Aug 30, 202115 min read

Integrative Medicine: Common Covid Questions from Vaccine Safety to Prevention and Treatments

Updated: Sep 1, 2021

If you haven't had covid yet, you probably know someone who has. As an integrative medicine provider trained in family medicine, I frequently am asked about conventional as well as alternative options to prevent or treat covid.

I continually field questions on vaccine safety, allergies, effectiveness against delta, ingredients, side effects, boosters, fetal cells, current hospitalizations and cases, ivermectin, covid complications, long-haul covid, infections in vaccinated vs unvaccinated, prescription options, and more.

This article is an effort to answer these commonly asked questions and discusses our current situation, prevention and treatment of covid from a combined perspective of integrative medicine, functional medicine, public health, and conventional medicine.

In a separate article, I review plant-based medicine and supplements that may help in the prevention, treatment and recovery of infection, such as astragalus, Vit D, zinc and many others (not to be used instead of vaccination and masking). Check it out here: https://www.hearthsidemedicine.com/post/integrative-functional-medicine-covid-prevention-treatment

Information in these articles is obtained from Andrew Weil Center for Integrative Medicine, the Institute of Functional Medicine, Yale Medical Center, John Hopkins Medical Center, The Mayo Clinic, the CDC, Oregon Health Authority, Children's Hospital of Pennsylvania and many other reputable resources.

What's critical to know right now?

The highly contagious Delta variant is filling hospitals across Oregon & the US with record levels of COVID-19 patients. COVID-19 related ICU admissions have increased more than 500% in Oregon

Oregon Health Authority reported that 88% of 14,523 coronavirus cases in the week of Aug. 15-21 were among unvaccinated individuals. The 12% were breakthrough (occuring in vaccinated patients).

The Delta variant poses an unprecedented threat because it is more contagious and more severe.

Our local hospital is following disaster protocol and has a critical shortage of staffed beds, having to double-room some patients and turn away others.

The average person infected with the original coronavirus strain will infect 2.5 other people in an unmasked, unvaccinated group; in the same environment, Delta spreads from one person to 3.5 or 4 other people.

The crisis facing our hospitals stems from a crisis in our communities. COVID-19 is spreading uncontrollably, and the surge in cases is sending more people to the hospital, including younger people, who represent a growing percentage of hospitalized cases

The vast majority of COVID patients (about 97%) in our ICUs are intubated and unvaccinated or only partially vaccinated.

The Delta variant appears to make people sicker, so on average patients stay in the hospital longer, meaning once a bed is occupied, it will be a while before it is available again. Covid ICU patients also require more staff than most patients.

Overcrowded hospitals have consequences for the lives of every single one of us – young and old, vaccinated and unvaccinated: thousands of surgeries and procedures are postponed; patients who need to be hospitalized can't get a bed; patients wait so long in the ER waiting room, that up to 10% of them leaving before being seen. Overcrowded hospitals also mean overwhelmed, exhausted, stressed medical staff. Staff who are repeatedly exposed to more COVID-19 cases face greater risk of breakthrough infections; exhaustion leads to making errors.

None of us want to need an ICU bed, but we all expect them to be there if we, our kids, or other family members need one. Today those beds are much harder to come by

Staff illness and strain compound critical staffing shortages adversely affect all patients--the patient needing a transfusion, the patient needing a tumor removed before the cancer spreads, the patient needing a non-emergent surgery, the patients in the ER who can't get seen in a timely fashion....

If you don't have a true emergency (can't breath, horrible car accident, chest pain, severed a finger, broke your femur or hip), please use urgent care or your primary care. Most of us in primary care are skilled in minor fractures, putting on casts/splints, order xrays, CTs, MRIs, ordering bloodwork, testing you for covid, suturing lacerations, cleaning or draining wounds or abscesses, getting an EKG on your heart, etc.

Why are there variants & what does it mean for us?

Viruses constantly change through mutation, and new variants of a virus are expected to occur. Sometimes new variants emerge and disappear. Other times, new variants persist.

