Covid vaccine: I’m an immune doctor and this is how I am prepping for my 1st and 2nd jab

With the Covid vaccination programme currently in full swing, there’s a lot of discussion around how vaccines work, so it’s only natural to have some questions about the process, from whether you can drink alcohol before the Covid vaccine, how long does the Covid vaccine take to work? What are the side effects?

Should I have the Covid vaccine if I have a cold or feeling unwell?

If you are feeling unwell then do not attend your appointment. There is no scientific reason not to get vaccinated while ill with an infection but you risk spreading your illness by attending your appointment and it’s best to have a vaccine when feeling fit and well.

Will I get a mild dose of Covid from the vaccine?

In the UK we have three approved vaccines. All have been shown to prevent death from Covid and significantly reduce severe disease, but they do this via different technologies. The Pfizer/BioNTech vaccine and the Moderna vaccine are both mRNA vaccines and the AstraZeneca/Oxford vaccine is a viral vector vaccine. None of them contains live virus, so cannot give you Covid-19.

The vaccine delivers the components of the virus known to induce the most effective immune response. Other vaccine approaches that are in use for different infections include using an inactivated ‘killed’ version of the germ or a ‘live’ but reduced form.

This is how it works. Vaccines contain a harmless form of the bacteria or virus that causes the disease you are being immunised against. Your immune system will recognise the harmless form without making you sick and it will produce a specific immune response to fight it off and maintain a memory of that specific germ. So, if a vaccinated person encounters that germ later, their immune system is already prepared to fight it off quickly and prevent an infection from developing.

Each vaccine will be recommended for use in defined groups of people, but it is normally very rare that a person is advised against being vaccinated. Always speak to your GP if you are concerned about whether you are able to receive a specific type of vaccine.

I’ve already had Covid. Do I still need the vaccine?

If you have already had an infection such as Covid you might be wondering if you still need to get the vaccine. For certain infectious germs, we can develop robust lifelong immune memory following infection (for example, chickenpox). But for others such as influenza, immunity wanes quite quickly and the virus tends to mutate to escape any immune protection we may have developed, so re-infection is common. While re-infection with Covid is reportedly rare, we do not yet know how long natural immunity lasts. Vaccination provides a more robust and controlled way of inducing protection against this novel virus.

I have long Covid, should I get the vaccine?

Long Covid is often used to describe the long-term effects of Covid-19, where some people have symptoms for weeks or months after the infection has been cleared. Those suffering from long Covid might be nervous about receiving the Covid vaccine which is highly understandable. Research is currently ongoing in this area but long Covid sufferers could benefit from vaccination to reduce their risk of further infection. We are even starting to hear case reports of people feeling much better after receiving the vaccination. The hypothesis is that those individuals were still experiencing symptoms of incomplete clearance of the virus, which was helped by vaccination.

How can I prepare myself for the Covid vaccine to get the best response?

Some scientifically-approved ways to have a good response to the vaccine include getting a good sleep the night before and being in a positive mood on vaccination day. Being a regular exerciser (and even moderate exercising on the day of the vaccine can improve your response) helps, as does being a non-smoker/drinker and having a healthy nutritional status (specifically avoiding deficiencies in vitamin A,  D  E and  zinc ).

We are even starting to hear cases of people feeling much better after receiving the vaccination

The good news is that these are all things well within our control to improve our vaccine response. Additionally, it’s thought that a healthy BMI may be important (I suspect that it’s not bodyweight per se but potentially the proportion of visceral ‘round the tummy’ fat to lean muscle mass.) We also know that a diverse  microbiome  can improve vaccine responses as can an absence of unwanted  inflammation . Finally, we know that higher levels of psychological stress can take their toll on your immune system leading it to give a poorer response to vaccination.

What should I drink before a vaccine?

Proper hydration helps mobilise your immune cells and help them move around your body to perform their functions. I love  green tea  in the mornings and then tend to switch to drinking water or  rooibos  tea throughout the day. I don’t think any special measures are needed here, just ensure you are not dehydrated, which could make you feel unwell.

Can I drink alcohol before or after the vaccine?

While there is no published evidence on the Covid vaccine and alcohol, there is some evidence that drinking alcohol, especially regular heavy drinking, could interfere with your body’s ability to build immunity in response to some vaccines or infections.

Some independent medical advisors are counselling that you don’t drink any alcohol for at least two days before and at least two weeks after your Covid vaccine to try to ensure your immune system is at its best to respond to the vaccine and protect you. It takes at least two weeks for your immune system to make a response. I will certainly avoid alcohol for this time frame. Plus, if you do experience any of the short-lived side effects from the vaccine in the 48 hours following the injection, the last thing you want is to also have a hangover to deal with on top.

