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Took Ibuprofen for 2nd Vaccine

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Specializes in Critical Care. Has 6 years experience.

I had my second dose of the Pfizer vaccine 1/9.  I was terrified of the potential side effects.  One hour after administration, I took 600mg of Ibuprofen.  I continued a regimen of 600mg q6h for the next 36 hours.  Despite being bathed in ibuprofen, I still had symptoms of malaise, nausea, headache, chills, and body aches.

I am terrified that I ***ED up.  That I blunted my immune response.  My crazy, neurotic, busy, fearful brain is ruminating on this. Perseverating.  I called Pfizer to inquire.... they couldn't say one way or another.  I've interrogated the pharmacists at my hospital... asked physicians.... no one can really say with any certainty.  

I am scared that I ***ED up my only chance at being vaccinated by drowning myself in Advil.

has anyone else done what I've done?

Any thoughts? Help!

nursej22, MSN, RN

Specializes in med/surg,CV. Has 36 years experience.

I'm not sure how ibuprofen would interfere with this immune response. The vaccine introduces messenger RNA, that enters your body cells and triggers them to manufacture the protein spikes. These protein spikes then trigger antibody formation, which will attack the spikes on covid virus. 

Ibuprofen halts the production of prostaglandins which can trigger vasodilation and inhibit clotting. I don't see how this is going to interfere with spike protein synthesis or antibody formation. I recommend ibuprofen all the time time for kiddos after their routine immunizations. 

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

34 minutes ago, nursej22 said:

I'm not sure how ibuprofen would interfere with this immune response. The vaccine introduces messenger RNA, that enters your body cells and triggers them to manufacture the protein spikes. These protein spikes then trigger antibody formation, which will attack the spikes on covid virus. 

Ibuprofen halts the production of prostaglandins which can trigger vasodilation and inhibit clotting. I don't see how this is going to interfere with spike protein synthesis or antibody formation. I recommend ibuprofen all the time time for kiddos after their routine immunizations. 

As far as I know, there are no large RCTs to either prove or disprove this, but the concern is that prostaglandins modulate T-cell response (inhibiting prostaglandins inhibits T cell response).  The goal of the Covid vaccine is a robust T-cell immune response, which is some recommendations are to only use acetaminophen immediately following a vaccine.

ladycody, BSN, RN

Specializes in CWON. Has 9 years experience.

CDC recommends it (with provider caveat)

ToddTheMechanic, EMT-I

Specializes in Industrial Rescueman. Has 14 years experience.

15 hours ago, jlv613 said:

I had my second dose of the Pfizer vaccine 1/9.  I was terrified of the potential side effects.  One hour after administration, I took 600mg of Ibuprofen.  I continued a regimen of 600mg q6h for the next 36 hours.  Despite being bathed in ibuprofen, I still had symptoms of malaise, nausea, headache, chills, and body aches.

I am terrified that I ***ED up.  That I blunted my immune response.  My crazy, neurotic, busy, fearful brain is ruminating on this. Perseverating.  I called Pfizer to inquire.... they couldn't say one way or another.  I've interrogated the pharmacists at my hospital... asked physicians.... no one can really say with any certainty.  

I am scared that I ***ED up my only chance at being vaccinated by drowning myself in Advil.

has anyone else done what I've done?

Any thoughts?

Help!

 

It's Tylenol they've been warning about, and you very clearly (based on side effects) had a strong immune response. I wouldn't be that worried. 

macawake, MSN

Has 13 years experience.

1 hour ago, ToddTheMechanic said:

It's Tylenol they've been warning about, and you very clearly (based on side effects) had a strong immune response. I wouldn't be that worried. 

Who has been warning about Tylenol? Could you possibly post a link to the source? Thanks. 

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

7 hours ago, ladycody said:

CDC recommends it (with provider caveat)

Not to be nitpicky, but the CDC recommends you discuss it with your Physician first before taking ibuprofen, which is different than recommending people take it, it's more a recommendation that it's use after a vaccine should be used sparingly.

ladycody, BSN, RN

Specializes in CWON. Has 9 years experience.

