Things You Should Never Do In Between COVID-19 Vaccine Doses

After waiting for more than a year, many started to become eligible for a vaccination, or were lucky enough to secure an excess COVID-19 vaccine (via CNBC). There may be an immediate shift in your psyche following your first dose of the Pfizer or Moderna vaccines — or only dose if you get the single-shot Johnson & Johnson vaccine. That's great news for mental health professionals, who remain concerned about the incidence of anxiety and depression. And, it's great news for you, your family, and your community as the benefits of getting a COVID-19 vaccine far outweigh the risks.

Once you are fully vaccinated, you can start to adjust your behavior. You can also socialize unmasked with other vaccinated people, as well as those who are unvaccinated but from a single household (as long as they do not have a health risk), according to the CDC. Plus, if you are exposed to someone who tests positive, you do not need to quarantine or get tested — unless, of course, you become symptomatic.

However, there are many things you need to keep doing until, or even after, your vaccination protocol is complete. And most importantly, there are things you should and should not be doing in between doses. Let's take a look.

Never consider skipping your second COVID-19 vaccine dose

According to the Journal of the American Medical Association, two doses are necessary for the Pfizer and Moderna vaccines. "Taking the first shot is like getting to the half time of a football game," Dr. Brian Castrucci, president of the de Beaumont Foundation, a public health nonprofit focused on state and local health, told Health Digest. "There's definitely progress and you may be ahead, but there is a whole other half to play."

The goal of a vaccine is to stimulate the body's natural immune response (the production of T-lymphocytes and antibodies), a mimicry that, metaphorically, trains your body so it knows what to do in the event of an actual infection (via CDC). For that to occur, two doses of the two-part COVID-19 vaccine are needed. As Dr. Carlos Malvestutto of the Ohio State University Wexner Medical Center explained, "The first dose primes the immune system while the second dose induces a vigorous immune response and production of antibodies."

Your body will have a weak immune response to just one dose, but a robust response with receipt of the second in the series. And according to the CDC, you are not considered fully vaccinated until a full two weeks after your second dose of the Moderna or Pfizer vaccine, or two weeks after the one-and-only dose of the Johnson & Johnson vaccine.

Don't be concerned about some redness or tenderness at the vaccine injection site

As of mid-March 2021, more than 113 million COVID-19 vaccine doses have been administered in the United States; each day, approximately 2.4 million doses are given (via NPR). And 22.2 percent of the population has received at least one dose. With each shot given, we see a brightening light at the end of what has been a long and dark tunnel.

With so many shots going into arms, we've also learned a lot about what to expect, which includes some soreness or redness at or around the injection site. "With any vaccination, you can expect a bit of pain during and after the injection," Dr. Thomas Duszynski, director of epidemiology education at Indiana University, told CNET. If you experience this type of discomfort, take a pain reliever, use an ice pack, soak in an Epsom salt bath, or exercise your arm a bit (via USA Today).

Some people reported a delayed local reaction, known as "COVID arm," but you do not need to be concerned. "One of the biggest messages that we wanted to relay was that this isn't worrisome. It'll go away on its own," Dr. Kimberly Blumenthal, an allergist at Massachusetts General Hospital, told Today.

Never ignore lingering side effects

According to US News & World Report, less than 1 percent of those who received the Moderna vaccine had adverse side effects. An even smaller amount of people had an adverse reaction to the Pfizer vaccine. Of course, that doesn't mean mild side effects aren't possible.

"Many people do report side effects with the COVID-19 vaccine; these are generally mild, but more than 80% of vaccine recipients reported side effects during the clinical trials," Dr. Joel Kammeyer, infectious disease specialist at the University of Toledo College of Medicine and Life Sciences, told Health Digest. People have reported head or muscle aches, fatigue, fevers, and chills (via Cleveland Clinic). "Vaccine side effects basically show that the immune system is being primed," Dr. Richard Watkins, infectious disease and professor of internal medicine at the Northeast Ohio Medical University, told Prevention.

If you have side effects that linger, however, you should call your doctor. Nevertheless, you shouldn't skip your second dose unless advised by your physician, according to the CDC. "Both the Pfizer and Moderna vaccines were studied in the clinical trials as a two-dose administration, and these vaccines are 94 to 95 percent effective in preventing COVID-19 after the second dose," said Dr. Kammeyer.

Don't doubt the efficacy of your first dose of the COVID-19 vaccine

Considering the fast-tracked creation of the COVID-19 vaccines paired with the reality that some people don't experience any side effects, it's easy to slip into cynicism about the vaccine's efficacy. But everyone should trust that they are working as designed.

"Like with other vaccines, the development of antibodies is not something felt tangibly," Dr. Sachin Gupta, a pulmonologist in the San Francisco Bay Area and attending physician with Alameda Health System, told Health Digest. "It is happening on the inside, with cells doing the job of converting amino acids into antibodies."

