CME INDIA Presentation by Admin.
We have seen complex interplay of heightened lockdown difficulties with social isolation, mental illness and mad rush to get one bottle of alcohol disrupting social distancing. Now COVASHIED vaccine is a reality from 16th January 2021. Great hope emerges post मकर संक्रांति 2021, when vaccination starts pan-India. Makaraa Sankrānti or Maghi, which is a festival day in the Hindu calendar, commemorated in the name of the deity Surya, the Sun god, signifies the first day of the Sun’s transit into the Makara, or the Capricorn constellation, which denotes the end of the month with winter solstice and marks the start of longer days. COVID vaccine might denote the end of a pandemic and the start of a new era. With such a historic moment, people do ask about alcohol intake and its effect on vaccination…
Dr K N Manohar, Bengaluru asks:
Many of our colleagues are getting vaccine this Sunday,17.01.2022!! They are asking – How long should we not drink alcohol after vaccination!? (Apologies for the natural concern 🙃!)
Dr H D Sharan, Sr. Cardiologist, Ranchi:
- From 3 days before the first dose to 3 days after the 2nd dose.
Dr Nikhil Pursnani, Ass. Prof Med., SN. Med. Col, Agra:
- As per memorandum Documented Abstinence for 28 days in case of Sputnik
Dr N K Singh, Admin:
- Vaccine efficacy is reliant on our immune system. We do not want it operating at half-capacity when you take vaccine. Alcohol can alter the make-up of the gut that helps stop viruses getting through. Binge drinking can deplete the ability of certain white cells to fight infections. (Binge drinking is defined as four or more drinks on one occasion for women and five or more for men.)
Dr Anil Motta, Sr. Consultant, Medicine, Max Hosp. Delhi:
- It’s still a subject of debate.
- Drinking alcohol shortly before or after getting vaccinated can impact its effectiveness.
- We are early in this vaccine process, it’s a bit of a theoretical risk.
- The effect of alcohol that in general, it can be an immunosuppressant.
- For the best response, say no to alcohol.
- It looks ,one drink, occasionally is not going to cause any problems with this vaccine.
Dr Keyur Acharya, Intensivist, UK:
- See Russian guidelines!!!😀😀
- Head of the Gamaleya National Center of Epidemiology and Microbiology in Moscow responsible for developing the Russian vaccine, noted that 300 grams of vodka, containing around 120 grams of alcohol, was shown to suppress the generation of antibodies. One glass of champagne though was fine.
- In Russia then health authorities instructed citizens not to drink for two weeks before and six weeks after getting the country’s Sputnick V vaccine.
- Alexander Gintsburg, later tweeted to clarify that he believed that recommendation was too extreme, and that recipients should not drink for three days before and three days after being vaccinated (regardless of vaccine type). “One glass of champagne won’t hurt anyone, not even your immune system.”
- Meanwhile, in the UK, a health expert recommended people limit their alcohol intake one day before and one day after vaccination.
Dr T R Hemkumar, Diabetologist, Bengaluru:
- So Champagne, one glass of champagne won’t hurt anyone, not even your immune system.
Dr Chandrabhushan Prasad:
What about smoking?
Dr Anil Motta Max Delhi:
Best time to QUIT! Cigarette smoke increases cell vulnerability to COVID-19… that’s all I understand.
Dr Prabhat Agarwal, Agra:
Sputnik vaccine sponsor suggest that smoking should be less than 10 cigarettes per day.
Dr Awadhesh K Singh, DM Endo., Kolkata:
Why Alcohol should have any interaction with IM Covid vaccine? It’s different issue of general warning ⚠️ to reduce or stop alcohol. I don’t see any scientific reason – neither has anyone studied it’s effect on attenuation of vaccine response!
CME INDIA Learning Points
- Alcohol has been found to suppress the immune system.
- Expert guidance on avoiding alcohol before and after the vaccine, and for how long, varies
- Health official for Russia, Anna Popova says: “People should not drink two weeks before their first vaccine injection and then should continue this for another six weeks after their jab to ensure that there has been a strong immune response.”
