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Why Video Channeling Is Right For You

Why Video Channeling Is Right for You

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Do you dread getting sick? Not only because of the body ache, the fever or the migraines but because you know that you will have to make a trip to the hospital, sit around for hours, feeling worse by the minute, and rush through a few minutes with your doctor? Or maybe you have a chronic condition, such as diabetes, where you need to visit your endocrinologist every few months and show them your latest reports. You go to the hospital, wait till you’re called for your tests and then wait some more to show your results to your doctor? And in recent times, having to do all this with the worry that you might be exposing yourself to COVID-19?

It’s a good thing that oDoc has another option for you, one where you can start recovering without ever having to leave your home. oDoc allows you to channel your doctor on a video call so all you need is a mobile phone and an internet connection!

Online video consultations with doctors has been around for a long time but has definitely become more popular and practical during the COVID-19 pandemic.

We know that it can be hard to wrap your mind around having your doctor’s appointment on your mobile phone where the doctor speaks to you and provides a diagnosis. But there are many advantages of channelling a doctor virtually.

channel doctor

No transportation time or costs

When you video channel your doctor on your phone, you can save money on petrol and public transportation. You also don’t waste time travelling to a clinic or sitting for hours in a waiting room or risk running into a traffic jam.

For those of you who live outside the big cities, you don’t have to worry about setting aside your whole day or half your day to travel into the city for your appointment with the doctor.

Comfort and convenience when channelling online

You can consult the doctor on oDoc from your own bed if you feel like it.

A virtual consultation is much easier to fit into your busy schedule. You don’t need to take time off work, you can simply schedule a consultation during your break, or before or after work. If you are taking care of children or an elderly parent, usually you would need to find alternative care while you go to a clinic for your doctor’s appointment. But with oDoc, this worry is eliminated as you can still uphold your family responsibilities.

Reduced exposure to other diseases commonly spread in hospitals

With virtual consultations, you are less exposed to other people’s germs, which is an even greater benefit if you’re chronically ill, pregnant, elderly or immunocompromised. This reduces the spread of COVID-19, flu and other infectious diseases. Doctors are protected as well.

Immediate paediatric care for babies and children.

If your baby or little child has suddenly got sick in the middle of the night, you can immediately channel a doctor on oDoc who can ease your worries, provide a diagnosis and a prescription if needed.

Online psychiatric support

Taking care of your mental health is as important as taking care of your physical health, which is why oDoc gives you the opportunity to speak to a counsellor or psychiatrist confidentially and privately.

Channelling with a doctor online is not meant to take the place of in-person appointments but it can be an important addition to patient care. Consult with a doctor on oDoc today!

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Dengue: the whats, whys and hows.

කොරෝනා අතරට පැමිණි ඩෙංගු වසංගතය

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 Dengue seemed to have taken a back seat in the news the last year but it is fast becoming  a household concern, yet again. With  9,669* dengue patients being reported in Sri Lanka so far in 2021, it is safe to say that dengue ‘is back’ (not like it ever went away though). So we at oDoc are breaking it down for you. We go into detail about the causes, treatment and prevention of dengue, so keep reading!

What is dengue and how is it caused?

Dengue is a mosquito-borne disease. Dengue viruses spread among people through the bite of an infected Aedes species mosquito. These are the same types of mosquitoes that spread Zika and chikungunya viruses. These mosquitoes breed and lay eggs in still water (in buckets and pots in your garden which has collected water). These eggs can even survive up to 1 year and can withstand dry conditions till they are in water again.

Is dengue contagious?

Dengue is not contagious so you cannot catch the virus via contact with an infected person. However, an infected mother can pass the virus to her fetus during pregnancy or around the time of birth. In the case of infected breastfeeding mothers, it is encouraged that they continue breastfeeding their infant due to the benefits of breastfeeding. So far, there has only been 1 case of the virus passing to the infant via breast milk.

 

What are the symptoms of dengue?

