Editor's note:For the latest news on COVID-19, visit http://bit.ly/AAPNewsCOVID19.
As health care workers begin to receive COVID-19 vaccines, federal officials are offering guidance on when post-vaccination symptoms may necessitate testing or time off work.
Post-vaccination symptoms indicate the immune system is responding to the vaccine, but they also could cause confusion as they overlap with symptoms of COVID-19.
“Strategies and guidance on evaluating and managing post-vaccination systemic signs and symptoms in personnel are needed to avoid unnecessarily excluding personnel with only post-vaccination signs and symptoms from work as well as to avoid inadvertently allowing contagious persons to work,” David T. Kuhar, M.D., from the Centers for Disease Control and Prevention’s (CDC’s) Healthcare Infection Control Team, said Monday during a CDC webinar on vaccine safety.
People who receive the new Pfizer-BioNTech vaccine may experience mild to moderate fever, fatigue, headache, chills, myalgia or arthralgia. These symptoms typically occur within the first three days of vaccination and resolve in a day or two.
To avoid staffing shortages, the CDC recommends health care facilities try to schedule vaccinations just before an employee is scheduled to be off work and stagger the timing so not everyone in a department or unit is vaccinated at the same time. Organizations also should offer paid sick leave to remove barriers from reporting symptoms and make sure SARS-CoV-2 testing is readily available if needed.
Even if they have been vaccinated, health care personnel should continue to follow all CDC infection-control measures, according to Dr. Kuhar. It is unclear whether vaccination can prevent someone from transmitting the virus to others.
Symptomatic employees who have had unprotected exposure to SARS-CoV-2 in the past 14 days should get tested for infection. The guidance that follows applies to employees who develop symptoms consistent with vaccination within three days of receiving the vaccine and are not known to have an unprotected exposure to the virus in the past 14 days. It is intended to be adapted to local circumstances and relies on clinical judgment.
Employees with symptoms common to both vaccination and COVID-19 can consider returning to work without viral testing if they do not have recent unprotected exposure, they feel well enough, are afebrile and they do not have other COVID-19 symptoms. If symptoms worsen or persist for more than two days, they should stay home from work and consider viral testing. Vaccination will not cause a positive result on viral nucleic acid or antigen tests.
Ideally, those with a fever should be evaluated and get a SARS-CoV-2 test before returning to work. Employees not suspected or confirmed to have an infectious disease can return to work when they feel well enough.
Cough, shortness of breath, rhinorrhea, sore throat and loss of taste or smell are not typical following vaccination. If an employee develops these symptoms, the CDC recommends the person stays home from work pending evaluation for possible causes including SARS-CoV-2.