The more people who opt out of vaccination, the less we can suppress the virus, which gives the virus ample opportunity to mutate and become vaccine resistant--this is a major reason why we want to completely suppress the circulation of the virus in the community with masks and vaccines and social distancing

"If the U.S. does not get control over the community spread of the delta COVID variant, the nation will continue to see more variants that evade the protection of the vaccines," according to Dr. Anthony Fauci, the chief medical adviser to the White House

Vaccines are highly effective against severe illness, but the Delta variant causes more infections and spreads faster than earlier forms of the virus that causes COVID

I heard that vaccinated people are getting infected and spreading infection, contributing to the crisis. If that's true, why should I bother to get vaccinated?

Unvaccinated adults and children are highly vulnerable to catching the Delta variant, getting sick, and spreading it. Those who are vaccinated are also able to get infected and spread the virus (88% of infections) but this is occuring at a much lower rate (12% of infections). This is why it is so critical that everyone, regardless of vaccine status, practices social distancing, avoids crowds, and masks in indoor and outdoor public spaces.

Are the vaccines still effective against the Delta variant and other variants?

While research suggests that COVID-19 vaccines are slightly less effective against the Delta variants the vaccines still provide protection against severe COVID-19 that often leads to hospitalization. For example:

Pfizer-BioNTech COVID-19 vaccine is about 88% effective at preventing infection & 96% effective at preventing severe disease
Moderna COVID-19 vaccine is about 72% effective at preventing infection & One dose of the vaccine is 96% effective at preventing severe disease
The Janssen/Johnson & Johnson COVID-19 vaccine is 85% effective at preventing severe disease
Data from the state of New York showed vaccine effectiveness dropping overall from 91.7 to 79.8% against infection on average, although the vaccine continued to protect against hospitalization by about a 96% protection rate.

A COVID-19 vaccine might :

Prevent you from getting COVID-19 or from becoming seriously ill or dying of COVID-19
Prevent you from spreading the COVID-19 virus to others
Add to the number of people in the community who are protected from getting COVID-19
Prevent the COVID-19 virus from spreading and replicating, which allows it to mutate and become more resistant to vaccines
Stop new variants--if enough people get vaccinated and take precautions

What are "breakthrough infections?"

Infections in those who are vaccinated are called "breakthrough infections" and are more likely with COVID, especially if more than 6 months since last vaccine. Breakthrough infections can still spread covid. For this reason, we encourage everyone regardless of vaccination status , to continue wearing masks in public places, including crowded outdoor spaces. In Oregon, about 88% of our cases are in unvaccinated and 12% in vaccinated.

What else can I do to prevent covid or treat covid naturally?

I wrote an entire article on this topic! Please check it out, but first, read this article: https://www.hearthsidemedicine.com/post/integrative-functional-medicine-covid-prevention-treatment

Who CAN'T get vaccinated?

Primarily, those who have had severe reactions to previous vaccines or one of the other COVID vaccines.

People with autoimmune conditions may receive a COVID-19 vaccine. However, be aware that no data are currently available on the safety of COVID-19 vaccines for people with autoimmune conditions. Rheumatologists are advising most patients with autoimmune diseases to get vaccinated, but please discuss this with your personal rheumatologist or provider.

Those under 12 years of age. Those 12- to 18-years of age can get the Pfizer, but not the Moderna or J&J/Janssen vaccines.
If someone currently has symptoms of COVID-19 or is isolating per Centers for Disease Control and Prevention (CDC) protocols, they should wait until they recover.
If a person recently had COVID-19 and was treated with monoclonal antibodies or convalescent plasma, they should wait 90 days before getting vaccinated.
In most cases if someone is exposed to COVID-19, they should wait until the quarantine period is over. Exceptions to this are people living in group settings (e.g., nursing homes, correctional facilities, or homeless shelters).

If I already had COVID-19, do I still need to get vaccinated?