It is said that 1 out of 4 people who are infected with the dengue virus will get sick and can show mild to severe symptoms.  Mild symptoms include high fever along with a combination of aches and pain in muscles and joints, rashes and nausea. Symptoms last about 2–7 days. Most people will recover after about a week. Severe cases of dengue usually require hospitalisation. Symptoms and warning signs include:
  • Belly pain, tenderness
  • Vomiting (at least 3 times in 24 hours)
  • Bleeding from the nose or gums
  • Vomiting blood, or blood in the stool
  • Feeling tired, restless, or irritable

කොවිඩ් 19 වසංගත තත්වය මේ වන විට ශ්‍රී ලංකාවේ විශාල මරණ සංඛ්‍යාවකට හේතු වී ඇත. මෙම තත්වය මත ඩෙංගු වසංගතය හිස ඔසවා ඇති අතර ඩෙංගු රෝගීන් ප්‍රමාණය ද ඉහල ගිය හොත් අපට රටක් වශයෙන් විශාල අර්බුදයකට මුහුණ පාන්නට සිදු වනු නොඅනුමාන ය.

ඩෙංගු රෝගය වසර 50ක් දක්වා ඈතට දිව යයි. දැනට ලංකාව තුළ මදුරු වර්ග 150 ක් පමණ සංඛ්‍යාවක් සිටින අතර ඊඩ්ස් ඊජිප්ටි( Aedes Aegypti ) සහ ඊඩ්ස් ඇල්බොපික්ටස් ( Aedes Albopictus) යන මදුරුවන් වර්ග දෙක රෝග වාහක මදුරු විශේෂ දෙකක් ලෙස හඳුන්ව යි. මෙම ඊඩ්ස් මදුරුවාගේ බිත්තර කිසිම දේශගුණික තත්වයක් මත විනාශ වන්නේ නැත. එනම්, ඒවා ඕනෑම පාරිසරික තත්වයකට ඔරොත්තු දෙයි. එහෙයින් ඊඩ්ස් මදුරු බිත්තර විනාශ කළ නොහැකි දෙය කි. හිරු පායා පැය කිහිපයක් ගත වන කාලයේ මෙන් ම හිරු බැසීමට පැය කිහිපයක් ගත වීමට ආසන්න වන මොහොතේ දී ඊඩ්ස් මදුරුවන් දෂ්ඨ කිරීම ආරම්භ කර යි. ඊඩ්ස් ඊජිප්ටි මදුරුවා දෂ්ඨ කිරීමෙන් අනතුරුව දින 3 ත් දින 14 ත් අතර කාලයක් වෛරසය ශරීරයේ පවති යි. අනතුරුව ඇතිවන උණ අවධිය දින 2 ත් 10 ත් අතර කාලයේ පවතින අතර ඒ අවධිය වෛරසය ප්‍රතික්‍රියා කරන අවධිය යි.

මදුරුවන් ස්වභාවිකව වෛරස් රැගෙන නොය යි. තව ද මදුරුවන් රෝගය බෝ කරන්නේ වෛරස ආසාදිත පුද්ගලයන්ට දෂ්ඨ කිරීමෙන් ය.ඔවුන් නැවත දෂ්ඨ කළ විට වෛරසය ඊළග පුද්ගලයාට සම්ප්‍රේෂණය විය හැකි ය. මදුරුවන්ගෙන් බෝ වන රෝග ව්‍යාප්ත වන ප්‍රධාන ආකාරය වන්නේ මෙය යි.මිනිසුන්ට දෂ්ඨ කරන්නේ ගැහැනු මදුරුවන් පමණක් බැවින් වෛරසය පැතිර විය හැක්කේ ගැහැනු මදුරුවාට පමණ කි. ඩෙංගු (Dengue), සිකා(Zika), චිකුන්ගුන්‍යා(Chikungunya) සහ කහ උණ (Yellow Fever ) හි ප්‍රධාන සම්ප්‍රේක්ෂකයා වන්නේ ඊඩ්ස් ඊජිප්ටි මදුරුවා ය.

මෙම ඊඩ්ස් මදුරුවා අප්‍රිකාවේ ඉපදුණ නමුත් ලොව පුරා නිවර්තන සහ උප නිවර්තන කලාපයන් හරහා ලොව පුරා ව්‍යාප්තව ඇත. 15 සහ 19 සියවස අතර කාලයේ දී සිදු කළ වහල් වෙළඳාම හරහා මදුරුවන් පිටතට ව්‍යාප්ත වී ඇත. එසේම 18 ත් 19 ත් යන සියවස් අතර ආසියාව තුළ සිදු වූ වෙළඳාම් හරහා මදුරු පැතිරීම වූ අතර පසුව නැවතත් දෙවන ලෝක යුද්ධ සමයේ දී හමුදා භට කණ්ඩායම් සමග ව්‍යාප්ත විය.

මෙම ඩෙංගු රෝගය වැළඳීම අතිශය භයානක තත්වය කි. මෙම තත්වය ප්‍රධාන අවධි දෙකක් ගනි යි. එනම් ඩෙංගු උණ තත්වය සහ ඩෙංගු රක්තපාත තත්වයයි. ඩෙංගු උණ රෝගයේ දී අධික හිසරදය සමග ඇති වන උණ තත්වය ඇතිවෙ යි. එමෙන් ම හංදි සහ පේශිවල වේදනාව සහ ශරීරයේ ඇතිවන දද ස්වභාවයන් දැක්විය හැකි ය. ඇතැම් අවස්ථාවල දී විදුරුමස් නාසය සහ ශ්ලේෂ්මල පටල මෙන් ම සමෙන් ද රුධිරය වහනය වීමට ඉඩ ඇත.ඩෙංගු රක්තපාත උණ තත්වය රෝගය උත්සන්න වූ විට ඇතිවන තත්වය කි. එය අවධි තුනක් ඔස්සේ පැහැදිලි කළ හැකිය.

  • දින හතකට අඩුවෙන් පවතින තද උණ සහිත කාලය.මෙය උණ සහිත අවධිය ලෙස හඳුන්ව යි.
  • උණ් බැස යාමත් සමග ඇතිවන රුධිර වහනය පවතින අවධානම් අවධිය, මෙම තත්වය දින 1 ත් 2 ත් අතර කාලයක් පවතියි.
  • රෝගියාගේ කෑම රුචිය වර්ධනය වී හෘද ස්පන්දනය අඩු වන අවධිය තෙවන අවස්ථාව යි. එය සුව වන අවධිය ලෙස හඳුන්ව යි. මෙම කාලයේ දී රතු පැහැති පසුබිමේ සූදු පැහැ ලප ඇතිවීම ශරීරය පුරා ඇතිවෙන කැසීම මුත්‍රා වැඩි වශයෙන් පහ වීම සිදු වෙයි.

නමුත් උණ බැසයන අවස්ථාවේ දී යම් රෝගියෙකු තද පිපාසය, බඩේ කැක්කුම, නොනවත්වා වමනය කිරීම, ආහාර ප්‍රතික්ෂේප කිරීම, අධික නිදිමත සහ සිහි මද බව, අසාමාන්‍යය ලේ ගැලීම එනම් ඔසප් වීම නියමිත කාලයට පෙර හෝ ඊට පසුව සිදුවීම, අත් සහ පාද සුදුමැලි වීම සහ සීතල බව නොසන්සුන් බව, සමේ පැහැය වෙනස් වීම, හැසිරී මේ වෙනස්කම්, සිහි මද ගති ලක්ෂණ පෙන්නුම් කරන්නේ නම් වහාම වෛද්‍යය උපදෙස් පිළිපැදිය යුතු ය. ඩෙංගු වෛරසය ශරීරගතව ඇතිබව තහවුරු කිරීමට සිදු කරන NS 1 සහ ඩෙංගු ප්‍රතිදේහ පරීක්ෂාවන් මගින් ඩෙංගු උණ සහ ඩෙංගු රක්තපාත උණ වෙන් කර හඳුනා ගත හැකිය. එසේම, ඩෙංගු රෝගියෙකු සුදු රුධිරාණු අඩුවීම, රුධිර පට්ටිකා සහ රුධිරයේ ඝන භාවය වැඩිවීම පිළිබඳ අවධානය යොමු කළයුතු ය. සියලු රෝගීන් උණ් වැළඳී තෙවන දිනයේ රුධිර පරීක්ෂාවක් සිදු කර ගැනීම අවශ්‍යය වේ. ගර්භනී කාන්තාවන්, වයස අවුරුද්දට අඩු දරුවන්, මහලු පුද්ගලයන් යන අය පලමු දිනයේ දී ම රුධිර පරීක්ෂාවක් කර ගත යුතු ය. විශේෂයෙන් මෙම ඩෙංගු තත්වය පවතින රෝගියෙකු පිටස්තර ඖෂධ ගැනීමේදී අතිශය සැලකිලිමත් විය යුතු ය. මෙම රෝගීන්ට පැරසිටමෝල් ඖෂධයක් පවා ලබා ගත හැක්කේ වෛද්‍ය උපදෙස් මත පමණි. මෙෆනෙමික් ඇසිඩ් ( Mefenamic Acid ) ඇස්ප්‍රින් (Asprin) ඩිස්ටොෆෙනැක් ( Distoenac)ඉබියුප්‍රොෆෙන් ( Ibuprofen)යන කාණ්ඩ ඖෂධ කිසි විටකත් භාවිත නොකළ යුතු ය. මෙබඳු ඖෂධ භාවිතයෙන් රුධිර වහනය උග්‍ර වෙයි.

