COVID-19 vaccination side effects: What's normal, what's worth getting checked out?

A sore arm. A foggy head. An occasional swollen lymph node.

As more and more Calgarians receive their COVID-19 shots, more and more people are comparing the after effects. What's normal? What's worth getting checked out? 

Calgary urgent care Dr. Raj Bhardwaj says he's seeing more people consulting doctors with concerns about their side effects.

"I think that's partly just because more people are getting the vaccines, which is great," Bhardwaj told the Calgary Eyeopener. "And then a small percentage of those folks are having side effects that they're worried about, and a smaller percentage of those people are coming to see us."

There has been a lot of activity on social media as people post about their sore arms and feeling tired and feverish — which Bhardwaj says are all common side effects.

Many people will have some kind of reaction at the injection site, Bhardwaj said, like tenderness, redness, itching and swelling, and possibly tingling.

Also very common, in order, are headaches, body rash or hives, nausea, tiredness, swollen lymph nodes and fever. 

"I've seen a few people now who have developed a really sore lymph node just above their collarbone on the side where they got their shot, just like, when you get sore lymph nodes after a throat infection, you get them in your neck, same kind of thing,"  Bhardwaj said.

"I saw another person who ended up with a neck muscle spasm after their shot. Not dangerous, but, you know, pretty painful and a little bit surprising."

Bhardwaj said he has seen others coming in with concerns about possible blood clots — a rare adverse reaction.

"So far, most of the time they're not. But they're concerned enough to come in and get checked out, which is, you know, perfectly acceptable and makes sense" 

Bhardwaj said people getting reactions to a vaccination can be generally placed in two groups. Those who are experiencing a reaction to the vaccine, and those who are experiencing a reaction to the needle; the latter tend to become faint or think they may pass out.

"Those are scary. But the nurses and pharmacists and family docs who are doing the vaccinations, they know how to deal with those reactions, although they would probably be happier if you warned them that you're not great with needles … that would probably make everybody's day a little bit easier," Bhardwaj said.

Serious reactions extremely rare

In terms of the most common side effects, each vaccine is slightly different. Health Canada is tracking all of the side effects here.  

As of April 16, 9,525,732 vaccine doses have been administered in Canada, with side effects reported by just 3,738 people.

Of those, 3,209 were considered non-serious (0.034 per cent of all doses administered) and 529 were considered serious (0.006 per cent of all doses administered), according to the Health Canada page, which is updated every Friday.

"That works out to about six serious side effects per 100,000 people getting a dose of vaccine," Bhardwaj said.

There is no one reason why there are so many different reactions when a person's immune system gets riled up by a vaccine.

"Your immune system is a fine-tuned machine that's been built through your entire life to protect you from your set of threats that you have experienced, and because of that, it's a little bit different than everybody else's," he said.

"So things like genetics and age and sex and hormone levels and stress levels and your previous viral or bacterial exposures all make a difference."

Mild reaction means it's working

One thing immunologists agree on is that some form of reaction means the vaccine is taking effect.

"When we hear about side effects, we actually think of them as effects because they're all signs that your immune system is being activated and reacting to the little spike proteins that your body is building as a result of being vaccinated," he said. 

"So when they got their shots, they were like, 'Oh, good, I'm having a sore arm, that's such a good sign.'"

Bhardwaj said it's OK to give yourself a break after getting the vaccine — some extra rest, Tylenol or a hot compress.

He said if your reaction to a COVID-19 vaccine seems out of step with previous experiences — for example, "signs of serious reactions like swelling of your face or difficulty breathing or lots of belly pain or chest pain" — it's worth talking to a health professional. 

"If you're not sure, you know, call the HealthLink, call your family doctor or call the pharmacist who gave you your shot … we would much rather see you, check you out and say, yes, this is nothing serious than miss something that was serious."

There is one more side effect that Bhardwaj hopes everyone gets to experience.

"The unofficial side effect of being vaccinated is feeling good, that you've done something to protect yourself and that you've done your part in controlling the pandemic," he said. "So don't forget to enjoy that side effect."

With files from the Calgary Eyeopener. 

• Listen to the full interview with Dr. Raj Bhardwaj on the Calgary Eyeopener here: