6 Things Nurses Need To Know This Week: Nurse News Now

Nurses are the most trusted profession in the United States for the past 18 years, according to the Gallup Reports - so what we say matters. Patients, colleagues, and the general public are going to want to know our opinion on this and other vaccines. The nurse’s recommendation is going to be one of the strongest predictors as to whether an individual gets vaccinated or not. Let’s make sure what we say is rooted in science and facts, is compassionate and culturally competent, and with integrity. 

With so many advancements, updates, and changes surrounding COVID-19 and vaccines we decided to create a weekly forum to update nurses on the most recent changes so that you as frontline healthcare staff can be informed, feel more comfortable and confident when speaking about COVID-19, vaccines and other related matters to your patients. 

This week on Nurse News Now on Facebook we discuss the following COVID-19 and related matters:

Every Tuesday, I will lead a live discussion on Nurse News Now on Nurse.org’s Facebook page and will do our best to discuss, explain and clarify any stories around COVID-19 and vaccines as they come up. Join us! 

Here are some of the most urgent questions we’ve received from nurses this week. 

1. Why did a nurse faint shortly after receiving the COVID vaccine?

A Tennessee nurse fainted after she received the COVID-19 vaccine Thursday, but officials say that is not unexpected with vaccinations. In a video posted by WTVC, CHI Memorial nurse manager Tiffany Dover was being interviewed by members of the media after receiving her shot when she appeared to become lightheaded. When she recovered, Dover said the reaction is not uncommon for her. “I have a history of having an overactive vagal response, and so with that if I have pain from anything—hangnail or if I stub my toe — I can just pass out.”

Vasovagal syncope occurs when you faint because your body overreacts to certain triggers, such as the sight of blood or extreme emotional distress. It may also be called neurocardiogenic syncope. The vasovagal syncope trigger causes your heart rate and blood pressure to drop suddenly. This is believed to be the reason Dover fainted and that it was not associated with any components of the vaccine. 

2. Did a nurse attempt to administer the COVID vaccine with an empty syringe?

On December 14, 2020, five University Medical Center of El Paso nurses were the first people in their county to receive the COVID vaccine, but after watching the event on live television, reporters and viewers speculated as to whether one of the staff had received only a portion of or any vaccine at all. The nurse who administered the vaccine appeared to have inoculated the vaccine recipient with an empty syringe to administer the vaccine. This leaves one to wonder if the 10 rights of medication administration were followed or if any vaccine administration protocol was used.

According to the Institute of Medicine, a near miss is “an act of commission or omission that could have harmed the patient but did not cause harm as a result of chance, prevention, or mitigation. Recent studies of medical errors have estimated errors may account for as many as 251,000 deaths annually in the United States, making medical errors the third leading cause of death. 

The University Medical Center of El Paso in El Paso, Texas shared this press release two days after the incident. I reached out to them for further questioning on 12/22/2020 but have not received a response to date. 

3. What’s the difference between the Pfizer and Moderna vaccine?

Check out our complete article listing all the similarities and differences.

While vaccines from both manufacturers utilized mRNA technology and have similar reported effectiveness rates there are some differences between the two that nurses should know about. 

Pfizer vaccines require storage with special ultra-cold freezers (-94F degrees) that need to be topped up with dry ice every five days and have a minimum order of 975 vaccines. This large order quantity and storage requirement limits the number of locations where this particular vaccine can be stored and used. After thawing, a vial of the Pfizer vaccine must be used within five days. Unfortunately, doctors’ offices, small clinics, and neighborhood pharmacies do not have ultracold freezers and may not need as many vaccines at any one time. 

The Moderna vaccine is more practical to store and use. It can be stored at normal freezer temperatures of -4F, and is stable at fridge temperature for 30 days and at room temperature for 12 hours. The vaccine’s minimum order is 100 doses, a much more manageable number. This allows for smaller amounts of the vaccine to be stored and used in more remote locations and without the extensive storage requirements. 

Both vaccines require two doses however Pfizer vaccine recipients return for dose two at 21 days; and for Moderna, recipients return for dose two at 28 days. The vaccines are not interchangeable. Pfizer vaccines are approved for ages 16 and older. Moderna vaccines are approved for ages 18 and older. 

4. What you need to know about anaphylactic reactions and the COVID vaccine

To date, six people in the United States have experienced severe allergic reactions (anaphylaxis) after receiving the COVID-19 vaccine. As a result, officials at the National Institutes of Health are rushing to devise a study to find out why that is.

As nurses, it’s important to not only recognize the signs of severe reactions but to know that most severe reactions occur as quickly as a few minutes. Some milder reactions can be the delayed-type and occur within hours or days after exposure, although symptom onset can be delayed up to 2 to 3 weeks. These differ from the side effects that are expected. 

• Experts say anaphylaxis is rare, but those who’ve had serious reactions to vaccines or injectable medicines in the past should talk with their doctor before deciding to get the vaccine. And if they do they should be monitored for at least 30 minutes after getting the shot. Others are monitored for 15 minutes.
• For those administering vaccines, they are required to have certain medications and equipment available on-site to initially respond to reactions and then call 911 to get persons to a hospital for continued surveillance and treatment
• Those who are seriously allergic to any of the ingredients included in the shots should skip the vaccine, the CDC recommends.
• All vaccine administrators are required to report adverse or suspected adverse reactions using Vaccine Adverse Event Reporting System (VAERS), a national safety vaccine monitoring system run by the CDC & FDA that collects reports from healthcare professionals, vaccine manufacturers, and the public about adverse events that happen after vaccination.
• The general public is also encouraged to use “V-safe,” a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination. Through v-safe, you can quickly tell CDC if you have any side effects after getting the COVID-19 vaccine. Depending on your responses someone from the CDC may contact you. 

5. Who should not take the COVID vaccine right now?

• People with severe allergies to any component of the vaccine 
• Children under the age of 16
• People with active COVID-19 infections

6. Who should talk to their health provider and consider holding off on getting the COVID vaccine for now?

• People with severe allergies to any foods or medications
• Pregnant women
• Lactating women
• People who are severely immunocompromised
• People who have recently recovered from COVID-19
• People 16-18

Watch Nurse News Now Every Tuesday - LIVE

Turn in to watch Nurse News NOW with Nurse Alice every Tuesday at 6pm PST/ 9pm EST on @nurse_org Instagram and Facebook to learn more about COVID-19 and vaccine-related stories and developments, and for a live Q&A with Alice Benjamin, APRN, MSN, ACNS-BC, FNP-B.