Can I have a COVID-19 vaccination before a CT scan?

It is important to advise your oncologist or radiographer if you have received the COVID-19 vaccine recently. This is because the vaccine can cause the lymph nodes in your armpit and neck to swell which can be detected by CT scans used to diagnose and monitor cancers.

This is particularly detected by FDG PET/CT scans, in which you are given a contrast medium containing a type of radioactive sugar that is taken up by active cells. When an immune response to a vaccine takes place, the cells in the lymph nodes near the injection site become very active and take up a lot of this sugar. Depending on the type of cancer, you may be able to request the injection on the opposite side to your tumour. If possible, have the vaccination at least 2 weeks before a scheduled scan or as soon as you can afterwards. Do not delay any treatment.

COVID-19 vaccine may cause swelling of local lymph nodes. Does this affect mammogram results?

When you attend a mammogram, it is recommended that you mention to your doctor or radiographer that you have had a COVID-19 vaccination recently.

This is because occasionally the vaccine can cause swelling of the lymph nodes in the arm pit near to the injection-site. This usually settles after a few days after vaccination but may be detectable on a mammogram for up to a few weeks. In this case, it is advised to monitor such lymph node changes for at least 6 weeks after vaccination. You do not need to delay your vaccination or your mammogram.

Click this link for further information from BreastScreen Aotearoa.

Will ACC provide cover for COVID-19 vaccination injuries?

ACC can provide treatment and support for injuries caused by COVID-19 vaccination if the criteria for treatment injury are met. This means there’s a physical injury caused by the vaccination, that’s not a necessary part or ordinary consequence of the treatment.

For example, inflammation around the site of the injection is common with COVID-19 vaccination (an ordinary consequence) and is unlikely to be covered. Infections (such as cellulitis or septic arthritis) due to the vaccination, and anaphylaxis resulting in injury, are not ordinary consequences and are likely to be covered. 
 
To make a treatment injury claim for a patient please complete an ACC2152 treatment injury claim form as well as an electronic or manual ACC45 injury claim form.
 
To help with reporting, ACC needs to know the COVID-19 vaccine brand name and vaccination dose number (i.e. dose one or two). This can be noted: 

  • on the ACC45: please tick the treatment injury box, identify this as an adverse event in the drop-down menu and then enter the COVID-19 vaccine brand name and vaccination dose number in the open comments section
  • on the ACC2152: in Section 3 - Treatment claimed to have caused the injury.

 
More information about lodging a treatment injury claim is available on the ACC website and in the treatment injury claim lodgement guide.
 
To find out more please contact ACC on 0800 222 070 or email [email protected]
 

Can mRNA COVID-19 vaccine affect fertility or affect future babies?

There is no biologically plausible reason why this vaccine could have any effect on our genes or fertility.

Upon injection, the lipid nanoparticle containing the mRNA is taken up by specialised cells (dendritic cells) at the injection site in the arm. These cells use the instructions from the vaccine mRNA to make only the SARS-CoV-2 spike protein and the mRNA degrades rapidly. The mRNA from the vaccine does not enter the nucleus of any cells. Furthermore, no components of the vaccine or the spike protein produced reach the ovaries or the testes. More information about how this concern arose can be found here.

Will the vaccine make a person test positive on COVID-19 tests?

No. The vaccine makes a person produce antibodies against the virus spike protein but the nasal swab looks for particles of virus.

The spike protein that is made in your body in response vaccine does not travel far and does not reach your nose.

How long will COVID-19 vaccine immunity (i.e. protection from the COVID-19 disease) last?

We would expect COVID-19 vaccines to provide protection for longer than 2 months, although exactly how long for, remains unknown at this stage. This is because not enough time has passed since the clinical trials started to be able to accurately answer this.

We know that the Pfizer/BioNTech COVID-19 vaccine lasts for AT LEAST two months, because data supporting this has been reviewed by Medsafe. As part of the conditional approval of the Pfizer/BioNTech COVID-19 vaccine, more data is to be provided as it becomes available. It is anticipated that further data will be provided on durability of the immune response post vaccination in coming months.

If a person is vaccinated against COVID-19, will they still be able to spread the virus to susceptible people?

An ideal vaccine stops everyone from carrying and passing on the infection as well as protecting them from becoming seriously ill. It is currently unclear whether COVID-19 vaccines only protect against symptomatic and severe disease, or if they can also stop all infection, including asymptomatic infection (i.e. showing no symptoms).

If the vaccine is only able to stop the symptoms of the disease, but unable to stop the virus from infecting us and reproducing, then the virus may still be able to be spread. Even in this case, by reducing the number of people with symptoms will help to reduce spread of the virus because fewer people will be coughing large quantities of virus on others. However, this possible limitation of the vaccine highlights the importance of continuing to follow public health advice such as hand washing and isolating if unwell, even post vaccination. For more information, please click here.

Recently published data from Israel showed that its mass COVID-19 vaccination campaign (using the Pfizer vaccine) was working well with two doses cutting symptomatic cases by 94% across all age groups. Data reported by the CDC in the US has also shown that mRNA COVID-19 vaccines were 90% effective in health care workers against SARS-CoV-2 infection (with and without symptoms).

Will other COVID-19 prevention measures such as social distancing be needed if a COVID-19 vaccine is available?

As not all New Zealanders are be able to be vaccinated at once, the current public health measures, including social distancing, mask usage, rapid contact tracing and managing cluster outbreaks, will continue for some time.

With an effective vaccine programme, it is anticipated these control measures can be reduced. This will require a high proportion of the population (estimated to be at least 8 out of 10 people) being immunised.

Even when we have a high proportion of population vaccinated, we will still need to maintain a level of public health measures particularly when we can travel more freely. See this infographic to explain why.

What side effects may be expected after vaccination?

The most common responses to the COVID-19 vaccine are injection-site reactions (sore arm for example) and general symptoms such as ‘flu-like’ illness, headache, chills, tiredness, nausea, fever, dizziness, weakness or aching muscles.

Generally, these potential responses happen within a day or two after the vaccination and are not associated with more serious or lasting illness. These types of reactions reflect the normal immune response to this vaccine. Not everyone experiences this type of response. They are more likely after the second dose and tend to resolve within a day or two. Pain relief, such as paracetamol or ibuprofen, is not recommended to be taken before having the vaccine but can be used after it if required. 

In addition, as with any vaccine or medicine, there is a risk of allergic reactions shortly after the vaccinations. Because of this people should wait at a vaccination centre as instructed after having their vaccine. Those with previous allergic reactions or anaphylaxis should tell their vaccinator before going ahead.  

For more information about what to expect after the vaccination see the Ministry of Health's website. 

Monitoring for adverse reactions and side effects is being conducted in New Zealand and worldwide. Vaccine recipients and their health care providers are encouraged to report possible side effects to CARM (Centre for Adverse Reactions Monitoring). See here for the latest Adverse Events following Immunisation report from Medsafe on Comirnaty 
 

Will booster doses of a COVID-19 vaccine be needed?

Not enough time has passed since first vaccinations were given to be able to answer this question.

People enrolled in clinical trials are being followed up closely, which will allow this question to be answered in due course. For more information, please click here.

It is expected that small adjustments may be made to the vaccine if the COVID-19 virus changes so much that vaccine loses effectiveness. In this case booster doses will be required to better match the virus variants in circulation, like for the influenza vaccine. How frequently these changes will need to be made is unknown. A major advantage of mRNA vaccine technology is that these changes can be made very quickly (new batches available within a few months compared with more than 6 months for seasonal flu vaccines).