Currently, the CDC recommends that even those who have had COVID-19 get the COVID-19 vaccine; If someone with previous infection gets the vaccine, it will not harm them and will likely boost their immunity.

Vaccine Safety

About 1 in 5 people experience passing side-effects from the vaccines. But getting sick or hospitalized with the Delta variant lasts longer than the side effects, and the symptoms can be severe. Most medications given for covid are experimental.

Over the past nine months, nearly 200 million Americans and more than 2.5 million Oregonians have received at least one dose vaccine.

The vaccines have proven to be safe and effective for hundreds of millions of people. Like any vaccine, medication, or supplement, the more people involved, the more side effects/adverse reactions we will see, but the risks are very low, much much lower than your risk of being in a fatal car accident driving.

Think your immune system is healthy and strong enough to fight off the Delta variant? Your immune system, no matter how tough, can’t fight a pathogen it can’t recognize. The vaccines equip your immune system with the tools it needs to defeat Delta.

But don't vaccines have toxins and chemicals that could hurt my body?

These vaccines actually have quite simple ingredients that are commonly found in our body, foods, other medications, and even some creams. As someone who eats organic and avoids environmental toxic exposures like plastics and chemicals, I am very comfortable with the ingredients.

The main ingredient of the pfizer and moderna vaccine is genetic material called mRNA. Other ingredients include fats, acids, salts, and sugars.

For a great review of the ingredients, check this out:

https://www.uchealth.com/en/media-room/covid-19/a-comprehensive-list-of-all-covid-19-vaccine-ingredients

Does this vaccine use aborted fetuses?

No, the COVID-19 vaccines do not contain any aborted fetal cells. However, fetal cell lines – cells grown in a laboratory based on aborted fetal cells collected generations ago – were used in testing during research and development of these vaccines.

These cells were derived in the 1973 and 1985 from two elective abortions and have been used to create vaccines for diseases such as hepatitis A, rubella, and rabies.

Abortions from which fetal cells were obtained were elective and were not done for the purpose of vaccine development. Any vaccine that relies on these historic cell lines will not require nor solicit new abortions.

While fetal cell lines may be used to develop or manufacture COVID-19 vaccines, the vaccines themselves do not contain any aborted fetal cells.

Vaccine Side Effects

COVID-19 vaccines can cause mild side effects after the first or second dose, including:

Pain, redness or swelling where the shot was given
Fever
Fatigue
Headache
Muscle pain
Chills
Joint pain
Nausea and vomiting
Swollen lymph nodes

Most side effects happen within the first three days after vaccination and typically last only 1 to 2 days.

A small number of young men have experienced a temporary inflammation of the heart, called myocarditis, within 4 days of the second dose of the mRNA vaccine. Those affected can feel chest pain or shortness of breath and should seek medical care to ensure proper diagnosis. The condition most commonly goes away in a few days and does not appear to cause permanent damage to the heart, but it can be scary.

This condition is currently estimated to occur in about 1 of 50,000 males in their teens to 30s after receiving the second dose of the mRNA vaccine (Pfizer or Moderna)

The Johnson & Johnson vaccine can cause a very rare blood-clotting condition that also causes low platelet counts. The condition, named thrombosis with thrombocytopenia syndrome or TTS, occurs in 1 or 2 people per million who get the J&J vaccine.

Serious side effects of the Janssen/Johnson & Johnson COVID-19 vaccine can occur within three weeks of vaccination and require emergency care. Possible symptoms include:

Shortness of breath
Persistent stomach pain
Severe or persistent headaches or blurred vision
Chest pain
Leg swelling
Easy bruising or tiny red spots on the skin beyond the injection site

Mild to moderate headaches and muscle aches are common in the first three days after vaccination and don’t require emergency care.

Rarely, some people may develop Guillain-Barre syndrome after getting the Johnson & Johnson COVID-19 vaccine. Seek immediate medical care if you have weakness or tingling sensations, difficulty walking, difficulty with facial movements, double vision, and difficulty with bladder control.

