms, and (2) avoiding inadvertent transmission of COVID-19 by HCPs.

Current data on the COVID-19 indicated post-vaccination signs and symptoms are mild, occur within the first three days of vaccination, and resolve within 1-2 days of onset.  Immediate reactions and local pain/redness at the injection site are not consistent with COVID-19.

Importantly, cough, shortness of breath, runny nose, sore throat, or lost of taste or smell are not consistent with post-vaccination symptoms and may be signs of COVID-19 or another infection.  All vaccinated HCP should continue to follow current infection prevention recommendations per IDH and CDC protocol.

A person recently exposed to COVID-19 (within 2-14 days) of receiving the vaccine can still become infected with COVID-19.  The vaccine itself does not cause a person to become infected.

When evaluating new-onset post-vaccination signs and symptoms, the CDC recommends the following for any HCP who received the COVID-19 vaccine in the prior three days (including the day of vaccination) and are not known to have had an unprotected exposure.  Any HCP with an unprotected exposure within the last 14 days should not work, quarantine, and be evaluated.

  • Signs and Symptoms from vaccine unlikely to be from vaccine – presence of any systemic COVID-19 sign or symptom (cough, shortness of breath, runny nose, sore throat, or lost of tase or smell) or other infectious diseases like flu.
    • Exclude from work pending evaluation.  Criteria for return to work depend on suspected or confirmed diagnosis from the evaluation.
  • Signs and Symptoms from vaccine that may be from either the vaccine, COVID-19, or other infection (fever above 100F, fatigue, headache, chills, muscle or joint pain)
    • HCPs who meet the following criteria may be considered for return to work without COVID-19 viral testing:
      • Feel well enough and are willing to work,
      • Are afebrile, and
      • Do not have systemic signs and symptoms of COVID0-19 (cough, shortness of breath, runny nose, sore throat, or lost of taste or smell)
    • HCP that return to work under the above should be monitored and if symptoms do not improve within 2-days, further evaluation and exclusion from work should be considered.  Testing should also be considered.
      • Some exception may apply to HCPs with fever only when facilities are in critical staffing shortage – see CDC guidance for detail.
  • See note in CDC guidance regarding antigen tests being confirmed with a n nucleic acid amplification test.
  • Positive viral (nucleic acid or antigen) tests for SARS-CoV-2, if performed, should not be attributed to the COVID-19 vaccine, as vaccination does not influence the results of tests.

Please refer to the CDC guidance for additional detail on suggested approaches to minimize impact of post-vaccination signs and symptoms on staffing availability.

About the Author

Zach Cattell, President, Indiana Health Care Association