- William Moss, Executive Director of the International Vaccine Access Center at Johns Hopkins University says “There’s no evidence that, if you have one beer or a glass of wine a couple days after you get your vaccine, that’s going to interfere with your immune response or protection following the vaccine.”
- While one drink is unlikely to interfere with your immune response to the vaccine, a heavy drinking session before having the vaccine is not advisable.
- Some evidence exists that enjoying three drinks prior to having the vaccine can lower levels of lymphocytes by up to 50%. As per BBC documentary, Dr Ronx Ikharia collect blood samples from individuals before and after consumption of three glasses of Prosecco. Her analysis revealed that that quantity of alcohol was enough to reduce the number of white lymphocyte cells in the blood by half.
- A 2015 study published in the journal Alcohol found that a single bout of binge drinking increases inflammation in just a few hours and inhibits body’s ability to regulate its immune system and effectively fight off infection for up to days afterward
- For instance, Alcohol also puts more stress on the body, making it more difficult to recover from being under the weather, experts say. (Speaking of, here is the biggest sign you’re drinking too much alcohol, according to doctors.
- It is best as policy not to drink alcohol during vaccination period as a common sense wisdom but no appropriate evidence exists about the span of time you should avoid alcohol
- New debate has emerged over the potential effects that alcohol consumption may have on the effectiveness of vaccines.
- Pfizer, which developed the vaccine being rolled out in the UK in collaboration with German outfit BioNTech, has issued no advisory about the effect of alcohol consumption on vaccine efficacy, and neither have UK regulators.
- Interestingly, Rhode Island Health Department says that a story out of Russia warning people not to drink alcohol for two months when getting vaccinated against the coronavirus is not true.
CME INDIA Tail Piece
1. A study titled “The effect of smoking and alcohol consumption on markers of systemic inflammation, immunoglobulin levels and immune response following pneumococcal vaccination in patients with arthritis” concluded:
Smoking predicted impaired immune response to pneumococcal conjugate vaccine in RA patients on MTX. Smokers with arthritis had higher inflammatory markers and lower IgG regardless of diagnosis and treatment. Low to moderate alcohol consumption was related to lower levels of inflammation markers but had no impact on immune response.
(Roseman, C., Truedsson, L. & Kapetanovic, M.C. The effect of smoking and alcohol consumption on markers of systemic inflammation, immunoglobulin levels and immune response following pneumococcal vaccination in patients with arthritis. Arthritis Res Ther 14, R170 (2012). https://doi.org/10.1186/ar3923)
2. What Alcohol can do:
- Alcohol gets absorbed via the bronchial circulation directly across the ciliated epithelium of the conducting airways.
- Vaporization during exhalation is followed by condensation as the air cools the vapours in the trachea eventually leading to a higher concentration of alcohol, which modifies airway-epithelium host defenses by altering cytokine release, barrier function, and ciliary function .
- Alcohol also causes oxidative stress and alterations in alveolar macrophage functions .
- This alteration in pulmonary defense could enhance the risk of acquiring SARS-Cov-2 infections. Moreover, ARDS is more likely in patients who have an injury to the lung by pathogens including viruses.
(Vasudeva A, Patel TK. Alcohol consumption: An important epidemiological factor in COVID-19?. J Glob Health. 2020;10(2):020335. doi:10.7189/jogh.10.020335)
3. This virus may stay with us for a long time if not forever and changing drinking habits may go a long way in both reducing the spread of infection as well as reducing the chances of persons developing a serious illness.
4. About COVISHIELD:
Stored in a refrigerator (+2ºC to +8ºC)
Do not shake the vial. Each vaccine dose of 0.5 ml is withdrawn into a syringe for injection to be administered intramuscularly.
Source: The COVISHIELD (read Oxford Vaccine) from Serum Institute India has given the fact sheets fully and transparently. https://www.seruminstitute.com/product_covishield.php
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Someone may ask, whether there is a RCT done,properly. Others say don’t worry, take Champaign!!! Alcohol, Smoking, Substance abuse causes a lowering of immune system, hence, preferably avoid them, before and after Vaccinations, time, duration, still debated ???
Sharing my personal experience – took 30 ml of whisky about 36 hours after getting the shot of COVISHIELD. Had no problem at all.