රුධිර පට්ටිකා ප්‍රමාණය ≥150,000/ mm3 නම් දිනකට දෙවරක් සම්පූර්ණ රුධිර පරීක්ෂාවට යොමු විය යුතු ය. නමුත් රුධිර පට්ටිකා ප්‍රමාණය ≥100,00/ mm3 වන අවස්ථාවලදී රෝගියා රෝහලකට
ඇතුළත් කිරීම අනිවාර්ය වේ.

ඩෙංගු රෝගියෙකු විසින් ඉතා සැහැල්ලු සහ පෝෂ්‍යදායී ආහාර වේලක් ලබා ගත යුතු ය. යම් ආකාරයකින් දින දෙකකට වඩා පවතින උණ තත්වය ඇති පුද්ගලයෙකු රෝහල් ගතවීම සුදුසු ය. ඩෙංගු රෝගියෙකු හොඳින් විවේක ගැනීම කළ යුතු අතර මහන්සි වීම තෙහෙට්ටු වීම නුසුදුසු ය. වැඩිපුර දියර වර්ග පානයට ගැනීම, නිදසුනක් ලෙස කිරි කැඳ, පළතුරු යුෂ, තැඹිලි, සුප් ආදී ද්‍රව්‍යයන් භාවිතයට සුදුසු ය.රෝගියාට ආහාර රුචිය ඇත්නම් ඝන ආහාර ලබා දිය හැකි අතර බීට් රූට් චොකලට් රත් පැහැයට හුරු පැණි බීම වර්ග ලබා දීමෙන් වැළකිය යුතු ය. මෙය මලපහ පිටවීමේ දී රුධිරය යාමේ තත්වය හඳුනා ගැනීමට බාධාවක් වෙයි.ඩෙංගු රක්තපාත අවධියේ දී වකුගඩු අක්මාව අකර්මණ්‍ය වීම මොළයට බලපෑම් සිදුවීම විය හැකිය.

මෙම මදුරුවාගේ බෝ වීම සිදුවන්නේ වතුර පිරුණු ටයර්, පොල්කටු, ප්ලාස්ටික් බඳුන්, යෝගට් කෝප්ප, පොල් සහ තැඹිලි කෝම්බ, වැහි පීළි, වතුර කාණු, ශීතකරණ තැටි, පොල් ලෙලි වලවල් යනාදී ස්ථානවල යි. ඔබ නිරන්තරයෙන් ඔබගේ නිවස සහ වත්ත පිටිය පිරිසිදුව තබා ගත යුත්තේ එබැවින් ය. මදුරුවන් දෂ්ඨ කිරීම් වලක්වා ගැනීම සඳහා පැඟිරි තෙල්, මදුරුදැල් භාවිතය, ශරීරය ආවරණය වන ඇඳුම් ඇඳීම වැනි ක්‍රම භාවිත කළ හැකි ය. පවතින කොරෝනා උවදුර හමුවේ මෙම ඩෙංගු උවදුරින් හැකි තරම් ආරක්ෂා වීමට ඔබට හැකියාව ඇත. ඔබ මේ වන විටත් පවතින ඇඳිරිනීතිය හමුවේ නිවසට වී සිටින අයෙක් නම් තම නිවස පිරිසිදුව තබා ගැනීමට ඔබට කාල වේලාව පවතියි. එබැවින් හැකිතාක් මෙම තත්වයෙන් ආරක්ෂා වීමට කටයුතු කරන්න.