Disease risks

Pneumonia (infection of the lungs)
Respiratory failure
Acute respiratory distress syndrome (ARDS)--lung failure
Sepsis (bloodstream infection) and septic shock
Multi-organ failure--Children and adults can develop a rare, yet severe, inflammatory disorder weeks after infection, called multi-inflammatory syndrome (MIS-C or MIS-A) that can be fatal
Long-term symptoms (“long COVID”) can last a year or longer
Disease can be fatal
Stroke

Vaccine risks

Fatigue
Headache
Muscle aches
Swelling of the lymph nodes under the arm in which the vaccine was given
Very rare: myocarditis (pfizer or moderna) mostly in young men (1 per 50,000 people)
Very rare: low platelets causing blood clots/ stroke following J&J/Janssen vaccination (1-2 per 1 million people), mostly in women age 20-50
Anaphylaxis (3-5 per 1 million people)

How does the coronavirus spread and when are folks most contagious?

We are still learning about the contagiousness of the delta variant, but from what what we know about the original covid virus, people tend to be most contagious 2 days before showing symptoms and about 3 days after starting symptoms, but some folks can still shed and spread the virus for weeks after being infected. Those with symptoms to tend to more contagious than those without symptoms (asymptomatic infected patients).

Coronavirus is spread through droplets released into the air when an infected person breathes, talks, laughs, sings, coughs or sneezes. Larger droplets may fall to the ground in a few seconds, but tiny infectious particles can linger in the air and accumulate in indoor places, especially where many people are gathered and there is poor ventilation. This is why mask-wearing, hand hygiene and physical distancing are essential to preventing COVID-19.

When is someone contagious and for how long?

Symptoms appear within two to 14 days of exposure to the virus. A person infected with the coronavirus is contagious to others for up to two days before symptoms appear, and they remain contagious to others for 10 to 20 days, depending upon their immune system and the severity of their illness. They can have no symptoms and still be contagious.

How can you avoid catching Covid?

Handwashing
Physical distancing (about the length of a car)
Masks —While they are most helpful in protecting others, they also can decrease the risk of infection for the person wearing them.
Vaccination — Humankind has never eliminated an infection solely through the use of public health measures, such as those described above, therefore, COVID-19 vaccines are important for stopping the spread of COVID-19.
Keeping your immune system strong using integrative medicine approaches (see end of article)

Covid-19 Infection Impact on the body

Common symptoms of COVID-19 include:

Fever
Dry cough
Fatigue

Other symptoms can include:

Loss of taste or smell
Nasal congestion
Conjunctivitis (“pink eye”)
Sore throat
Headache
Muscle or joint pain
Nausea or vomiting
Diarrhea
Loss of appetite
Rash or discoloration of fingers or toes

Symptoms/complications of severe disease can include:

Shortness of breath or difficulty breathing
Confusion
Chest pain
High fever
Blood clots
Strokes
Seizures
Pneumonia
Acute respiratory distress syndrome (lung failure)
Organ failure in several organs
Heart problems
Blood clots (stroke, pulmonary embolism)
Acute kidney injury
Liver injury
Additional viral and bacterial infections
Long-haul covid: long-term symptoms such as heart problems, dizziness, severe fatigue

Some groups of people, including those over 65 years of age, pregnant women, and individuals with high blood pressure, chronic heart and lung disorders, diabetes and obesity are at a greater risk of developing severe disease. However, all people, regardless of age or underlying conditions, can experience severe COVID-19 disease.

Most people who have coronavirus disease 2019 (COVID-19) recover completely within a few weeks and have just mild cold or flu-like symptoms. However, others may have very serious complications. We are seeing complications even in those who are "young and healthy" with no underlying medical problems.

Multisystem inflammatory syndrome (MIS-C or MIS-A)

Some children and adults experience a delayed onset of symptoms called multisystem inflammatory syndrome (MIS-C or MIS-A). This syndrome can occur in anyone who was infected with COVID-19, including people who had minimal or no symptoms during infection. The condition develops a few weeks after infection (up to 6 weeks) at a time when individuals no longer test positive . Symptoms may include fever, abdominal pain, vomiting, diarrhea, rash, pink eye, fatigue, neck pain, or headache.

Long-haul Covid

COVID-19 symptoms can sometimes persist for months. The virus can damage the lungs, heart and brain, which increases the risk of long-term health problems.

Even young, otherwise healthy people can feel unwell for weeks to months or even longer after infection. Common signs and symptoms that linger over time include:

Fatigue
Shortness of breath or difficulty breathing
Cough
Joint pain
Chest pain
Memory, concentration or sleep problems
Muscle pain or headache
Fast or pounding heartbeat
Loss of smell or taste
Depression or anxiety
Fever
Dizziness when you stand
Worsened symptoms after physical or mental activities

Covid can cause organ damage in some people, which may increase the risk of long-term health problems. Organs that may be affected by COVID-19 include:

Heart. Imaging tests taken months after recovery from COVID-19 have shown lasting damage to the heart muscle, even in people who experienced only mild COVID-19 symptoms. This may increase the risk of heart failure or other heart complications in the future.
Lungs. The type of pneumonia often associated with COVID-19 can cause long-standing damage to the tiny air sacs (alveoli) in the lungs. The resulting scar tissue can lead to long-term breathing problems.
Brain. Even in young people, COVID-19 can cause strokes, seizures and Guillain-Barre syndrome — a condition that causes temporary paralysis. COVID-19 may also increase the risk of developing Parkinson's disease and Alzheimer's disease.

Who is most at risk?

People who are older have a higher risk of serious illness from COVID-19, and the risk increases with age. People who have existing medical conditions also may have a higher risk of serious illness. Certain medical conditions that may increase the risk of serious illness from COVID-19 include:

Serious heart diseases, such as heart failure, coronary artery disease or cardiomyopathy
Cancer
Chronic obstructive pulmonary disease (COPD)
Type 1 or type 2 diabetes
Overweight, obesity or severe obesity
High blood pressure
Smoking
Chronic kidney disease
Sickle cell disease or thalassemia
Weakened immune system from solid organ transplants
Pregnancy
Asthma
Chronic lung diseases such as cystic fibrosis or pulmonary fibrosis
Liver disease
Dementia
Down syndrome
Weakened immune system from bone marrow transplant, HIV or some medications
Brain and nervous system conditions
Substance use disorders

Allergies

You might be having an allergic reaction to a COVID-19 vaccine if you experience these signs within four hours of getting vaccinated:

Hives
Swelling of the lips, eyes or tongue
Wheezing

Individuals with a known allergy to polysorbate should not get the COVID-19 vaccine made by Johnson & Johnson/Janssen.

If you had a severe reaction to the first vaccine, you should not get a second one.

People who have had an anaphylactic reaction (face swelling, difficulty breathing) to anything else (medications, foods, bees, etc.) are allowed to get the COVID-19 vaccine, but should remain at the site where the injection was given for 30 minutes, instead of the 15 minutes

In a study by the CDC, only 21 anaphylactic allergic reactions occurred 2 million vaccine recipients. Of these 21 people, 17 of 21 had previously identified allergies, but 4 of 21 had no previously identified allergies at all

Testing

In light of breakthrough infections and the delta variant, it is advised that everyone who has potential exposures or symptoms of covid get tested. Testing is most accurate after days 4-5 of post-exposure or symptoms. If testing is done sooner, rate of false negatives is higher. We offer both rapid and PCR testing via curbside visit. We don't allow patients who have been exposed or having symptoms enter our clinic. All care is provided outside in our tent or in your car.