The data helps us trust that these vaccines are working. "Even a single dose of either vaccine was 85% to 94% effective in reducing COVID-19 hospitalization within a little more than a month after the first shot," according to Time. Plus, the mRNA COVID-19 vaccines are up to 95 percent effective against symptomatic illness after both shots are administered (via Yale Medicine). "The science supports that the body is producing antibodies; [research shows] that antibodies become quite measurable after receiving the second dose," said Dr. Gupta.

While awaiting your second dose of vaccine, do not stop wearing a mask in public

If you are in between COVID-19 vaccination doses, you should continue to wear a mask outside your home. Dr. Francis Collins, the director of the National Institute of Health, put it quite simply on his site: "Masks save lives."

"People between COVID vaccine doses need to remain as vigilant about catching the virus as they are before they get the vaccine," Dr. Sachin Gupta, a pulmonologist in the San Francisco Bay Area and attending physician with Alameda Health System, told Health Digest. "If receiving the two-part vaccine, even a week after the first dose should be handled with care as the antibody response will not have been fully mounted."

Plus, you might inadvertently infect someone else. "We are still learning if those who have been vaccinated may still pose a risk for transmission," Dr. Brian Castrucci, president of the de Beaumont Foundation, the nation's largest public health nonprofit focused on state and local health, told Health Digest. "So if you are around folks who are older or chronically ill who have not been vaccinated, please wear a mask and stay at least six feet apart."

Do not forgo social distancing practices

The rollout of vaccines is an exciting development and a beacon of hope for many. Nevertheless, following social distancing guidelines will continue to be very important, even if you've had your first dose.

"Because we don't have clear answers about how the vaccines will affect the asymptomatic transmission versus simply protecting the person who received it, it's important to continue to be careful even if you've had your first dose," Dr. Neil Brown, a board-certified emergency medicine physician and K Health's chief diagnosis officer, told Health Digest.

Social distancing, or physical distancing, is the practice of maintaining a safe distance between yourself and others — at least six feet, or two arm lengths, apart (via CDC). "We are still in a learning phase with this vaccine so people should still continue to observe social distancing guidelines following first and second doses of the vaccine to protect themselves and others," said Dr. Brown.

While awaiting your second vaccine dose, do not join the crowds

Although capacity restrictions are loosening up in many states, that doesn't mean you should suddenly throw caution to the wind and return completely to pre-pandemic life simply because you've received your first dose of vaccine. Experts are still advising Americans to avoid highly congregated areas as much as possible (via CDC). Even after you've received both doses of the two-part vaccine and are considered "fully vaccinated," the CDC advises "avoiding crowds and poorly ventilated spaces until we know more."

"Right now, we're still learning a lot about the vaccines, but social distancing is a proven method to lower the rate of transmission so I'd encourage people to continue mask wearing and staying socially distant as much as possible," Dr. Neil Brown, a board-certified emergency medicine physician and K Health's chief diagnosis officer, told Health Digest.

If you are equipped with tech, take advantage of remote solutions for important things like doctors appointments and faith services. If you have the financial ability, continue to use remote grocery delivery options. And if you must head into a crowded environment, wear your mask and socially distance yourself from others.

Don't get lax about hand-washing just because you've had a COVID-19 vaccine dose

Hand-washing, and the use of hand sanitizer when soap and water is not an option, "is the first line of defense in stopping the spread of infection," according to an editorial published in the Journal of Clinical Nursing in 2020.

Focusing on proper hygiene to fight contagion is not a new concept. For years, campaigns have been effectively teaching students to 'cover their coughs' (via CDC). According to Dr. Poonam Khetrapal Singh, regional director of the World Health Organization's South-East Asia region, "Handwashing has always been one of [the] most effective ways of keeping diseases at bay. It is a simple act that pays in dividends when it comes to keeping ourselves healthy and safe" (via WHO).

There's evidence of the effectiveness of these measure in the data surrounding influenza activity in 2020 and 2021. No doubt heightened sanitation vigilance contributed to the historically low rates of influenza during the pandemic (via CDC). So while you're in between vaccine doses, continue to wash your hands for at least 20 seconds (sing a song to yourself, as some have suggested) or when water is unavailable, use a hand sanitizer that contains at least 60 percent alcohol (via CDC).

Do not skimp on sleep between COVID-19 vaccine doses

"There is little that you would need to change between doses," Mariea Snell, assistant director of the Doctor of Nursing Practice programs at Maryville University, told Health Digest. Nevertheless, she recommended sleeping a minimum of eight hours a night. If you aren't already doing so, consider right now a great time to start. A good night's sleep supports your immune system. And according to the National Sleep Foundation, getting enough sleep can improve your body's antibody response to vaccinations.

In between vaccine doses, work on optimizing your sleep health by getting to bed early enough to allow for seven to nine hours of sleep a night. While scientists are still studying circadian rhythms and the ways sleep quality may impact vaccination efficacy, no harm will come to you by optimizing your sleep quality in between doses.

