Got the Shot!

This week, I saw many of my medical friends, colleagues, and other frontline health workers posting photos on social media of "Got the [COVID-19] Shot." It brought so much joy to my heart to see this miracle in action, and I was eager to get my own vaccine, whenever it was offered to me. I definitely didn't want to "jump any lines," as there are many people who likely are closer to more potential COVID patients than I am, but I also have been increasingly uncomfortable and paranoid in labor rooms especially during patients' second stages (the pushing part) with all the exertion and aerosolization of breath, saliva, etc., and when patients are generally unmasked (women pushing on hands and knees make me sigh with relief, as they're faced away and it's a great birthing position!). We've still had pretty low local case numbers in our rural county (daily case numbers in the teens-30s), compared to the rest of the country; however, cases have been rising in the last month (I've had co-workers and friends, as well as several patients, test positive), and we're all nervous and bracing for a higher surge with low human and facility resources. 

Like many healthcare workers this year, my biggest concern (more so than getting "ill" with COVID, as I'm a young and healthy person without any underlying health conditions) has been my overwhelming anxiety about the "what-ifs" about bringing it home to my family and kids, who attend group childcare, and all of the implications if one of us tested positive. Who would take the extra OB call when we're already all exhausted and stretched too thin?  Who would step up in clinic while we watched isolated or quarantined kids at home, not being able to rely on any other childcare due to the infectiousness of this virus but still feeling a commitment to our patients and trying to not leave our colleagues out on a limb? How many other teachers, kids, and families would be affected if one of my children "got it"? When could we ever feel safe or comfortable enough to take the risk to have family visit?  I basically felt that I could not be the one to suggest a physically distant social walk or chat, because my risk allocation was “all used up” by my profession and kids, I was the most likely vector of disease for transmission, and I didn't want anyone to be uncomfortable nor feel unsafe (and definitely didn't want to have the responsibility of making "I'm sorry"/ contact-tracing phone calls). We had two scares and COVID rule-outs when each of the kids had a cough/fever but they were regular old URIs to which we understandably overreacted. The burden felt very weighty for me/us, which is why the possibility of a vaccine on the horizon felt so incredibly hopeful (I told many people that "all I want for Christmas is my COVID vaccine!").  

I know the vaccine rollout feels fast, and it is (that's what the urgency, will, and science, with some money, can do!). But that doesn't mean it's unsafe, and if the vaccine skeptics out there want to wait for a bit, I hope they're convinced by us healthcare workers/guinea pigs volunteering to get one first (after those who already self-enrolled in the clinical trials), and that they realize the risks of not getting this vaccine (and living like this) far outweigh any *theoretical* long-term risks of the vaccine, as is my medical opinion. I’m about as pro-vax as they come, and I don't know any doctors that aren't planning to get a vaccine when given the chance.  Like many drugs and vaccines, these mRNA vaccines have not been studied in pregnant or lactating women and many may opt out at this time for that reason, but if I were pregnant based on my understanding of the science (and because COVID-19 can be so serious in this population), I would definitely get it, too, which is what I've shared with my patients (ACOG, CDC, and MFM organizations agree that it's not unreasonable for this group to get the vaccine after shared decision-making despite the lack of data).

Kelvin has led our organization's COVID-19 response and has been involved in the discussions about local vaccine distribution. The hospitals (actually quite surprising, as we're a rural area without a lot of COVID) got a shipment of the Pfizer-BioNTech vaccine this week, and started vaccinating hospital frontline staff, including RTs, nurses, emergency department personnel and hospital-based physicians including those in the ICU, surgery, and medicine units. While I work in the labor and delivery unit about every fourth day managing laboring patients and catching babies, in the OR performing cesareans, and consult on emergency department patients for gynecologic and OB concerns, I am not considered a "hospital employee" but rather employed by our FQHC and mostly clinic-based in my direct patient care duties. I knew I'd be one of the first in our organization to be offered the vaccine due to the inpatient work, but I didn't know how long it would be in terms of weeks or months. 

After I saw some of my nursing friends getting inoculated, I had reached out to the hospital chief nursing officer on Thursday afternoon to inquire if clinicians like us OB providers could also be offered the vaccine if the hospital had enough for all of those first responders, and was told "not now, but maybe later."  Nevertheless (after undoubtedly some advocacy by my nurse friend, Patricia), I got a call on Friday (the very next morning) from him that "they had a few extra thawed and if I could pop over, I could get one." Unfortunately, I was working in my primary care clinic about a ten-minute drive away and didn't see how, with patients scheduled every fifteen minutes, I was going to be able to make this work (as desperately as I wanted to). However, the stars aligned and I miraculously had a no-show, which allowed me to race to the hospital, fill out a brief form, get poked, get my vaccine card, and be observed for about 15 minutes, before I had to dash back to clinic to continue with my office visits, which ran mostly on time for the rest of the morning (Hamilton’s “I’m not throwing away my shot” lyrics were running through my head!).  It truly felt like I'd won the lottery, and I was like a child on Christmas morning, in awe of a miracle (and a huge gift).

In all this last-minute rush and haste, I didn't get a masked "action shot" of getting the vaccine like I saw many friends take, but it's not the picture, but the act, which was the milestone here. It truly felt historic. Kelvin took this photo at home in the evening, where I think the joy on my face is evident (and while my arm is still pretty sore a day later, and I had mild aches and fatigue last night, I observed no serious ill effects). I go back on January 8th for my booster.

I know there are so many people out there who desperately want and need this shot (I've had soooo many of my patients ask me anxiously when they'll be able to get the vaccine!), and I am sensitive that as an American healthcare worker, I was so fortunate to get one so early, this week, while others in the general public (and across the world) may have to wait months or more.  I am so relieved that, to date, my family has dodged COVID and us adults are eligible for the shot (my kids also want theirs, as soon as a pediatric one may be available!). And while I know that relative and temporary "vaccine scarcity" due to high demand is not the worst problem in the world for this country to have, every person that gets the shot now is less likely to spread this virus to those most vulnerable and still-unvaccinated, and everyone will ultimately benefit from the people who are in this first wave of recipients. When I felt that needle in my arm, the tears that came out were not from the pain of the stick, but mostly of relief and joy (while mixed with some guilt and the sorrow for those who suffered through or succumbed to this disease before this vaccine was available). For me, it truly felt like an injection of hope. All these long months of sacrifice, being stuck at home with spirited little kids, missing travel, not seeing family and not having outings with friends, not having in-person kindergarten for Iver or playdates for either of my children, not going in a library or anywhere besides work (and the occasional grocery store) and all of the grief, just seemed to recede in their consequence, because V-day was here (for me, at least).  

It takes several weeks (probably two weeks after the second shot) for me to be near-fully protected from COVID-19. Kelvin hopes to get his in the coming weeks or month. We don't know if vaccinated/immune people are still capable of asymptomatic spread, nor how long immunity will last, so masking and distancing are still important and our lives won't change much for the near or intermediate-term future, but this vaccination felt like such a blessing and validates our strong efforts this year at staying safe (and makes them far easier to keep doing). This is the beginning of the end. We have turned a corner. There is light at the end of this long COVID tunnel. Thank God for science.  Joy comes in the morning. 

BEST. CHRISTMAS. GIFT. EVER.

I can't wait for all of you to get your shot at the shot(s), too! Let’s move forward (and look forward to herd immunity) and say goodbye to horrible 2020.