ලෝකයේ රටවල් එක්ව ඩෙංගු මර්දනයට ‘වොල්බැකියා බැක්ටීරියාව’ යොදා ගත් ආකාරය පිළිබඳ ලිපිය මීළඟට බලාපොරොත්තු වන්න.

ආශ්‍රිත ග්‍රන්ථ නාමාවලිය

  • Comprehensive guidelines for prevention and control of Dengue and Dengue Haemorrhagic Fever, WHO
  • Dengue, Guideline for diagnosis, treatment prevention and control, WHO
  • Dengue and severe dengue, WHO
  • ඩෙංගු මදුරුවා, National Dengue Control Unit, Sri Lanka
  • World mosquito program, Sri Lanka
  • කොවිඩ් 19 මැද ඩෙංගු අවදානමක්: ජාතික ඩෙංගු මර්දන ඒකකය අනතුරු අඟවයි, BBC සිංහල

If you are showing any of these symptoms or warning signs, seek medical attention immediately. It is also important to note that these warning signs usually begin 24–48 hours after your fever has gone away.

What’s the treatment for dengue?

Unfortunately, there is still no specific treatment to cure dengue. However, it is vital that you rest as much as possible and keep yourself hydrated by taking a lot of fluids if you are diagnosed with dengue. You can also take paracetamol (do not take aspirin or ibuprofen) to help with the fever and body aches and pains. 

It is advised to seek medical advice rather than self-diagnosing and opting for self-treatment. 

What can you do to prevent dengue?

  • Keep neighborhoods clean and free of still water 
  • Frequently clean garden, pots, vases and balconies
  • Wear clothes that cover the body and minimize exposure to mosquito bites
  • Always use mosquito repellents
  • Use mosquito nets
  • Installing net screens on doors and windows.

In these difficult times, it is vital we look after ourselves and our loved ones. If you or anyone you know is suffering from any of the above-mentioned symptoms you can speak to an on-demand doctor on oDoc from the comfort of your home.

Stay indoors. Stay safe.

*At day of writing (13th July 2021)

Sources

  1. Epidemiology Unit – Ministry of Health. (2021, July 13). Dengue update. Epidemiology Unit – Ministry of Health Sri Lanka. https://www.epid.gov.lk/web/index.php?option=com_content&view=article&id=171%3Adengue-update&catid=51%3Amessage-for-public&Itemid=487&lang=en
  2. Content source: Centers for Disease Control and Prevention. (2021, June 28). Dengue | CDC. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/dengue/index.html
  3. Dunkin, M. A. (2010, July 26). Dengue Fever. WebMD. https://www.webmd.com/a-to-z-guides/dengue-fever-reference
  4. WHO. (2019, July 8). Preventing Dengue in Sri Lanka. World Health Organization. https://www.who.int/srilanka/news/detail/08-07-2019-preventive-action-is-vital-to-curtail-dengue-outbreaks-in-sri-lanka

 

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Breaking down the Delta Variant

Breaking down the Delta Variant

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It seems we hear of a news report of a newly discovered Delta COVID19 case in Sri Lanka almost on a daily basis. Resulting in the question, what is the delta variant and what does that mean for us?

For our more in-depth blog on variants, please click here

Short read: It is highly transmissible and has caused more hospitalisations than the Alpha variant in the UK (and India, though the data isn’t as neatly available), especially in young people and the unvaccinated. It is found to be more resistant to the Pfizer and AstraZeneca vaccine responses especially after only one dose but continues to provide 80-90% protection after two doses against symptomatic disease. A widespread of this variant in Sri Lanka could overburden an already overwhelmed medical system. Until vaccines can be rolled out to the majority of the population, adhering to strict COVID19 protocols by businesses and individuals is our only avenue for protection. 