Does stress affect the effectiveness of vaccine?

Trying to be as relaxed as possible and being in a positive mood on the day of your Covid vaccine is key. Scientific evidence has shown both feeling stress and low mood impact the function of the immune system and reduce vaccine responses.

For me, I will aim to get my vaccine on a day where I don’t have to immediately rush back to a full block of meetings and stressful work-related tasks. I’ll also aim to start the day with a positive morning routine: gentle exercises such as  Pilates  and a meditation followed by a  blood-sugar balancing breakfast  of eggs, kimchi, avocado and oatcakes. To lift my mood, I’ll try to take a walk whilst listening to a positive and upbeat  podcast  ahead of my appointment.

Can I exercise before or after the Covid vaccine?

I’ll definitely do some moderate exercise such as an online Pilates class or some functional training in the morning of the day I am scheduled to have my vaccine because studies show that this leads to heightened rates of vaccine efficacy, with increased antibody levels. I’d probably not do anything too intense such as  HIIT  or a long endurance session for a prolonged duration (over one and a half hours) on the day of the vaccination or two to three days afterwards as there would not be enough time for the body to recover.

What should I eat on the day of my vaccine?

I’ll be eating normally on the days before and after the vaccine. I generally eat a balanced and varied diet along the lines of an anti-inflammatory  Mediterranean style diet  which is known to support a healthy balanced immune system. We don’t actually have scientific data to suggest that a particular way to eat or specific foods before or after vaccination will affect the response. But if you have a fear of needles then perhaps aim to balance your blood sugar levels by eating a protein-rich meal beforehand.

What supplements should I take before the Covid vaccine?

I will be supplementing with  vitamin D  (I recommend  Healthspan Vitamin D3 , £3.95 for 60 tablets) consistently on the approach to the appointment; I take 10mg/day. This is aligned with the current Public Health England suggested dose. Higher doses may be needed if you are at risk of deficiency. If you are unsure, it’s best to talk to your doctor first. A multivitamin supplement can be a good idea to take regularly (both before and after vaccination) only if you are worried about your diet being less than complete or you are at risk of a vitamin or mineral deficiency.

How much sleep do I need before the Covid vaccine?

There is some evidence that morning vaccinations produce better responses than those given in the afternoon. When it comes to sleep we now have extensive scientific evidence to support the strong link between sleep and immunity. Several studies have found a relationship between sleep duration and vaccination response. For example, the flu has been shown to be more effective in people who had seven to nine hours of sleep for two nights before receiving their vaccine. The best way to get a good sleep is to have a consistent bedtime and wake time.

MORE GLOSS: The bedtime routines of good sleepers 

Sleep advice may be one of the best I can offer. It’s really the bedrock of good immune function. This is because your immune cells work on a circadian clock which means they are programmed to different jobs at different times of the day. In reality, we need to take any vaccine slot we can get when it becomes available to us. Aim for eight hours of sleep, work back from the time you need to get up and account for the time it will then take you to wind down before bed. Personally, I love to make my bedroom quiet, dark and cosy. I then do some gentle stretching and mobility before reading in bed. I also recommend taking it easy the next day to free up resources for your immune system to do its job!

Should I take anti-allergy medication or paracetamol before my vaccine?

I certainly wouldn’t advise specifically pre-medicating with antihistamines as has been suggested online (unless you are already taking them as prescribed by your doctor for another reason). Allergic reactions to vaccines are extremely rare (for example 21 allergic reactions have been noted following 1.2 million doses of the Pfizer vaccine), and happen within minutes of the injection and would require immediate medical intervention, they would not be blunted by over-the-counter antihistamines. Always discuss your concerns with your health care practitioner who would have your full medical history and can advise appropriately.

What to do after your Covid vaccine

Remember to keep your vaccine record card, schedule any follow-up appointments for boosters and continue to follow government guidance. This is important for several reasons: it takes around two weeks for your immune system to make a response and you need to wait until you have had all shots in the schedule for full protection.

Dr Jenna Macciochi is an immunologist and brand ambassador for supplement and well-being brand Healthspan. Based in Brighton, Jenna is a lecturer at Sussex University and a qualified fitness instructor. She is a mother of five-year-old twins and a keen home cook, creating recipes inspired by her farm-to-table Scottish roots and capturing her Italian heritage.