"Not to be nitpicky"

Pretty sure I mentioned the provider caveat...so yeah nitpicky.  The provider contingency, however, doesn't indicate any concern about taking it related to post vaccine discomfort but is a cya for anyone taking those meds for ANY reason.  There have been cautions not to PREmedicate with otc to avoid muting effectiveness.

Edited by ladycody

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

37 minutes ago, ladycody said:

"Not to be nitpicky"

Pretty sure I mentioned the provider caveat...so yeah nitpicky.  The provider contingency, however, doesn't indicate any concern about taking it related to post vaccine discomfort but is a cya for anyone taking those meds for ANY reason.  There have been cautions not to PREmedicate with otc to avoid muting effectiveness.

As I said, admittedly nitpicky.  Just clarifying that the CDC doesn't recommend people take NSAIDS with immunizations, even though it's OTC they recommend talking to your Physician before taking it for vaccine symptoms.  The common wisdom is that if you've already had significant symptoms of an immune response then you can go ahead and take an NSAID, one of the main concerns is that people will take it just for a sore arm, which itself doesn't signify you've had a successful immune response.

ToddTheMechanic, EMT-I

Specializes in Industrial Rescueman. Has 14 years experience.

19 hours ago, macawake said:

Who has been warning about Tylenol? Could you possibly post a link to the source? Thanks. 

Under the "Can my medications effect the COVID-19 vaccine?" category — https://www.goodrx.com/blog/covid-19-vaccine-drug-interactions/

In my position, we're not supposed to be vaccinating those who've taken Tylenol within the past 6 hours. 

macawake, MSN

Has 13 years experience.

5 hours ago, ToddTheMechanic said:

Under the "Can my medications effect the COVID-19 vaccine?" category — https://www.goodrx.com/blog/covid-19-vaccine-drug-interactions/

In my position, we're not supposed to be vaccinating those who've taken Tylenol within the past 6 hours. 

Thanks for replying. I’m glad you clarified that your information concerns not to premedicate. The reason I asked you to clarify is that OP’s post is about taking OTC meds after the vaccine was given. If you warn people about taking one type of OTC pain med that could possibly steer them towards another OTC med, which is why I think it’s important to post a source whenever making claims of a medical nature. 

jlv613, RN

Specializes in Critical Care. Has 6 years experience.

On 1/15/2021 at 9:54 PM, nursej22 said:

I'm not sure how ibuprofen would interfere with this immune response. The vaccine introduces messenger RNA, that enters your body cells and triggers them to manufacture the protein spikes. These protein spikes then trigger antibody formation, which will attack the spikes on covid virus. 

Ibuprofen halts the production of prostaglandins which can trigger vasodilation and inhibit clotting. I don't see how this is going to interfere with spike protein synthesis or antibody formation. I recommend ibuprofen all the time time for kiddos after their routine immunizations. 

Thank you... in doing more research I feel better about it.. I absolutely appreciate your response.

On 1/15/2021 at 10:30 PM, MunoRN said:

As far as I know, there are no large RCTs to either prove or disprove this, but the concern is that prostaglandins modulate T-cell response (inhibiting prostaglandins inhibits T cell response).  The goal of the Covid vaccine is a robust T-cell immune response, which is some recommendations are to only use acetaminophen immediately following a vaccine.

this is what concerns me... that I could've blunted a more robust response with memory cells.  I couldn't really find much literature that supports the blunting or shows it doesn't blunt the effects.

jlv613, RN

Specializes in Critical Care. Has 6 years experience.

5 hours ago, macawake said:

Thanks for replying. I’m glad you clarified that your information concerns not to premedicate. The reason I asked you to clarify is that OP’s post is about taking OTC meds after the vaccine was given. If you warn people about taking one type of OTC pain med that could possibly steer them towards another OTC med, which is why I think it’s important to post a source whenever making claims of a medical nature. 

I did take it after, however, it was only one hour after vaccine administration... hardly feels like it is after since it was so close to when I got the shot.  It was last week that the CDC recommend not premedicating and using NSAIDs and Antipyretics sparingly.... which is why my head is spinning... I didn't know at the time I took all the ibuprofen!

macawake, MSN

Has 13 years experience.

18 minutes ago, jlv613 said:

I did take it after, however, it was only one hour after vaccine administration... hardly feels like it is after since it was so close to when I got the shot.  It was last week that the CDC recommend not premedicating and using NSAIDs and Antipyretics sparingly.... which is why my head is spinning... I didn't know at the time I took all the ibuprofen!

I’m pragmatic by nature. You can’t change the past, what’s done is done. Try to take some comfort from the fact that it sounds like you had a rather noticable immune response after getting the vaccine.

Best wishes! 

14 hours ago, ToddTheMechanic said:

Under the "Can my medications effect the COVID-19 vaccine?" category — https://www.goodrx.com/blog/covid-19-vaccine-drug-interactions/

In my position, we're not supposed to be vaccinating those who've taken Tylenol within the past 6 hours. 

From the GoodRx link (emphasis added):

Quote

The effect of medications on vaccines has been studied a great deal in children. In particular, researchers have looked into whether giving a child a fever-reducing medicine, like acetaminophen (Tylenol), right before they get their regular shots will make these shots less effective. For this particular situation, researchers found that the kids who’d taken acetaminophen before their shot had a lower immune reaction measured in their blood work than the kids who hadn’t. However, the vaccines still worked well enough to protect them in the real world. 

That ^ article links to a literature review worth perusing:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027726/

Quote

The answer to the question of whether antipyretic analgesics have a clinically significant impact on vaccine response has significant public health implications. Although generating a great deal of interest in the topic, the 2009 Prymula study did not answer the question because the acetaminophen-associated antibody blunting that was observed following vaccination still resulted in protective antibody levels. Additionally their follow up study showed a robust antibody response following booster vaccine doses. The studies included in our review reported no significant blunting of the immune response in papers published prior to the 2009 Prymula study, but since that report there have been several studies that have suggested immune blunting. One study showed lower response to a novel influenza strain following vaccination; however the difference was not statistically significant.26 Thus, at this time, there is no clear answer as to whether antipyretic analgesic administration blunts the immune response to a degree that could result in vaccine failure.

 

14 hours ago, ToddTheMechanic said:

In my position, we're not supposed to be vaccinating those who've taken Tylenol within the past 6 hours. 

Thank you for posting your source/link.

The policy you're working with seems like an abundance of caution to say the least, and frankly it begs the question of how it plays out with any individual patient's risk/benefit profile. I mean...it's no covid protection vs. the yet unconfirmed possibility that they may have a slightly blunted response but still come out protected, especially after the second shot.

Are these patients being rescheduled ASAP?

jb_mmmm, BSN, RN

Specializes in Rehabilitation. Has 2 years experience.

20 hours ago, JKL33 said:

From the GoodRx link (emphasis added):

That ^ article links to a literature review worth perusing:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027726/

 

Thank you for posting your source/link.

The policy you're working with seems like an abundance of caution to say the least, and frankly it begs the question of how it plays out with any individual patient's risk/benefit profile. I mean...it's no covid protection vs. the yet unconfirmed possibility that they may have a slightly blunted response but still come out protected, especially after the second shot.

Are these patients being rescheduled ASAP?

I took Tylenol x2 after receiving my first dose and am scheduled for my second dose in feb, did I f up?

PoodleBreath

Specializes in Hospice, LPN. Has 15 years experience.

That's a lot of Ibuprofen to take OTC for the symptoms you're describing. Hoping you have backed off on that or followed up with your provider about dosing. 

hopefulRN'17, ASN, BSN, RN

Has 3 years experience.

All of the providers in my area have pushed not taking anything and try letting your body fight it on its own.  So crazy to hear so many different instructions.  I do hope you are better