Study of COVID Vaccine Side Effects May Help Plan for Missed Work

Marcia Frellick

September 03, 2021

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Results from a survey of healthcare workers who received some of the first Pfizer and Moderna vaccines in 2020 may hold clues for how healthcare facilities and other organizations should plan for missed work time.

Julie M. Stausmire, MSN, RN, APRN, CNS, academic research coordinator at Mercy Health St. Vincent Medical Center, in Toledo, Ohio, told Medscape Medical News that the information in their study may be especially relevant in light of the predicted coming wave of booster vaccinations and of new mandates regarding the original COVID-19 vaccines.

Researchers at one of the first 10 sites in Ohio to distribute the COVID-19 vaccines in December 2020 surveyed frontline healthcare workers regarding their experiences with the effects of the vaccine. The participants worked in an urban tertiary care center and a rural regional hospital.

Results of the study were published online August 27 in the Journal of Healthcare Risk Management.

Participants were asked to complete the survey 1 week after they had received their first vaccine dose and 1 week after they had received their second dose. Completed surveys were returned via an online website. They had to have been received by March 1, 2021, to be included in the study.

Surveys were completed by 1656 healthcare workers. Of these, 1391 returned the survey after their first vaccine dose, and 850 returned it after their second dose. The response rate was 20.3%.

After the first dose of vaccine, 9.6% (134 of 1391) of the participants missed work or considered calling in sick for a work shift. After the second dose, 39.1% (332 of 850) of participants missed work or considered calling in sick. Of those who did miss work, the majority reported missing one work shift.

Many of those who responded to the survey said they didn't call in sick but that they felt sick and would have called in had circumstances been different.

"If people wrote in, 'I would have called in sick, but I had the day off,' we counted that as a missed shift," Stausmire said.

Participants were asked to assign a rating regarding the worst they felt during the week after receiving the vaccine. Overall, among the 1391 respondents who received the first dose, 5.5% had "major" symptoms (defined as difficulty completing routine tasks) or "worst" symptoms (unable to engage in daily activities, sleeping more than normal). With the second dose, overall, 29.8% (253 of 850) had major or worst symptoms.

The most common side effects after the second dose were injection site pain (92.1% reported that it lasted more than 2 hours); fatigue (66.4%); body or muscle aches (64.6%); headache (60.8%); chills (58.5%); joint or bone pain (35.9%); and a temperature of 100° F or higher (29.9%).

Side effect rates were substantially higher after the second dose.

"Notably, the rate of chills increased by 43.0% (from 15.5% after the first dose to 58.5% after the second), body aches increased by 42.1%; fatigue 40.5% and headache by 31.8%," the authors write.

The authors point out that a limitation of the study is that the survey did not ask about the length of shifts, so the researchers couldn't distinguish whether the missed shifts were 4-, 8-, 12-, or 24-hour shifts. They note that community first responders, such as firefighters, commonly work longer shifts.

Implications for Boosters

Co-author James Tita, DO, with the Department of Pulmonary and Critical Care Medicine, Mercy Health St. Vincent Medical Center, told Medscape Medical News, "I hope this prompts a discussion of trying to be a little more deliberate and proactive in term of scheduling the vaccines."

Paul Goepfert, MD, director for the Alabama Vaccine Research Clinic at the University of Alabama Birmingham (UAB), told Medscape Medical News that many healthcare organizations, including UAB, from the beginning adjusted their work schedules to accommodate aftereffects of the vaccine. The vaccines are now required at UAB.

"We knew the side effects could be significant ― 75% of people have some sort of side effects," he said.

The results of the Stausmire study, Goepfert said, emphasize the need for spacing out healthcare worker vaccinations and not vaccinating entire departments or locations at the same time. That may be particularly important for smaller healthcare systems.

He said it is reasonable to expect side effects of booster shots to be similar to the aftereffects of the second mRNA shots, but that is not yet well studied.

"If you were to boost with the [Johnson & Johnson] vaccine, you wouldn't have this problem," Goepfert said. "That vaccine is much better tolerated than [the Pfizer or Moderna vaccines]."

He notes that those in the study who did miss work missed one shift.

Goepfert cautions that workforce complications will be much worse if healthcare workers don't get vaccinated and become infected with the Delta variant.

"You certainly will miss more than 1 or 2 days of work," he said.

The average age of the participants' in the Stautmire et al study was 49.3 years; 72.5% were women; and 92.4% were White. Moderna's vaccine was administered to 81.9%, and 18.1% received Pfizer's vaccine.

The authors note that the American Rescue Plan Act stipulates that a paid-leave tax credit be provided to offset costs for employers with fewer than 500 workers to provide full pay for any time needed to receive or recover from COVID vaccinations.

The authors write, "This could have a huge impact on smaller long-term care facilities, assisted living, and group homes who may not have encouraged employee vaccinations."

The study authors have disclosed no relevant financial relationships. Goepfert has consulted on one occasion in 2021 for Johnson & Johnson. Goepfert's institution receives clinical grant support from Sanofi.

J Health Risk Manag. Published online August 27, 2021. Full text

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune and and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick.

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