Want more details? Read on!

The Delta variant (B.1617.2) was first sequenced in India post its recent COVID wave of March 2021. The variant was classified as a variant of concern by the WHO alongside the Alpha variant (B.1.1.7) first discovered in Britain, the Beta variant (South Africa) and the Gamme variant (Brazil). Variants of concern are those that are considered highly transmissible, highly infectious and/or deadly.

So what do we know about this newest variant on the block?

Image source: Dr. Eric Topol

How transmissible is it?

WHO’s Dr Mike Ryan described the Delta variant as “faster, fitter and will pick off the more vulnerable more efficiently than the previous variants”. The variant is the fastest spreading one in the UK and has prompted medical professionals to estimate that it is around 60-70% more transmissible than the Alpha variant. 

Tracked data shows that COVID cases have grown 75% week over week in May in the UK (mostly amongst young people and the unvaccinated). 

Why is more transmissible more dangerous?

To quote Zeynep Tufecki on a New York Times op-ed:

“Increased transmissibility is an exponential threat. If a virus that could previously infect three people on average can now infect four, it looks like a small increase. Yet if you start with just two infected people in both scenarios, just 10 iterations later, the former will have caused about 40,000 cases while the latter will be more than 524,000, a nearly 13-fold difference.”

What are its symptoms?

Even in the early throes of the Indian third wave, reports of different COVID19 symptoms began to circulate amongst social media. 

Updated COVID19 symptoms as per the CDC now include:

  • Fatigue
  • Muscle or body aches
  • Headache
  • Sore throat
  • Congestion or runny nose
  • Diarrhoea
  • Nausea and vomiting

How does it affect hospitalisations and the death rate?

A Public Health Scotland study found that the risk of hospital admissions was almost doubled with Delta vs. Alpha. 

Amongst those vaccinated with Pfizer or AstraZeneca, the Public Health England study reported that those with one dose of vaccine were 75% less likely to be hospitalised and those with both doses are 94% less likely to be hospitalised when compared to the unvaccinated population.

How does it respond to vaccines? 

A report published by Public Health England indicated that the variant is moderately resistant to vaccines, especially just the first dose. A single dose of AZ or Pfizer reduced a person’s risk of developing symptomatic illness by 30% (vs. 50% for the Alpha variant). A second dose of AZ increased protection to 60% (compared to 66% for Alpha). Two doses of Pfizer were 88% protective against the variant (compared to 93% against Alpha). 

No studies are available about the Sputnik or Sinopharm response to the new variant.

How can we stay safe?

Whilst richer countries look to rapid deployment of vaccines to counteract the rising Delta cases, Sri Lanka – with limited access to vaccines – must rely on the tried and tested COVID19 safety precautions:

  • Limiting physical gatherings (especially, AC & indoors)
  • Masking indoors & outdoors (over nose & mouth, when around those that are not of the same household)
  • Washing hands with soap
  • Sanitising high touch surfaces

As the third wave has taken us to the brink of medical capacity, any spread of the Delta variant in Sri Lanka could have serious ramifications to public health, but also to the overburdened medical system.

We encourage all Sri Lankans to get vaccinated, to stay home and follow COVID19 protocols to the utmost of your abilities. 

If you are experiencing any COVID19 symptoms or would like to speak with a doctor about your general health, download the oDoc app here

If the uptick of cases and variants are causing your mental health to suffer, speak to a psychologist on the oDoc app safely from your home.

Sources

  1. Stowe, J. et al. Effectiveness of COVID-19 vaccines against hospital admission with the Delta (B.1.617.2) variant., Preprint at https://go.nature.com/3gnqwxr (2021)
  2. Sheik, Z et al. SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness., The Lancet: 397: 2461-262 (2021)
  3. WHO says delta is the fastest and fittest Covid variant and will ‘pick off’ most vulnerable, CNBC (2021)
  4. UK reports 6,238 daily Covid cases amid fears over Delta variant infectiousness, The Guardian (2021)
  5. Tufecki, Z., Covid’s Deadliest Phase May Be Here Soon, The New York Times (2021)
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Understanding the dynamics – breastfeeding, pregnancy and COVID vaccines

Understanding the dynamics - breastfeeding, pregnancy and COVID vaccines

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As Sri Lanka rolls out its vaccination program, the questions have shifted from “Which vaccine should I get?” to “Should pregnant and breastfeeding women get vaccinated?” 