To start, avoid caffeine, alcohol, nicotine, and other sleep-inhibiting chemicals, according to the Division of Sleep Medicine at Harvard Medical School. Also, consider creating an environment in your bedroom that is conducive to sleep, and establish a stress-relieving bedtime routine.

Never stop monitoring your personal health

Because you are not fully protected from the coronavirus after a single dose of a two-dose vaccine, it is important to monitor your health for symptoms that might indicate infection. Those infected may have a fever (100 degrees or higher), cough, sore throat, congestion, nausea, vomiting or diarrhea, shortness of breath, difficulty breathing, fatigue, muscle or body aches, headaches, or a loss of taste or smell (via Yale Health)

There are tech options you can utilize to help. The CDC has an interactive self-checker available online to assist anyone 13 years of age or older. Google also has a self-assessment tool in place for anyone with access to the browser. If you haven't already invested in a digital thermometer, consider getting one now; it'll definitely make your life a little easier.

If you experience symptoms of COVID-19, err on the side of caution. The CDC recommends you stay home except to get medical care. Separate yourself from others in your household, tell people you interacted with that you are experiencing symptoms, consult with your doctor about your symptoms, and get tested.

Do not ignore quarantine guidelines simply because you've received your first dose of the COVID-19 vaccine

When it comes to quarantine guidelines, it's important to remember the point: to keep people who might have been exposed to the coronavirus from others (via CDC). It's not the same thing as isolation, which keeps someone who has tested positive for COVID-19 from others who are not infected, even within their own home.

If you are in between vaccine doses and have been exposed to the virus, you will still have to quarantine. That means staying home and monitoring your health for ten days, without testing, or seven days after receiving a negative test result for a test taken on day five or later. There are a couple exceptions to this guideline: Those who tested positive for COVID-19 within the previous three months and recovered and those who are fully vaccinated.

"While we are waiting for the second shot, it is best to maintain public health guidance," Dr. Brian Castrucci, president of the de Beaumont Foundation, the nation's largest public health nonprofit focused on state and local health, told Health Digest.

Avoid getting too close to household members with COVID-19 symptoms

If you are in between COVID-19 vaccine doses and someone you live with develops symptoms, encourage them to get tested. That's the only way to find out if you are at risk of contracting the virus yourself.

Concurrently, you should avoid coming into close contact with them as a precautionary measure. That means keeping a safe distance of at least six feet, wearing masks even in the house, and giving the potentially sick person dedicated space in the home to begin to self-isolate until they get their test results (via Michigan Health). And don't delay. According to the CDC, household transmission is "common and occurs early after illness onset."

"If you have to be in close proximity to the person who is sick, you can all wear masks," Dr. James Merlino, chief clinical transformation officer at the Cleveland Clinic, told Health Essentials. "But trying to keep people separated as much as possible is the best thing you can do."

Don't stop disinfecting surfaces in your home after getting your first COVID-19 vaccine dose

In the early days of the COVID-19 pandemic, we wondered just how thorough we had to be with our cleaning protocols. We scrubbed our houses and our groceries. We left mail and packages outside and stripped off our clothes when returning home from our necessary errands. Spring 2020 was, at best, a confusing time.

Since then, we've learned a lot about how COVID-19 spreads — mainly through droplets released when infected people cough, sneeze, or talk (via Cleveland Clinic). And while wearing masks helps reduce that person-to-person contact, there is evidence that the virus is present in droplets that land on surfaces, at least for a time, according to the New England Journal of Medicine. That means our household surfaces are vulnerable if someone in the family has contracted the virus and isn't in isolation.

Researchers at the National Institute of Health found the virus can live up to three days on stainless steel and plastic surfaces (via Mayo Clinic). They recommend cleaning and disinfecting household surfaces ("tables, countertops, doorknobs, light switches, toilets, faucet handles and sinks") regularly.

Don't underestimate the power of healthy eating

There's almost nothing a good bowl of chicken soup can't fix, right? Seriously, though, it just might boost the efficacy of your COVID-19 vaccine (via Eat This, Not That). And according to a letter by Dr. Margaret Rayman, professor of nutritional medicine at the U.K.'s University of Surrey, and Dr. Philip Calder, professor of nutritional immunology at the University of Southampton, efficacy of the COVID-19 vaccine is likely optimized with proper nutrition.

So while you are waiting for your second dose, focus on the food you eat. Mariea Snell, assistant director of the Doctor of Nursing Practice programs at Maryville University, told Health Digest that people should support their immune systems with healthy eating. That means eating plenty of fresh fruits and vegetables and, yes, some soup.

If you are wondering if  you can have that glass of wine you might be craving, know that it's not completely off the table. "I know people have said you should not drink, but that has not been indicated by the manufacturer nor was it part of the clinical trials' protocol," said Snell. However, you may want to avoid alcohol for a few days after getting your first and second doses of the COVID-19 vaccine. As you may feel a bit run down, "being intoxicated or hungover will make things less pleasant," Richard Watkins, an infectious disease physician and a professor of internal medicine at the Northeast Ohio Medical University, told Prevention.