For more information on testing accuracy, rapid vs PCR, etc, check out my infoblog: https://www.hearthsidemedicine.com/post/rapid-covid-tests-we-have-them-but-how-accurate

Boosters/Additional Doses

CDC recommends people who are moderately to severely immunocompromised should receive an additional dose after the initial 2 doses at least 28 days after a second dose
This additional dose is intended to improve immunocompromised people’s response to their initial vaccine series is not the same as a booster dose
This includes those who are on immunosuppressants, have had an organ or stem cell transplant or are undergoing cancer treatment.
Although CDC does not recommend additional doses or booster shots for any other population at this time, there is a plan to begin offering COVID-19 vaccine booster shots this fall and these must be given 8 months after last covid vaccine (pfizer or moderna)
People currently being treated with one of the following types of medications:
- High-dose corticosteroids (more than 20 mg prednisone or similar medications per day)
- Alkylating agents
- Antimetabolites
- Transplant-related immunosuppressive medications
- Cancer chemotherapeutic medications that are considered severely immunosuppressive (e.g., tumor-necrosis, or TNF, blockers)
- Biologic agents that suppress or modulate the immune response

People who should NOT get an additional dose of COVID-19 vaccine at this time:

Immune-compromised people who received the J&J/Janssen vaccine – Data are still being accumulated
People who do not have compromised immunity.
People without a spleen.
People who had cancer but are no longer being treated.
People with chronic conditions that do not involve the immune system or require treatment with high doses of corticosteroids. If you aren't sure, ask your provider

Prescription treatments

No prescription treatments have been approved for standard outpatient (non-hospitalized) patient use at this time, though studies are looking at inhaled steroids and anti-inflammatories.

Ivermectin is not approved at this time and lacks safety data to support its use. In the last few weeks, reports of numerous overdoses have been called in and the FDA and CDC strongly caution against its use.

Monoclonal Antibody Therapy

Monoclonal antibodies mimic the immune system’s ability to fight back against harmful antigens such as viruses. Whereas the body takes time to produce natural antibodies, monoclonal antibodies allow a sick person to fight the virus earlier, which may prevent them from getting sicker and needing to be hospitalized.

We can order this for our patients to receive at St Charles Hospital.

Monoclonal antibody therapy is for COVID-positive people at high risk for becoming severely ill because they are not fully vaccinated or not expected to mount an adequate immune response to full vaccination. The following conditions may be an indicator of eligibility:

Age 65 and older
Obesity or being overweight
Pregnancy
Chronic kidney disease
Diabetes
Immunosuppressive disease or immunosuppressive treatment
Cardiovascular disease or hypertension
Chronic lung diseases
Sickle cell disease
Neurodevelopmental disorders
Other medical conditions or factors (for example, race or ethnicity) that may also place individual patients at high risk for progression to severe COVID-19

A Word on Covid & Pregnancy

There has been a sharp increase in pregnant women being sent to the ICU or passing away from covid and having to deliver preterm babies they cannot meet as they are in quarantine from their babies.

Vaccines are particularly important for pregnant women, as they are at an increased risk for serious illness if they become infected with COVID-19. Pregnant women have altered immune systems, and that could make them more susceptible to COVID-19. Also, research shows that pregnant women with underlying comorbidities or medical health conditions are at higher risk of having worse outcomes if they are infected with COVID-19.

About the author

Havilah Brodhead is a board-certified family nurse practitioner and chief medical officer of Hearthside Medicine Family Care in Bend, Oregon, an integrative medical practice. She has a special interest in disease prevention. Havilah loves incorporating natural, plant-based medicine and alternative medicine into her conventional medicine training. She has studied integrative medicine as well as functional medicine. Havilah loves to mountain bike, practice yoga, write, and spend time with her husband and two young daughters exploring Oregon when she is working at Hearthside Medicine.

Havilah Brodhead, FNP and Marie Mency, FNP/Women's Health are accepting new patients of all ages and take most insurances and can see patients virtually or in person in Oregon and virtually in California.

www.hearthsidemedicine.com

Bend, Oregon

541-316-5693