The answer in short: Yes, everyone should get vaccinated when offered the chance.

For a more detailed answer on how the vaccine affects pregnant and lactating women, read more below.

Breastfeeding and vaccinations 🤱🏾

Women who have recently given birth or are still breastfeeding should get the vaccine. 

Initially, the clinical trials for the COVID-19 vaccines currently in use did not include women who were breastfeeding. So, there was no clinical data on the safety of vaccines in lactating women, effects of the vaccine in breastmilk production and the consequences on the baby. However, now according to the WHO and new research, lactating women can receive a COVID-19 vaccine.

Recent reports have shown that breastfeeding women who have received COVID-19 vaccines have antibodies that pass on to the baby via breast milk, helping in protecting the baby. 

 A study conducted in Israel with thePfizer-BioNTech vaccine, with 84 breastfeeding women, showed that IgA antibody (the first line of defence when exposed to an infection) secretion was present as early as 2 weeks after vaccination in the breast milk. This was followed by a spike in IgG antibody (important for remembering the virus to prevent future infections) 1 week after the second dose in the breast milk. This suggests a potential protective effect against infection in the infant as these antibodies are passed on to them via the milk. No mother or infant experienced any serious adverse event during the study period.

More data is needed to understand what protection these antibodies provide to the baby. Even though the studies on breastfeeding and vaccinations are not advanced, the present data shows no indication of harm to the mother or child.

Pregnancy and vaccinations 🤰🏾

As with many other vaccines, the effects of the COVID-19 vaccines on pregnant women have not been studied extensively yet. However, health professionals assess the risks of COVID19 vs. the COVID vaccine when deciding whether pregnant women should receive the vaccine. 

Pregnant women with any of the following conditions are at a higher risk of contracting severe COVID than women who are not pregnant: 

  • have underlying health conditions (for example diabetes, high blood pressure or asthma)
  • are overweight
  • are aged 35 years or over

Preliminary findings in a study conducted in the US on the effects of mRNA vaccine in pregnant women did not show obvious safety signals among pregnant women who received mRNA Covid-19 vaccines compared to the control group.

It must be noted that injection-site pain was reported more frequently among pregnant women than among non-pregnant women, whereas other side effects such as headache, chills, and fever were reported less frequently. However, a more detailed and longitudinal study is needed to understand the full impact of vaccination on pregnant women. 

We already know pregnant women are at a higher risk of getting severe COVID and also at a higher risk of delivering a baby prematurely. So in a country like Sri Lanka, where the transmission rate is high, the benefits of getting the vaccine far outweigh the risks. 

Fertility and vaccinations 🌸

Women who are planning to get pregnant in the near future can absolutely take the vaccine. There is no evidence of COVID vaccines affecting fertility or the chances of getting pregnant. So get your vaccine when it becomes available to you. 

If you want more detailed information on getting vaccinated you can speak to one of our on-demand GPs at any time via the oDoc app. If you or your loved ones are showing any COVID symptoms please consult a doctor via oDoc immediately or use the oDoc COVID symptom checker to understand what you should do next.

Sources

  1. Perl, S. H., Uzan-Yulzari, A., Klainer, H., Asiskovich, L., Youngster, M., Rinott, E., & Youngster, I. (2021). SARS-CoV-2–Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women.
  2. Vaccination Considerations for People Pregnant or Breastfeeding. (2021, June 16). Centers for Disease Control and Prevention. 
  3. Public Health Scotland. (2021, June 18). Pregnancy, breastfeeding and the coronavirus vaccine. The Coronavirus (COVID-19) Vaccine. 
  4. WHO. (2021, June 4). Episode #41 – Vaccines, pregnancy, menstruation, lactation and fertility. World Health Organisation.
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So, can we mix and match vaccines?

So, can we mix and match vaccines?

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As the first dose recipients of the AstraZeneca vaccine started to reach the 12-week mark in May, a lot of people were dismayed that they wouldn’t be able to receive the second jab in a timely manner. A lot of conversations began to revolve around “well, what happens to my immunity?” or “can’t we use another vaccine as a second dose?” and at the time, there weren’t much scientifically sound answers to ease people’s nerves. 

The dearth of the second jab of AstraZeneca vaccine for over 500,000 in Colombo was largely due to the Indian COVID surge shutting down Serum Institute exports in late March. As India hurried to absorb all its domestic production to stop a calamitous third wave, a large number of developing countries, including ours, were left without a way forward. 

In December, Russia & the UK began a study of the safety & efficacy of following up a first AstraZeneca dose with a Sputnik booster and in the UK & Spain, researchers started studying the effects of a follow-up Pfizer booster.

Short answer: The jury is still out on exact findings but some preliminary data is available: side effects were more pronounced in intensity (however not severe and no hospitalisations) and higher antibody levels were seen after a Pfizer booster. 

Want more details? Read on: 

What do we know about safety?

In a UK trial, of the ca. 460 people (median age of 50+ years) that received the AZ jab and then a Pfizer booster 28 days later saw greater intensity in post-second jab side effects than those that received a second AZ dose (“control group”). 

More people felt feverish, had chills, felt fatigued, had joint pain and muscle aches in the study group than in the control group. Most of these effects were felt in the first 48 hours after. Efficacy data has not yet been made available. 

Safety and efficacy data of a booster shot being administered after 84 days is expected in June.

What do we know about efficacy?

A study by the Carlos III Health Institute in Madrid enrolled 663 people who had received the AstraZeneca first dose to receive the Pfizer second dose after eight weeks. The control group did not receive any booster shots. 

The results showed a much stronger immune reaction producing a higher level of antibodies in the Pfizer group than they did with the first dose of AstraZeneca. No severe side effects were reported.

What about a Sputnik booster? 🇷🇺

In December 2020, the UK & Russia began to partner on a study to test safety and efficacy of mixing these two vaccines. On May 28th, Russia announced a hold on it’s mix and match trial with Sputnik as the national ethics committee awaited further data.

What about a Sinopharm booster? 🇨🇳

No data is available at the time of publication however Bahrain has allowed mixing with a second dose of SinoPharm. 

What are other countries doing?

Some countries have already begun allowing a second dose of mRNA to supplement the first dose of another brand. On 1st June, Canada’s National Advisory Committee of Immunization announced it would allow second doses of mRNA to be administered to those that received the first dose of another brand of vaccine. 

Bahrain, Finland, France and Norway had begun allowing second doses of mRNA to be administered to those with AstraZeneca first doses.

What about us in Sri Lanka? 🇱🇰 

The health authorities have not approved the mixing of vaccines in Sri Lanka at the time of publication. The government is attempting to procure the shortfall of AstraZeneca doses by any means possible and has signed an agreement with Pfizer for 900,000 doses for delivery in July. 

The recent crowdings and altercations at AstraZeneca vaccination drives serve to be more harmful than helpful when limiting the spread of COVID19. Until sufficient data is available and vaccines are approved & available for mixing, we believe it’s most prudent for those that received the first AZ dose to adhere to strict COVID19 protocols, limit travel as much as possible and avoid crowded gatherings. 

If you or a loved one have been diagnosed with COVID19 and are awaiting transfer to an intermediate care centre or government facility, oDoc Home Care is available for you. 

With oDoc Home Care, you receive daily calls from a medical doctor for symptom monitoring & medical advice, a wellness bundle including gloves & masks, a pulse oximeter and blood pressure monitors. Click here for more details. 

Sources

  1. Shaw, R., et al (2021) Heterologous prime-boost COVID-19 vaccination: initial reactogenicity data., The Lancet., 397:2043-2046. 
  2. Callaway, E (2021) Mix-and-match COVID vaccines trigger potent immune response, Nature Magazine
  3. Miller, A (2021) Canada recommends mixing and matching AstraZeneca, Pfizer and Moderna COVID-19 vaccines, CBC
  4. Explained: Which are the countries allowing you to mix Covid-19 vaccines?, Indian Express (2021)
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